{"reporting_entity_name": "GIIC_TPA","reporting_entity_type": "GIIC_Geisinger Indemnity Insurance Company","last_updated_on": "2026-10-07","version": "2.0","provider_references": [ {"provider_group_id":2025504211,"network_name":[],"provider_groups":[{"npi":[1942281266],"tin":{"type":"ein","value":"520607949","business_name":"Meritus Medical Center Inc"}}]} ], "in_network" : [ {"negotiation_arrangement":"ffs","name":"ICD-NEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME0","description":"ICD-NEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF0","description":"ICD-IALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB1","description":"ICD-FABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD1","description":"ICD-OGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1088T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1088T","description":"CPT-1088T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD1","description":"ICD-OJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21120","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED1","description":"ICD-ICED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quant results activity &symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3115F","description":"Quant results activity &symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA0","description":"ICD-MICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physician standby services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99360","description":"Physician standby services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB0","description":"ICD-KAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF0","description":"ICD-KEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE112","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0023U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem duplication_ p.D835_ p.I836_ using mononuclear cells_ reported as detection or non-detection of FLT3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC0","description":"ICD-JBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC0","description":"ICD-JIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC0","description":"ICD-OIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD1","description":"ICD-OILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD1","description":"ICD-BCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED0","description":"ICD-KHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC1","description":"ICD-NHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF1","description":"ICD-MIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19499","description":"Breast surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj/inhib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86977","description":"Rbc serum pretx incubj/inhib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syringe w/needle insulin 3cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4232","description":"Syringe w/needle insulin 3cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC0","description":"ICD-MEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7568","description":"HCPCS-C7568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA1","description":"ICD-BECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWC1","description":"ICD-LCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD1","description":"ICD-IBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit sympathomim diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9348","description":"Hit sympathomim diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66985","description":"Insert lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC0","description":"ICD-NATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD1","description":"ICD-NCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC0","description":"ICD-JADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Nusinersen 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9489","description":"Injection Nusinersen 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB1","description":"ICD-JICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE0","description":"ICD-IGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC0","description":"ICD-OFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD0","description":"ICD-MBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX55","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC1","description":"ICD-GGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB0","description":"ICD-NJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Na ferric gluconate complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2916","description":"Na ferric gluconate complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB0","description":"ICD-JBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC1","description":"ICD-OKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB101","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB0","description":"ICD-OHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE1","description":"ICD-IBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX60","description":"Low Rehab plus Extensive _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA1","description":"ICD-FEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC1","description":"ICD-OBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD1","description":"ICD-CDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA1","description":"ICD-CDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12014","description":"Rpr f/e/e/n/l/m 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35471","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70551","description":"MRI brain stem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQC0","description":"ICD-OAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak pelvic control belt pad/l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5694","description":"Ak pelvic control belt pad/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27615","description":"Resect leg/ankle tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE0","description":"ICD-BBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA0","description":"ICD-FFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjv thxpyrxd/rcvd colon ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4180F","description":"Adjv thxpyrxd/rcvd colon ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE0","description":"ICD-LHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31580","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF0","description":"ICD-CFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1088","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB0","description":"ICD-JHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic pre one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0490","description":"Tlso rigid plastic pre one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA1","description":"ICD-OGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD0","description":"ICD-EEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB1","description":"ICD-OHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD1","description":"ICD-JBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37565","description":"Ligation of neck vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVB0","description":"ICD-CCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC0","description":"ICD-OHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE0","description":"ICD-GFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9489","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD1","description":"ICD-FIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8720","description":"Total kt/v less than 1. 7 per week (total clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects >10.0 cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11954","description":"Tx contour defects >10.0 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","description":"CPT-00630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73201","description":"Ct upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA1","description":"ICD-KIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gi wireless capsule measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91112","description":"Gi wireless capsule measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA0","description":"ICD-GHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF1","description":"ICD-KEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC0","description":"ICD-KCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tacrol envarsus ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7503","description":"Tacrol envarsus ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD0","description":"ICD-KDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21465","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7288","description":"Brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB11","description":"ICD-4GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76883","description":"Ultrasound_ nerve(s) and accompanying structures throughout their entire anatomic course in one extremity_ comprehensive_ including real-time cine imaging with image documenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aoe intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9465","description":"Aoe intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ggt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82977","description":"Assay of ggt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8659","description":"Fun stat score ls >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD0","description":"ICD-EGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6014","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD1","description":"ICD-LESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport mini-bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0120","description":"Noner transport mini-bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF0","description":"ICD-HBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remov vertbr dcmprn thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63087","description":"Remov vertbr dcmprn thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB54","description":"Medium Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA1","description":"ICD-CHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD144","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC0","description":"ICD-KEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95919","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC1","description":"ICD-CDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA0","description":"ICD-FGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted ambulance service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0999","description":"Unlisted ambulance service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7208","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated-aucl_ (Jivi)_ 1U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"XCellerate_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4234","description":"XCellerate_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC31","description":"Very High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE1","description":"ICD-CILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF0","description":"ICD-GCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX22","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93315","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic cont infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64463","description":"Pvb thoracic cont infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC1","description":"ICD-OJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rickettsia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86757","description":"Rickettsia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC1","description":"ICD-CBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43286","description":"Esophagectomy_ total or near total_ with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (fiasp)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1812","description":"Insulin (fiasp)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB1","description":"ICD-KHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC06","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31267","description":"Endoscopy maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44366","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tray w/o bag/cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4310","description":"Insert tray w/o bag/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy abdominal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49180","description":"Biopsy abdominal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF1","description":"ICD-OKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","description":"CPT-01270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED0","description":"ICD-CDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2B","description":"High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME0","description":"ICD-NGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duodenal exclusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48547","description":"Duodenal exclusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Truss addition to std pad wa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8320","description":"Truss addition to std pad wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct metacarpal flaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26565","description":"Correct metacarpal flaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1012","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incobotulinumtoxin a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0588","description":"Incobotulinumtoxin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC1","description":"ICD-NFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1455","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","description":"HCPCS-M1455","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-99445","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","description":"CPT-99445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND1","description":"ICD-KCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt max lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5750","description":"Denture reln cmplt max lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cleft palate repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17251","description":"Anesth cleft palate repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49441","description":"Place duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct toric prism ballast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2511","description":"Cntct toric prism ballast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63650","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36513","description":"Apheresis platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF1","description":"ICD-CCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46762","description":"Sphincteroplasty_ anal_ for incontinence_ adult; implantation artificial sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lang express goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9163","description":"Lang express goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF1","description":"ICD-GDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Position back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2614","description":"Position back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB0","description":"ICD-FGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31603","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA0","description":"ICD-KAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1015","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC1","description":"ICD-CIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp spenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35636","description":"Art byp spenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70559","description":"MRI brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA1","description":"ICD-CCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB0","description":"ICD-KGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE1","description":"ICD-MIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC0","description":"ICD-GATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy nail unit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11755","description":"Biopsy nail unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB1","description":"ICD-KDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053U","description":"Oncology (prostate cancer)_ FISH analysis of 4 genes (ASAP1_ HDAC9_ CHD1 and PTEN)_ needle biopsy specimen_ algorithm reported as probability of higher tumor grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA0","description":"ICD-JAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD0","description":"ICD-KGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise nerve back of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64744","description":"Incise nerve back of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23570","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB1","description":"ICD-JCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyst eval not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9608","description":"Intraop cyst eval not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB1","description":"ICD-CBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC1","description":"ICD-GEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA1","description":"ICD-MBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA1","description":"ICD-OCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF1","description":"ICD-MHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA1","description":"ICD-KEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3915","description":"Who nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB0","description":"ICD-NHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF1","description":"ICD-BBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB1","description":"ICD-OCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9081","description":"Idecabtagene vicleucel_ up to 460 million autologous anti-BCMA CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA1","description":"ICD-NITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dextranomer/hyaluronic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8604","description":"Dextranomer/hyaluronic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC1","description":"ICD-ACDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE1","description":"ICD-OHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB1","description":"ICD-OAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE1","description":"ICD-KCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC0","description":"ICD-PDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB0","description":"ICD-EBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6515","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","description":"HCPCS-A6515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF1","description":"ICD-OFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewho cap design w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3971","description":"Sewho cap design w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC0","description":"ICD-CGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3702","description":"Eo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD0","description":"ICD-CAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB1","description":"ICD-CIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF1","description":"ICD-HAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2955","description":"Post removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC60","description":"High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40844","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","description":"HCPCS-J9289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97763","description":"Orthotic(s)/prosthetic(s) management and/or training_ upper extremity(ies)_ lower extremity(ies)_ and/or trunk_ subsequent orthotic(s)/prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF1","description":"ICD-KGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYA0","description":"ICD-OKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp femoral-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35656","description":"Art byp femoral-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND1","description":"ICD-CIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65772","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23472","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spinal fluid tap diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62270","description":"Spinal fluid tap diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD0","description":"ICD-CCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01230","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","description":"CPT-01230","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19081","description":"Bx breast 1st lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0939T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","description":"CPT-0939T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC0","description":"ICD-MJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE0","description":"ICD-JFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB0","description":"ICD-CDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA31","description":"ICD-2FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag rig pnl stays pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0626","description":"Lo sag rig pnl stays pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0B","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD0","description":"ICD-GIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA0","description":"ICD-HEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC1","description":"ICD-DDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esketamine_ nasal spray_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0013","description":"Esketamine_ nasal spray_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9767","description":"Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC0","description":"ICD-OETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1834","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","description":"HCPCS-J1834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36483","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE0","description":"ICD-PFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodic orthodontc tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8670","description":"Periodic orthodontc tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAF0","description":"ICD-MGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC1","description":"ICD-GFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD0","description":"ICD-DCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA1","description":"ICD-ICIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avelumab_ 10mg (bavencio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9491","description":"Injection_ avelumab_ 10mg (bavencio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PrecisionBloodâ„¢_ San Diego Blood Bank","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0246U","description":"PrecisionBloodâ„¢_ San Diego Blood Bank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF1","description":"ICD-HIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27470","description":"Repair of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smear gram stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87205","description":"Smear gram stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD1","description":"ICD-EIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27435","description":"Incision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95974","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Modification of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92325","description":"Modification of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLB1","description":"ICD-IBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA0","description":"ICD-FDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1214","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD0","description":"ICD-MILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20206","description":"Needle biopsy muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX11","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA0","description":"ICD-NBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Review patient spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94016","description":"Review patient spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX36","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip flex inner socket ext fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5643","description":"Hip flex inner socket ext fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD0","description":"ICD-BHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD1","description":"ICD-FGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD1","description":"ICD-OCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC0","description":"ICD-FECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC1","description":"ICD-LHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2212","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air ambulanc nonemerg fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9960","description":"Air ambulanc nonemerg fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF1","description":"ICD-KENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23545","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD0","description":"ICD-CDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric derisomaltose_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1437","description":"Injection_ ferric derisomaltose_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE0","description":"ICD-NHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11107","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC1","description":"ICD-NGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA0","description":"ICD-BICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC1","description":"ICD-IAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD1","description":"ICD-ABMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57720","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ippb all types","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0500","description":"Ippb all types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX14","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND E","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE0","description":"ICD-KEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD1","description":"ICD-LEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF0","description":"ICD-NHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA0","description":"ICD-NFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA0","description":"ICD-JBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2144","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 22 Or Functional Status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA1","description":"ICD-CCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF1","description":"ICD-ADUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","description":"HCPCS-J7174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF1","description":"ICD-JBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB1","description":"ICD-BCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facility-based respite_ 24-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0531","description":"Facility-based respite_ 24-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Segmental pneumatic trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0656","description":"Segmental pneumatic trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA1","description":"ICD-IDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB260","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF1","description":"ICD-HBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC1","description":"ICD-KAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND0","description":"ICD-NCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE1","description":"ICD-CEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE0","description":"ICD-NFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0631U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0631U","description":"CPT-0631U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE1","description":"ICD-KEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA1","description":"ICD-KDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","description":"CPT-92639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject trigger points 3/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20553","description":"Inject trigger points 3/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF1","description":"ICD-HISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC0","description":"ICD-JFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA0","description":"ICD-PCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB1","description":"ICD-HFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0B","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc prosth delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33886","description":"Endovasc prosth delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE0","description":"ICD-CIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73718","description":"MRI lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2321","description":"Lenticular lens_ trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE0","description":"ICD-NGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA1","description":"ICD-IEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD1","description":"ICD-BFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4064F","description":"Antidepressant rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22600","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24341","description":"Repair arm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0819T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subfas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb musc/fascia 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11043","description":"Deb musc/fascia 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91307","description":"SARSCOV2 VAC 10 MCG TRS-SUCR (pediatric vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB1","description":"ICD-FHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2560","description":"Phenobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthodont high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6210","description":"Prosthodont high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0020","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC0","description":"ICD-CHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC0","description":"ICD-OERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas no hospice refer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9525","description":"Doc pt reas no hospice refer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abd&pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74174","description":"Ct angio abd&pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD0","description":"ICD-NFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB0","description":"ICD-ABBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiof trsmtr implt scrl neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8684","description":"Radiof trsmtr implt scrl neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3A","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/clin ascvd dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9674","description":"Pt w/clin ascvd dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj ivig privigen 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1459","description":"Inj ivig privigen 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD1","description":"ICD-FBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES126","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise/graft midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28305","description":"Incise/graft midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cardiac electrophys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53751","description":"Anesth cardiac electrophys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKF1","description":"ICD-KGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC144","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3513F","description":"Hep b scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N blk inj sciatic cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64446","description":"N blk inj sciatic cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung ventilation imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78579","description":"Lung ventilation imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6527","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE1","description":"ICD-DHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1101","description":"CDT-D1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA1","description":"ICD-ODCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA1","description":"ICD-ABMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE1","description":"ICD-NGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35341","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA221","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF0","description":"ICD-JFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA0","description":"ICD-GBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vag lesions complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57065","description":"Destroy vag lesions complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF1","description":"ICD-BHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyurea 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0176","description":"Hydroxyurea 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9026","description":"Cryoprecipitated fibrinogen complex_ pathogen reduced_ eachunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE0","description":"ICD-NEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment plan development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1007","description":"Treatment plan development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD0","description":"ICD-NKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft repair perimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6103","description":"Bone graft repair perimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replc tth&acrlc mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5671","description":"Replc tth&acrlc mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58540","description":"Revision of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create tear sac drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68720","description":"Create tear sac drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whole body photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96904","description":"Whole body photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF0","description":"ICD-OJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD0","description":"ICD-NAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAB1","description":"ICD-OIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC0","description":"ICD-FIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2083","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA234","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML40","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxymorphone hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2410","description":"Oxymorphone hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB17","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC1","description":"ICD-AHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF1","description":"ICD-IHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF0","description":"ICD-NDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES114","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elisa hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0433","description":"Elisa hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCD1","description":"ICD-JCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD0","description":"ICD-FBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD0","description":"ICD-PDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE1","description":"ICD-DBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC1","description":"ICD-FEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA1","description":"ICD-LGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis w/huhner","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89300","description":"Semen analysis w/huhner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC0","description":"ICD-LISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF1","description":"ICD-NAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC0","description":"ICD-NHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB0","description":"ICD-KAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB1","description":"ICD-OHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD0","description":"ICD-LIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA0","description":"ICD-FIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11402","description":"Exc tr-ext b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42892","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure ureter/skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50920","description":"Closure ureter/skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy biceps tenodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29828","description":"Arthroscopy biceps tenodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5158","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","description":"HCPCS-Q5158","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1302","description":"Injection_ sutimlimab-jome_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC0","description":"ICD-GIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1334","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE0","description":"ICD-NBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD0","description":"ICD-OJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF0","description":"ICD-GCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE0","description":"ICD-JEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC1","description":"ICD-NDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86231","description":"Endomysial Antibody (Ema)_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb laminated socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5540","description":"Prep bk ptb laminated socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC0","description":"ICD-AHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cptr ophth dx img post segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92134","description":"Cptr ophth dx img post segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD1","description":"ICD-GDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7522","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCA0","description":"ICD-BCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD0","description":"ICD-DGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7519","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF1","description":"ICD-AHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF0","description":"ICD-DDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAID0","description":"ICD-KAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB1","description":"ICD-CAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1108T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1108T","description":"CPT-1108T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc advncd dis cmfrt not 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1153F","description":"Doc advncd dis cmfrt not 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61533","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEF0","description":"ICD-KGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl counterpulse_ per tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0166","description":"Extrnl counterpulse_ per tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92851","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE1","description":"ICD-OBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36252","description":"Ins cath ren art 1st bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF0","description":"ICD-FFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF1","description":"ICD-FIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62329","description":"Spinal Puncture_ Therapeutic_ For Drainage Of Cerebrospinal Fluid (By Needle Or Catheter); With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD1","description":"ICD-IFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-programble infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0782","description":"Non-programble infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC1","description":"ICD-GIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59610","description":"Vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC0","description":"ICD-MHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD1","description":"ICD-JFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA1","description":"ICD-MGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF1","description":"ICD-GCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC0","description":"ICD-ECHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF1","description":"ICD-JIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF0","description":"ICD-IBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC0","description":"ICD-NJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA14","description":"Default_ /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE1","description":"ICD-IIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB0","description":"ICD-LDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF1","description":"ICD-EHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE0","description":"ICD-IFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB1","description":"ICD-NDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB0","description":"ICD-JDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB211","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA0","description":"ICD-NIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA0","description":"ICD-KIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pelvic organ surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84851","description":"Anesth pelvic organ surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood mucoprotein","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2038","description":"Blood mucoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF0","description":"ICD-DIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD0","description":"ICD-JHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD0","description":"ICD-KGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Euflexxa inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7323","description":"Euflexxa inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj theophylline per 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2810","description":"Inj theophylline per 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYA0","description":"ICD-CDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60220","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF1","description":"ICD-NKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0608T","description":"Rem mntr pulm flu mntr alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME0","description":"ICD-AFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21154","description":"Lefort iii w/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA1","description":"ICD-EBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF1","description":"ICD-JIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF1","description":"ICD-KAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE1","description":"ICD-HHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA1","description":"ICD-EDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD1","description":"ICD-DEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1007","description":"Bilateral hip_ knee_ ankle_ foot device_ powered_ includes pelvic component_ single or double upright(s)_ knee joints any type_ with or without ankle joints any type_ includes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE1","description":"ICD-BFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA1","description":"ICD-IDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC0","description":"ICD-OEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC0","description":"ICD-GBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC0","description":"ICD-OEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHF0","description":"ICD-FDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA1","description":"ICD-NLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE0","description":"ICD-KECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB0","description":"ICD-MFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD0","description":"ICD-KAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20606","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0285","description":"Amphotericin b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1031","description":"Nonpneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB34","description":"Very High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE0","description":"ICD-IILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD1","description":"ICD-BGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34001","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65435","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93245","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA1","description":"ICD-NKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD0","description":"ICD-JHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB0","description":"ICD-BCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/in 2yr dxa not order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9471","description":"W/in 2yr dxa not order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE0","description":"ICD-JEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumb artif diskectomy addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163T","description":"Lumb artif diskectomy addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE1","description":"ICD-LBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB1","description":"ICD-PIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF1","description":"ICD-HBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC1","description":"ICD-BHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF1","description":"ICD-MAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA1","description":"ICD-CIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC1","description":"ICD-IFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind ch_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4288","description":"Dermabind ch_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33897","description":"Percutaneous Transluminal Angioplasty Of Native Or Recurrent Coarctation Of The Aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w iv ab given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8916","description":"Pt w iv ab given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF1","description":"ICD-AEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33278","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; system_ including pulse generat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 xhd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0864","description":"Pwc gp3 xhd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93793","description":"Anticoagulant management for a patient taking warfarin_ must include review and interpretation of a new home_ office_ or lab international normalized ratio (INR) test result_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Staph a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87640","description":"Staph a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Latex leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5113","description":"Latex leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE1","description":"ICD-KDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC0","description":"ICD-OHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64790","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB1","description":"ICD-BCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0045","description":"Clinical Follow-Up And Mrs Score Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45393","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE0","description":"ICD-KBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE1","description":"ICD-NGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No hist cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3493F","description":"No hist cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0691T","description":"Automated Analysis Of An Existing Computed Tomography Study For Vertebral Fracture(S)_ Including Assessment Of Bone Density When Performed_ Data Preparation_ Interpretation_ A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE1","description":"ICD-EBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via av graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4053F","description":"Hemodialysis via av graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration behind abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49010","description":"Exploration behind abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33282","description":"Implantation of patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temporary external pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92953","description":"Temporary external pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1355","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB1","description":"ICD-JEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low extemity neur exam docum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8404","description":"Low extemity neur exam docum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF1","description":"ICD-JEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE1","description":"ICD-OHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC21","description":"ICD-2EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smoker/exposed 2nd hnd smoke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1032F","description":"Smoker/exposed 2nd hnd smoke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMB1","description":"ICD-NHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked upr&lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95939","description":"C motor evoked upr&lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1126","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99341","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82679","description":"Assay of estrone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0048U","description":"Oncology (solid organ neoplasia)_ DNA_ targeted sequencing of protein-coding exons of 468 cancer-associated genes_ including interrogation for somatic mutations and microsatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD1","description":"ICD-MKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef >/=40% systolic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3022F","description":"Lvef >/=40% systolic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0553","description":"Supply allowance for therapeutic continuous glucose monitor (CGM)_ includes all supples and accessories_ 1 unit = 1 mo. supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC1","description":"ICD-MITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC0","description":"ICD-EDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54438","description":"Replantation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4A","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temozolomide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8700","description":"Temozolomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77085","description":"Dxa bone density study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alarm symp assessed-1+ prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1071F","description":"Alarm symp assessed-1+ prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1030T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1030T","description":"CPT-1030T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace strap_ any orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4002","description":"Replace strap_ any orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD1","description":"ICD-ADBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB1","description":"ICD-DIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB1","description":"ICD-OKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE0","description":"ICD-KARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB130","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1703","description":"HCPCS-A1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove nail bed/tip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11752","description":"Remove nail bed/tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB0","description":"ICD-MHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA1","description":"ICD-MEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF1","description":"ICD-AAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE1","description":"ICD-CBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40801","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE1","description":"ICD-GEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placental lactogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83632","description":"Placental lactogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70220","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC0","description":"ICD-CFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB1","description":"ICD-GIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1451","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","description":"HCPCS-M1451","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF0","description":"ICD-GDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9855","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC0","description":"ICD-GHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF0","description":"ICD-JIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC254","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE1","description":"ICD-KHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal kidney open complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50225","description":"Removal kidney open complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF1","description":"ICD-FAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33019","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA0","description":"ICD-NEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID1","description":"ICD-GCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF1","description":"ICD-MLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8I","description":"High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21123","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA0","description":"ICD-CGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA0","description":"ICD-IFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB1","description":"ICD-DISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF1","description":"ICD-NBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36572","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Macroscopic exam parasite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87169","description":"Macroscopic exam parasite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forensic autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88040","description":"Forensic autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC0","description":"ICD-FAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA0","description":"ICD-ABDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect tibia tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27645","description":"Resect tibia tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC0","description":"ICD-ACUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prior dx/active clin ascvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9662","description":"Prior dx/active clin ascvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE1","description":"ICD-NABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF0","description":"ICD-KHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mecasermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2170","description":"Mecasermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC0","description":"ICD-IEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC1","description":"ICD-FBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilio-mesenteric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35633","description":"Art byp ilio-mesenteric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD1","description":"ICD-JIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF0","description":"ICD-OBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA0","description":"ICD-JAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB236","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abut support retainer titani","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6194","description":"Abut support retainer titani","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE1","description":"ICD-CEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct gas permeable sphericl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2510","description":"Cntct gas permeable sphericl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB0","description":"ICD-MIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE1","description":"ICD-KEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6018","description":"Ileoscopy_through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00550","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","description":"CPT-00550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD0","description":"ICD-JETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zoledronic acid 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3489","description":"Zoledronic acid 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE1","description":"ICD-FATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB1","description":"ICD-GGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6604","description":"Gradient compression bandaging supply_ low density flat foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain bag/bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4911","description":"Drain bag/bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA1","description":"ICD-OJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC1","description":"ICD-KBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA1","description":"ICD-BBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE1","description":"ICD-GGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC1","description":"ICD-JDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB1","description":"ICD-CDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA0","description":"ICD-NCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE1","description":"ICD-GBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove middle ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69676","description":"Remove middle ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26185","description":"Remove finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF0","description":"ICD-LCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEA1","description":"ICD-NJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD1","description":"ICD-GGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF0","description":"ICD-BGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1446","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","description":"HCPCS-M1446","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31625","description":"Bronchoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE1","description":"ICD-BDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Homecare train pt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5108","description":"Homecare train pt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA1","description":"ICD-KEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD1","description":"ICD-KBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF1","description":"ICD-JILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of toe joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28054","description":"Biopsy of toe joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB1","description":"ICD-AIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knee 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73562","description":"X-ray exam of knee 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA0","description":"ICD-MKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF1","description":"ICD-NECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0850T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each multiplex probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC1","description":"ICD-BFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv xmatch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86077","description":"Phys blood bank serv xmatch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anes medscpy&thorscpy 1 lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52951","description":"Anes medscpy&thorscpy 1 lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB1","description":"ICD-JAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD1","description":"ICD-MHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUE1","description":"ICD-NFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC0","description":"ICD-CFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4207","description":"2 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD101","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug abuse svc nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0047","description":"Alcohol/drug abuse svc nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA1","description":"ICD-MEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC1","description":"ICD-OIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC1","description":"ICD-FCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD1","description":"ICD-OARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5645","description":"Bk flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulp cap indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3120","description":"Pulp cap indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF0","description":"ICD-OGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB1","description":"ICD-GERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC1","description":"ICD-NFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm a-grft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15115","description":"Epidrm a-grft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjustable chair for esrd pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1570","description":"Adjustable chair for esrd pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC1","description":"ICD-GGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA0","description":"ICD-CFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE1","description":"ICD-OLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8X","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE1","description":"ICD-MFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC1","description":"ICD-KEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB116","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2b hr_nopro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9071","description":"Onc dx brst stg1-2b hr_nopro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB0","description":"ICD-FDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC1","description":"ICD-BBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE0","description":"ICD-PESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA1","description":"ICD-JBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit pain imp pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9328","description":"Hit pain imp pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346U","description":"Beta amyloid_ AB40 and AB42 by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ ratio_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474T","description":"Insertion of anterior segment aqueous drainage device_ with creation of intraocular reservoir_ internal approach_ into the supraciliary space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB0","description":"ICD-OHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE1","description":"ICD-KGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND1","description":"ICD-JGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB0","description":"ICD-NCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50948","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF1","description":"ICD-JAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF1","description":"ICD-GIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF1","description":"ICD-BCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6025","description":"Colonoscopy_ flexible_ proximal to splenic flexure; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB0","description":"ICD-ICLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration - non-resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6107","description":"guided tissue regeneration - non-resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA1","description":"ICD-AEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC54","description":"Medium Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tension ring_ vac erect dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7902","description":"Tension ring_ vac erect dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","description":"HCPCS-G0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73610","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skn splt a-grft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15121","description":"Skn splt a-grft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB0","description":"ICD-MEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0680U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680U","description":"CPT-0680U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36625","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastro-Enterology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4006","description":"Gastro-Enterology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD0","description":"ICD-IGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive med svc 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2010","description":"Comprehensive med svc 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC1","description":"ICD-NDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-tnf per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9359","description":"Hit anti-tnf per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB0","description":"ICD-ADDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD0","description":"ICD-KFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC0","description":"ICD-IALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF1","description":"ICD-NJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8020","description":"Limited dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue and neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41135","description":"Tongue and neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75945","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervisio and interpretation; initial vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA0","description":"ICD-CAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB0","description":"ICD-GAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group audiometric testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92559","description":"Group audiometric testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF0","description":"ICD-LAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2304","description":"Lens sphcy trifocal 4.0/2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC1","description":"ICD-GHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28715","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl push transfuse 2 yr/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36440","description":"Bl push transfuse 2 yr/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66762","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94060","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply long arm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29105","description":"Apply long arm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA0","description":"ICD-NFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB1","description":"ICD-ODMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC0","description":"ICD-HERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLD0","description":"ICD-MCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no ann srn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9384","description":"Doc med reas no ann srn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD1","description":"ICD-PEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA0","description":"ICD-GEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable peak flow meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8096","description":"Portable peak flow meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF0","description":"ICD-FGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE0","description":"ICD-IFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE234","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2638","description":"Brachytx_ stranded_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9198","description":"Injection_ gemcitabine hydrochloride_ (Infugem)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81400","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-first 30 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9220","description":"Deep sedation/general anesthesia-first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABE0","description":"ICD-NABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB1","description":"ICD-GGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB0","description":"ICD-KGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC1","description":"ICD-JCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD0","description":"ICD-PGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD0","description":"ICD-OATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bladder irrigation tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4355","description":"Bladder irrigation tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE1","description":"ICD-MJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC1","description":"ICD-GBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA1","description":"ICD-ABCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB32","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64893","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF1","description":"ICD-DEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC1","description":"ICD-NBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF0","description":"ICD-NCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD0","description":"ICD-HCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB0","description":"ICD-NFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA60","description":"Medium Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ ureteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1758","description":"Catheter_ ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01486","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","description":"CPT-01486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB1","description":"ICD-KEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1073","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB0","description":"ICD-KGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87634","description":"Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD1","description":"ICD-OAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF1","description":"ICD-KHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c quant rna tstng docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3220F","description":"Hep c quant rna tstng docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE0","description":"ICD-KBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC0","description":"ICD-NCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB0","description":"ICD-IEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF1","description":"ICD-EIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC55","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human ig sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90284","description":"Human ig sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC1","description":"ICD-EBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE0","description":"ICD-OAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYD0","description":"ICD-OJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC1","description":"ICD-MELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC1","description":"ICD-KGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB1","description":"ICD-CCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB0","description":"ICD-CADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67903","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80424","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB0","description":"ICD-KCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable gaseous 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0431","description":"Portable gaseous 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE0","description":"ICD-NDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF0","description":"ICD-PGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81415","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA0","description":"ICD-OBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF1","description":"ICD-MFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99157","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA1","description":"ICD-NHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metacarpophalangeal implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8630","description":"Metacarpophalangeal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"S bowel endoscope w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44379","description":"S bowel endoscope w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA24","description":"Low Rehab_ ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35261","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermacell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4122","description":"Dermacell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ coronary venous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1900","description":"Lead_ coronary venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA1","description":"ICD-JFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFB0","description":"ICD-FGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Graft hand or finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26416","description":"Graft hand or finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF1","description":"ICD-GCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal lamina add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63048","description":"Remove spinal lamina add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9029","description":"Injection_ nadofaragene firadenovec-vncg_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No recd cortico>=10mg/d >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9468","description":"No recd cortico>=10mg/d >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD254","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC1","description":"ICD-BIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33917","description":"Repair pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD1","description":"ICD-CABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF1","description":"ICD-JATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9205","description":"Injection_ irinotecan liposome_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calaspargase pegol-mknl_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9118","description":"Injection_ calaspargase pegol-mknl_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28230","description":"Incision of foot tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA1","description":"ICD-LARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGD0","description":"ICD-BCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB1","description":"ICD-BETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB1","description":"ICD-JAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA0","description":"ICD-DHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4366","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","description":"HCPCS-Q4366","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB155","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suture large intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44604","description":"Suture large intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB1","description":"ICD-GFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB0","description":"ICD-HESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD155","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF1","description":"ICD-OIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582T","description":"Transurethral Ablation Of Malignant Prostate Tissue By High-Energy Water Vapor Thermotherapy_ Including Intraoperative Imaging And Needle Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","description":"CPT-76015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval aud rehab status","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92626","description":"Eval aud rehab status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA1","description":"ICD-CGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME1","description":"ICD-BIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE0","description":"ICD-OGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF1","description":"ICD-ABUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB0","description":"ICD-NLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84392","description":"Assay of urine sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA0","description":"ICD-OCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA0","description":"ICD-BGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC1","description":"ICD-KAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0A","description":"High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE0","description":"ICD-MCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA1","description":"ICD-MCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF1","description":"ICD-PAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD0","description":"ICD-FEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9131","description":"Onc dx brst unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD1","description":"ICD-OCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ventral hern init block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49561","description":"Rpr ventral hern init block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29881","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1739","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1739","description":"HCPCS-C1739","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC1","description":"ICD-NGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME0","description":"ICD-OIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB0","description":"ICD-GILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKB1","description":"ICD-KAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA0","description":"ICD-MIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD225","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND0","description":"ICD-GHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ovulation tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84830","description":"Ovulation tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2115","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85557","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aldosterone suppression eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80408","description":"Aldosterone suppression eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0884","description":"Pwc gp4 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27650","description":"Repair achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTD0","description":"ICD-KCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9192","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9192","description":"HCPCS-J9192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF0","description":"ICD-EDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA0","description":"ICD-JBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE0","description":"ICD-JGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA1","description":"ICD-ODTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infus insulin pump non needl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4230","description":"Infus insulin pump non needl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF1","description":"ICD-MDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fresnell prism press-on lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2718","description":"Fresnell prism press-on lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD1","description":"ICD-ODHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular device implantation_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0725T","description":"Vestibular device implantation_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB11","description":"ICD-1AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE0","description":"ICD-CGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE0","description":"ICD-JCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA1","description":"ICD-CGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6624","description":"Inlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01925","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","description":"CPT-01925","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl artific disc addl crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095T","description":"Rmvl artific disc addl crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE0","description":"ICD-CHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv unl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338T","description":"Trnscth renal symp denrv unl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJA1","description":"ICD-BBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB1","description":"ICD-GBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE0","description":"ICD-GALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9731","description":"Patient unable to complete the FOTO foot or ankle intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC1","description":"ICD-CEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB0","description":"ICD-JEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA1","description":"ICD-IBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess hlth/behave init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96150","description":"Assess hlth/behave init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE0","description":"ICD-HBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99327","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF1","description":"ICD-BCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA1","description":"ICD-NFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth upper gi visualize","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74051","description":"Anesth upper gi visualize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24575","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUE0","description":"ICD-NGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA0","description":"ICD-KDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64469","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","description":"CPT-64469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb subq tissue 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11042","description":"Deb subq tissue 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB31","description":"ICD-4LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plas doub free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2036","description":"Kafo plas doub free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA1","description":"ICD-GARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA0","description":"ICD-OEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE0","description":"ICD-CBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF0","description":"ICD-EFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA1","description":"ICD-IDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attendant care service /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5125","description":"Attendant care service /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24006","description":"Release elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin dispos pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5571","description":"Insulin dispos pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE1","description":"ICD-MLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot add charge split s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3257","description":"Orth foot add charge split s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF1","description":"ICD-AIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF0","description":"ICD-MKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases any combination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82803","description":"Blood gases any combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC1","description":"ICD-KHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percut thrombect av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36870","description":"Percut thrombect av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE1","description":"ICD-KHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procure donor sperm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4026","description":"Procure donor sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED0","description":"ICD-OCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap ablat uterine fibroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336T","description":"Lap ablat uterine fibroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86037","description":"Antineutrophil Cytoplasmic Antibody (Anca); Titer_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24535","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD1","description":"ICD-NFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD0","description":"ICD-KAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC0","description":"ICD-DAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1804","description":"HCPCS-A1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB1","description":"ICD-CHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD0","description":"ICD-GFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD1","description":"ICD-MJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE0","description":"ICD-NLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE1","description":"ICD-OEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Slings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4565","description":"Slings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC0","description":"ICD-MDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC1","description":"ICD-GCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF1","description":"ICD-FIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC1","description":"ICD-OAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE0","description":"ICD-CHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC0","description":"ICD-OEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA1","description":"ICD-ODYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402U","description":"Infectious agent (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ Trichomonas vaginalis_ Mycoplasma genitalium_ multiplex amplified probe techni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE250","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD1","description":"ICD-KFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE0","description":"ICD-IGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE0","description":"ICD-FFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD0","description":"ICD-JFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15937","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quant pupillometry w/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341T","description":"Quant pupillometry w/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA1","description":"ICD-GIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC0","description":"ICD-MLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB0","description":"ICD-IHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27825","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB1","description":"ICD-OLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB1","description":"ICD-BAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE1","description":"ICD-BBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko rigid w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1836","description":"Ko rigid w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE1","description":"ICD-BCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJF0","description":"ICD-KHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLC1","description":"ICD-OLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD1","description":"ICD-NCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB1","description":"ICD-KABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0477","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8X","description":"Medium Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert remov molded spe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3001","description":"Foot insert remov molded spe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC31","description":"ICD-2HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD1","description":"ICD-PAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD0","description":"ICD-MDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA1","description":"ICD-DGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7648","description":"Isoetharine non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD0","description":"ICD-GAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF1","description":"ICD-OHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt edu re alcoh drnkng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4158F","description":"Pt edu re alcoh drnkng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB0","description":"ICD-CEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA1","description":"ICD-FEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD0","description":"ICD-CHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE0","description":"ICD-CCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped hospital bed semi/elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0329","description":"Ped hospital bed semi/elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20665","description":"Removal of fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB0","description":"ICD-KBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF0","description":"ICD-AGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED0","description":"ICD-FHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0628U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","description":"CPT-0628U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of nasal bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70160","description":"X-ray exam of nasal bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENF1","description":"ICD-NENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_hemodialysis_short-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1752","description":"Cath_hemodialysis_short-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE0","description":"ICD-CDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF1","description":"ICD-KIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chin cup interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2324","description":"Chin cup interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB0","description":"ICD-FAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA0","description":"ICD-OGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27258","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF1","description":"ICD-EECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME1","description":"ICD-OCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF1","description":"ICD-EADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5922","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGB0","description":"ICD-GHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF1","description":"ICD-BABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF1","description":"ICD-PDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA0","description":"ICD-CBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD0","description":"ICD-JBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC0","description":"ICD-LEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE0","description":"ICD-IDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1301","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB1","description":"ICD-BAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB1","description":"ICD-FFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC1","description":"ICD-BENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB1","description":"ICD-NKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA0","description":"ICD-MKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD1","description":"ICD-OAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57452","description":"Exam of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD0","description":"ICD-FBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF0","description":"ICD-GCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB0","description":"ICD-NJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate elbow w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24300","description":"Manipulate elbow w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD1","description":"ICD-HFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1335","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA0","description":"ICD-CGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME0","description":"ICD-EEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD0","description":"ICD-AGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA1","description":"ICD-CIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brompheniramine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0945","description":"Brompheniramine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0591U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","description":"CPT-0591U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2D","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain/barr lk flng/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4427","description":"Ost pch drain/barr lk flng/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE1","description":"ICD-NEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB0","description":"ICD-IFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC0","description":"ICD-CEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE1","description":"ICD-CBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1291","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA1","description":"ICD-FAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00934","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","description":"CPT-00934","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA1","description":"ICD-PBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9130","description":"Onc dx multi myeloma unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0688","description":"Injection_ cefazolin sodium (hikma)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD1","description":"ICD-EFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1903","description":"HCPCS-C1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brca2 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81217","description":"Brca2 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC1","description":"ICD-EITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33771","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA0","description":"ICD-IIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE1","description":"ICD-NALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD1","description":"ICD-JCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11312","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disartic myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6965","description":"Shldr disartic myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC241","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b lipid complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0287","description":"Amphotericin b lipid complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB1","description":"ICD-KIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC1","description":"ICD-OGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB0","description":"ICD-OJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB0","description":"ICD-NCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2010","description":"Apis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gad-base mr contrast nos_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9579","description":"Gad-base mr contrast nos_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand held low vision aids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2600","description":"Hand held low vision aids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Camp overnite waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2036","description":"Camp overnite waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB1","description":"ICD-MIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB115","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Francisella tularensis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86668","description":"Francisella tularensis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27394","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE1","description":"ICD-ODKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74290","description":"Contrast x-ray gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD1","description":"ICD-OFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA1","description":"ICD-KALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add clasp to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5660","description":"Add clasp to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF0","description":"ICD-HCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF0","description":"ICD-NAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF1","description":"ICD-BIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA1","description":"ICD-BGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA1","description":"ICD-KAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4016","description":"Cast sup gauntlet ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND0","description":"ICD-OKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27654","description":"Repair of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4D","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA35","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral fludarabine phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8562","description":"Oral fludarabine phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE1","description":"ICD-DHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF1","description":"ICD-GFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cross-over vein graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34520","description":"Cross-over vein graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA1","description":"ICD-JFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj brachial plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64415","description":"N block inj brachial plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA0","description":"ICD-ICHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft peri per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3428","description":"Bone graft peri per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED1","description":"ICD-IDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bioimpedance cv analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93701","description":"Bioimpedance cv analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45505","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81439","description":"Hereditary cardiomyopathy (eg_ hypertrophic cardiomyopathy_ dilated cardiomyopathy_ arrhythmogenic right ventricular cardiomyopathy)_ genomic sequence analysis panel_ must inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recomb obizur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7188","description":"Factor viii recomb obizur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10A","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0203","description":"HCPCS-A0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA0","description":"ICD-MEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME0","description":"ICD-ECME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD1","description":"ICD-GARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB0","description":"ICD-NDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80412","description":"Crh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC0","description":"ICD-NGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNB1","description":"ICD-NCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00410","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","description":"CPT-00410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC0","description":"ICD-BFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA0","description":"ICD-JEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97151","description":"Behavior identification assessment_ administered by a physician or other qualified health care professional_ each 15 minutes of the physician_s or other qualified health care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD1","description":"ICD-ECBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1025T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","description":"CPT-1025T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID1","description":"ICD-OAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydromorphone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1170","description":"Hydromorphone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDD0","description":"ICD-OFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA1","description":"ICD-NHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF0","description":"ICD-FBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF1","description":"ICD-MECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF1","description":"ICD-OIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF0","description":"ICD-MGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81463","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis_ copy number variants_ and micros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE0","description":"ICD-FGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of long arm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29065","description":"Application of long arm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA0","description":"ICD-KEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB0","description":"ICD-KGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE0","description":"ICD-MJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dextran 40 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7100","description":"Dextran 40 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD0","description":"ICD-CAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap f/c/c/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15620","description":"Delay flap f/c/c/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA0","description":"ICD-HAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csf leakage imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78650","description":"Csf leakage imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME1","description":"ICD-ACME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC1","description":"ICD-IILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0512T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; initial wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11403","description":"Excision_ benign lesion including margins_ except skin tag (unless listed elsewhere)_ trunk_ arms or legs; excised diameter 2.1 to 3.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD0","description":"ICD-JBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE0","description":"ICD-CDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC1","description":"ICD-GGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0401","description":"HCPCS-A0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA0","description":"ICD-EHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9365","description":"1high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD0","description":"ICD-FABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0561U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","description":"CPT-0561U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71260","description":"Ct thorax w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gross pulpal debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3221","description":"Gross pulpal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB0","description":"ICD-KAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA1","description":"ICD-MLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA0","description":"ICD-CAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB1","description":"ICD-JCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87627","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","description":"CPT-87627","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB0","description":"ICD-GCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF1","description":"ICD-JDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1240","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Copd symptoms assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1015F","description":"Copd symptoms assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21240","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF1","description":"ICD-OEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30300","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECF0","description":"ICD-EECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC0","description":"ICD-KDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB1","description":"ICD-CBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove implant of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65920","description":"Remove implant of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD0","description":"ICD-JCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB0","description":"ICD-IGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5001","description":"HCPCS-A5001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB0","description":"ICD-MEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDB1","description":"ICD-MIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metatarsal joint implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8641","description":"Metatarsal joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD1","description":"ICD-GHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81460","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise cornea with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65770","description":"Revise cornea with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toc tool incl key elem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9655","description":"Toc tool incl key elem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25420","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF0","description":"ICD-NHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9351","description":"Hit cont antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RegeneLink Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4315","description":"RegeneLink Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD1","description":"ICD-JDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB0","description":"ICD-GHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16376","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16376","description":"CPT-16376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA1","description":"ICD-BCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB0","description":"ICD-JFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD1","description":"ICD-LIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA0","description":"ICD-AELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protozoa antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86753","description":"Protozoa antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA0","description":"ICD-NDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8X","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","description":"CPT-01916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA0","description":"ICD-FHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB1","description":"ICD-OKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF0","description":"ICD-CACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0C","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB1","description":"ICD-NBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD1","description":"ICD-KAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE1","description":"ICD-GBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE0","description":"ICD-KCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","description":"CPT-01274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD0","description":"ICD-KEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILE0","description":"ICD-CILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Free omental flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49906","description":"Free omental flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB0","description":"ICD-OGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4007","description":"Cast sup long arm ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63746","description":"Removal of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF1","description":"ICD-EBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUF0","description":"ICD-AIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME0","description":"ICD-GBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF1","description":"ICD-CELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86769","description":"Antibody_ severe acute respiratory system coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC0","description":"ICD-DASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay phosphohexose enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84087","description":"Assay phosphohexose enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99443","description":"Phone e/m phys/qhp 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE0","description":"ICD-JFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1189","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1077","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD1","description":"ICD-OCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46606","description":"Anoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD0","description":"ICD-FHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA1","description":"ICD-KBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF0","description":"ICD-JFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 1-4 ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64643","description":"Chemodenerv 1 extrem 1-4 ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA1","description":"ICD-GEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA1","description":"ICD-NLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD1","description":"ICD-BHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery pneum vad replacemnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0503","description":"Battery pneum vad replacemnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVB0","description":"ICD-GGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quan mycophenolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80180","description":"Drug scrn quan mycophenolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74181","description":"MRI abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kit gene analys d816 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81273","description":"Kit gene analys d816 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC0","description":"ICD-DGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA0","description":"ICD-GCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE0","description":"ICD-BHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27279","description":"Arthrodesis sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA0","description":"ICD-MLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1198","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6022","description":"Sigmoidoscopy_ flexible; with ablation of tumor(s)_ polyp(s)_ or other lesions(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low pecarn ped head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9593","description":"Low pecarn ped head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC1","description":"ICD-IDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF0","description":"ICD-CCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plaelet rich plasma unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9020","description":"Plaelet rich plasma unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sympt show clin import drop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1451F","description":"Sympt show clin import drop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB0","description":"ICD-OBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD0","description":"ICD-NLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt & graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33764","description":"Major vessel shunt & graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs linear based","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77372","description":"Srs linear based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE0","description":"ICD-CCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30630","description":"Repair nasal septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37280","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","description":"CPT-37280","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB0","description":"ICD-EEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF1","description":"ICD-FCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC0","description":"ICD-CECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP NEXT GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222U","description":"RHD&RHCE GNTYP NEXT GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso milwauke initial model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1000","description":"Ctlso milwauke initial model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC1","description":"ICD-OKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert i-aort percut device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33967","description":"Insert i-aort percut device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spectinomycn di-hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3320","description":"Spectinomycn di-hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ivig non-lyophilized_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1599","description":"Ivig non-lyophilized_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD0","description":"ICD-ODTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA0","description":"ICD-KFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88152","description":"Cytopath c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB0","description":"ICD-NDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/divide/excise vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37785","description":"Ligate/divide/excise vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i/ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86829","description":"Hla class i/ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile_ gloves per pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4930","description":"Sterile_ gloves per pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB0","description":"ICD-OCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD1","description":"ICD-DFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/abn lvef inelig b-bloc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8451","description":"Pt w/abn lvef inelig b-bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of midfoot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28264","description":"Release of midfoot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26370","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE0","description":"ICD-OCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67420","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDA0","description":"ICD-FIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF1","description":"ICD-FBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA0","description":"ICD-MJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35188","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB1","description":"ICD-MCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB211","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5940","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5940","description":"CDT-D5940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE1","description":"ICD-CCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft local add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20936","description":"Sp bone agrft local add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF1","description":"ICD-NLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pharynx foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42809","description":"Remove pharynx foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular reeducation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97112","description":"Neuromuscular reeducation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD1","description":"ICD-JHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC1","description":"ICD-OAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE0","description":"ICD-CHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF1","description":"ICD-OJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ udenyca 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5111","description":"Injection_ udenyca 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porc 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2644","description":"Dental onlay porc 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD1","description":"ICD-FDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC0","description":"ICD-MEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA0","description":"ICD-GAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC1","description":"ICD-IGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA1","description":"ICD-BHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBD0","description":"ICD-IBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Each addtnl cast post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2953","description":"Each addtnl cast post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB0","description":"ICD-BIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"H pylori drug admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83014","description":"H pylori drug admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD0","description":"ICD-JGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33776","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA156","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE0","description":"ICD-GFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC1","description":"ICD-EAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC1","description":"ICD-JGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB226","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0607","description":"Physician Direct Care - Must be provided by a hospice physician and must be related to the patient_s terminal illness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOE0","description":"ICD-KCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phq-9 >9 during 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9511","description":"Phq-9 >9 during 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44377","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6238","description":"Hydrocolld drg >16<=48 w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA0","description":"ICD-JAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81436","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA1","description":"ICD-BCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF1","description":"ICD-CFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0965T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","description":"CPT-0965T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4226","description":"MyOwn skin_ includes harvesting and preparation procedures_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC1","description":"ICD-KDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC206","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB1","description":"ICD-DERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0132","description":"Acetylcysteine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpnt stay radiolabeled item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9898","description":"Inpnt stay radiolabeled item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB0","description":"ICD-KBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSF1","description":"ICD-KGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC0","description":"ICD-JEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary retinal disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81434","description":"Hereditary retinal disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81450","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81523","description":"Oncology (Breast)_ Mrna_ Next-Generation Sequencing Gene Expression Profiling Of 70 Content Genes And 31 Housekeeping Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD0","description":"ICD-KITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC0","description":"ICD-ICBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD0","description":"ICD-NFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF0","description":"ICD-FETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cognit assessed and reviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1494F","description":"Cognit assessed and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC0","description":"ICD-ODHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD0","description":"ICD-CHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0302","description":"HCPCS-C0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF0","description":"ICD-BHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1042T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1042T","description":"CPT-1042T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB0","description":"ICD-DFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOD0","description":"ICD-LIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF1","description":"ICD-GEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert_ pneum wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2383","description":"Insert_ pneum wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain transmis data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0610T","description":"Mrs disc pain transmis data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht care plan doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4050F","description":"Ht care plan doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27286","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD0","description":"ICD-OAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrocochleography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92584","description":"Electrocochleography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF1","description":"ICD-HGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE0","description":"ICD-MFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1009","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1179","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine_ on or after their 60th birthday and before or during measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB0","description":"ICD-EBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB1","description":"ICD-NFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81319","description":"Pms2 gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF1","description":"ICD-OLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD0","description":"ICD-KGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1725","description":"Cath_ translumin non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA1","description":"ICD-GAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE1","description":"ICD-PFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0592U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","description":"CPT-0592U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB1","description":"ICD-BCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99304","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC1","description":"ICD-EGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQC0","description":"ICD-DAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC1","description":"ICD-DGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE0","description":"ICD-EBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB1","description":"ICD-GABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB0","description":"ICD-FELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51860","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF1","description":"ICD-EACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87510","description":"Gardner vag dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","description":"CPT-00940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26075","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED0","description":"ICD-EHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD1","description":"ICD-ACHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF0","description":"ICD-PJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breast pump bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4285","description":"Replcmnt breast pump bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9711","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA0","description":"ICD-FIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9934","description":"Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma_ sessile serrated polyp_ or sessile serrated adenoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"22nf sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2361","description":"22nf sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC1","description":"ICD-CBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD1","description":"ICD-EAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72170","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigidlined cust fab two","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0486","description":"Tlso rigidlined cust fab two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue mouth neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41153","description":"Tongue mouth neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2267","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tinnitus assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92625","description":"Tinnitus assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81418","description":"Drug metabolism (eg_ pharmacogenomics) genomic sequence analysis panel_ must include testing of at least 6 genes_ including CYP2C19_ CYP2D6_ and CYP2D6 duplication/deletion an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 2nd dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0250","description":"Adm Tocilizu COVID-19 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"VitoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4317","description":"VitoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF0","description":"ICD-NCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC217","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01960","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","description":"CPT-01960","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLF1","description":"ICD-IDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose with potassium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5012","description":"5% dextrose with potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB1","description":"ICD-MFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power bone marrow bx needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1830","description":"Power bone marrow bx needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC0","description":"ICD-GIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1C","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4C","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF1","description":"ICD-PHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF1","description":"ICD-CFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD1","description":"ICD-OKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25A","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA0","description":"ICD-GAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL56","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA150","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRC0","description":"ICD-OGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27681","description":"Release of lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD0","description":"ICD-NBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA1","description":"ICD-NDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE0","description":"ICD-CIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA1","description":"ICD-EHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC1","description":"ICD-NFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB1","description":"ICD-JFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB1","description":"ICD-CIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC0","description":"ICD-OFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE1","description":"ICD-OLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78431","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Multiple Studies At","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA0","description":"ICD-BEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit routine device maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5035","description":"Hit routine device maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB0","description":"ICD-OJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB1","description":"ICD-BEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Russell viper venom diluted","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85613","description":"Russell viper venom diluted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory flow volume loop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94375","description":"Respiratory flow volume loop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intervene hlth/behave indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96152","description":"Intervene hlth/behave indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF0","description":"ICD-ICDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB21","description":"ICD-4EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGC0","description":"ICD-GAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1496","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","description":"HCPCS-M1496","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB1","description":"ICD-JBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB0","description":"ICD-CILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophoretic test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82664","description":"Electrophoretic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0902","description":"CDT-D0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0046","description":"Clinical Follow-Up And Mrs Score Not Assessed At 90 Days Following Endovascular Stroke Intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKD1","description":"ICD-KEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE1","description":"ICD-NHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1381","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","description":"HCPCS-M1381","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC11","description":"ICD-1BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87650","description":"Strep a dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME1","description":"ICD-FGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Basic life support mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0380","description":"Basic life support mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33518","description":"Cabg artery-vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF1","description":"ICD-NGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD0","description":"ICD-MATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tamoxifen/ai prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4179F","description":"Tamoxifen/ai prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc opioid tx 1x during ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9578","description":"Doc opioid tx 1x during ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr ang lwr ext w or w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73725","description":"Mr ang lwr ext w or w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25920","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA1","description":"ICD-BFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture complete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5863","description":"Overdenture complete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genesis Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4198","description":"Genesis Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA1","description":"ICD-JABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC1","description":"ICD-FAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis type 2 posit jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2570","description":"Hip clevis type 2 posit jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD1","description":"ICD-GIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB1","description":"ICD-NGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","description":"HCPCS-J0169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy test drug/bug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95024","description":"Icut allergy test drug/bug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC1","description":"ICD-HBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD0","description":"ICD-NCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA02","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99392","description":"Prev visit est age 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB0","description":"ICD-JDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29866","description":"Autgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVF0","description":"ICD-OLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0005","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusive eye patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6412","description":"Occlusive eye patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE0","description":"ICD-CHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ofatumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9302","description":"Ofatumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84432","description":"Assay of thyroglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF0","description":"ICD-GBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA1","description":"ICD-JDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA1","description":"ICD-NIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradation products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85362","description":"Fibrin degradation products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Varus/valgus strap padded/li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2270","description":"Varus/valgus strap padded/li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA0","description":"ICD-MHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91113","description":"Gastrointestinal Tract Imaging_ Intraluminal (Eg_ Capsule Endoscopy)_ Colon_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42227","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23420","description":"Repair of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pharyngeal walls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42894","description":"Revision of pharyngeal walls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE1","description":"ICD-AGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB1","description":"ICD-FFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1093","description":"Wheelchair wide w/ foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC0","description":"ICD-GADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB1","description":"ICD-KAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC1","description":"ICD-IFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive vaginal ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7303","description":"Contraceptive vaginal ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD145","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE1","description":"ICD-IEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC1","description":"ICD-OEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE0","description":"ICD-IBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE0","description":"ICD-JDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin (khapzory)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0642","description":"Injection_ levoleucovorin (khapzory)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC1","description":"ICD-BIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA1","description":"ICD-GCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE0","description":"ICD-JCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC1","description":"ICD-IAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB1","description":"ICD-MGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID1","description":"ICD-EDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF1","description":"ICD-LGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interim implant crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6085","description":"Interim implant crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96139","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; each additional 30 minutes (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9603","description":"Perc d-e cor stent ather br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19287","description":"Perq dev breast 1st mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21452","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB1","description":"ICD-BDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF1","description":"ICD-MGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D7252","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7252","description":"CDT-D7252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB1","description":"ICD-EFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2607","description":"Skin pro/pos wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymph node biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38570","description":"Laparoscopy lymph node biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA0","description":"ICD-BCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9246","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9246","description":"CDT-D9246","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD1","description":"ICD-MGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA0","description":"ICD-BIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gear reduction drive wheel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2227","description":"Gear reduction drive wheel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB33","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC0","description":"ICD-JFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1404","description":"HCPCS-A1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF1","description":"ICD-OFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"22nf nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2360","description":"22nf nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF0","description":"ICD-KDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8014","description":"HCPCS-C8014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA1","description":"ICD-BATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA1","description":"ICD-BIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin splt grft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15101","description":"Skin splt grft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decalcify tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88311","description":"Decalcify tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27330","description":"Biopsy knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF0","description":"ICD-NFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC1","description":"ICD-OITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE1","description":"ICD-CGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB0","description":"ICD-KFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA0","description":"ICD-OEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC0","description":"ICD-CAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF0","description":"ICD-IDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE0","description":"ICD-HEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA1","description":"ICD-ABAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av fistula revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36833","description":"Av fistula revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit periton dialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9339","description":"Hit periton dialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF1","description":"ICD-OLNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD0","description":"ICD-FBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD1","description":"ICD-NHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81541","description":"Oncology (prostate)_ mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ sock interscap-tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6690","description":"Frame typ sock interscap-tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 5.1-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12053","description":"Intmd rpr face/mm 5.1-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA0","description":"ICD-BETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID1","description":"ICD-BIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE0","description":"ICD-GBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE1","description":"ICD-CBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj cladribine per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9065","description":"Inj cladribine per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompressive lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61323","description":"Decompressive lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43865","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA1","description":"ICD-OJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect hand tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26117","description":"Rad resect hand tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA0","description":"ICD-CEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD0","description":"ICD-JFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF0","description":"ICD-NBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence treatment systm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0740","description":"Incontinence treatment systm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Latex suspension sleeve each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6632","description":"Latex suspension sleeve each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77401","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sphenoid sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31051","description":"Sphenoid sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA0","description":"ICD-NAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iop down >15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3284F","description":"Iop down >15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA11","description":"ICD-2JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF1","description":"ICD-OIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9940","description":"Documentation of medical reason(s) for not on a statin (e.g._ pregnancy_ in vitro fertilization_ clomiphene Rx_ ESRD_ cirrhosis_ muscular pain and disease during the measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB0","description":"ICD-KDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34710","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD0","description":"ICD-GAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC0","description":"ICD-LDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB0","description":"ICD-MHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC1","description":"ICD-GCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD0","description":"ICD-JAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ethosuximide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80168","description":"Assay of ethosuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA0","description":"ICD-JDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD0","description":"ICD-CBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC1","description":"ICD-KIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA1","description":"ICD-DEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axillary-axilry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35518","description":"Art byp grft axillary-axilry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA1","description":"ICD-FFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc sbsq vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37185","description":"Prim art m-thrmbc sbsq vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA1","description":"ICD-CETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD0","description":"ICD-JBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF1","description":"ICD-NHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0586U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","description":"CPT-0586U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of toe joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28272","description":"Release of toe joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & ureter catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52005","description":"Cystoscopy & ureter catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD1","description":"ICD-GAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE1","description":"ICD-ADCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC1","description":"ICD-GCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC11","description":"ICD-1IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB0","description":"ICD-BFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD1","description":"ICD-OGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA0","description":"ICD-OCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE0","description":"ICD-AIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD1","description":"ICD-CGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF0","description":"ICD-GESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB0","description":"ICD-NIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD1","description":"ICD-OHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA0","description":"ICD-CFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA135","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF1","description":"ICD-CGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Event recorder_ cardiac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1764","description":"Event recorder_ cardiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF1","description":"ICD-JFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC21","description":"Very High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF0","description":"ICD-JHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC1","description":"ICD-BDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD1","description":"ICD-ABAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58553","description":"Laparo-vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICED0","description":"ICD-ICED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC1","description":"ICD-BHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD0","description":"ICD-NECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26418","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combination bilateral ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1690","description":"Combination bilateral ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial hip replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27125","description":"Partial hip replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA1","description":"ICD-PBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg ordered rvwd reqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3650F","description":"Eeg ordered rvwd reqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB0","description":"ICD-NLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF1","description":"ICD-FDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC0","description":"ICD-FBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD1","description":"ICD-CELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA1","description":"ICD-CDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penis plastic surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54360","description":"Penis plastic surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk mold socket sach ft endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5301","description":"Bk mold socket sach ft endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caries preventive medicament application - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1355","description":"Caries preventive medicament application - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0573U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","description":"CPT-0573U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental coronoidectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7991","description":"Dental coronoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA0","description":"ICD-KFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound breast limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76642","description":"Ultrasound breast limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 10 gm lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4185","description":"Parenteral sol 10 gm lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC21","description":"ICD-4BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduce testis torsion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54600","description":"Reduce testis torsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36253","description":"Ins cath ren art 2nd+ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC1","description":"ICD-OBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD1","description":"ICD-MHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00529","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","description":"CPT-00529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA1","description":"ICD-IFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99224","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD1","description":"ICD-PASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES150","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enclosed walker w rear seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0144","description":"Enclosed walker w rear seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assist oocyte fertilization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89280","description":"Assist oocyte fertilization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC0","description":"ICD-NBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76941","description":"Echo guide for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVE0","description":"ICD-OKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB1","description":"ICD-NGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Er+ or pr+ breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3315F","description":"Er+ or pr+ breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA1","description":"ICD-HASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTD0","description":"ICD-KFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF1","description":"ICD-FGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC0","description":"ICD-AAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC24","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE0","description":"ICD-ODVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA1","description":"ICD-DDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients on peritoneal dialysis for any portion of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0052","description":"Patients on peritoneal dialysis for any portion of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA1","description":"ICD-FFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8625","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRD1","description":"ICD-GGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF1","description":"ICD-GDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD125","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME1","description":"ICD-GDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353U","description":"Infectious agent detection by nucleic acid (DNA)_ Chlamydia trachomatis and Neisseria gonorrhoeae_ multiplex amplified probe technique_ urine_ vaginal_ pharyngeal_ or rectal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0257U","description":"Very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD)_ leukocyte enzyme activity_ whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB1","description":"ICD-GAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetazolamid sodium injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1120","description":"Acetazolamid sodium injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FMRI brain by phys/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70555","description":"FMRI brain by phys/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC1","description":"ICD-FBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0516","description":"Safety frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78608","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound char size etc docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2050F","description":"Wound char size etc docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE0","description":"ICD-BDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64865","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB0","description":"ICD-NCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tendon shortening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26477","description":"Tendon shortening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA0","description":"ICD-IALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF0","description":"ICD-MDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF0","description":"ICD-NFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Netupitant palonosetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8655","description":"Netupitant palonosetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD1","description":"ICD-OCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4386","description":"Non-pneum walk boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE1","description":"ICD-KHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qty act card prev mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9677","description":"Qty act card prev mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAB0","description":"ICD-BCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert emergency airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31500","description":"Insert emergency airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Helicobacter pylori antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86677","description":"Helicobacter pylori antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFME0","description":"ICD-CFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE0","description":"ICD-CAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF1","description":"ICD-KDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/ fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21339","description":"Open nasoethmoid fx w/ fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA0","description":"ICD-OJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF1","description":"ICD-ODPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0560T","description":"Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF1","description":"ICD-JGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81222","description":"Cftr gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB0","description":"ICD-NHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eia hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0432","description":"Eia hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85370","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31205","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA1","description":"ICD-NLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL11","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF1","description":"ICD-NANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod solid food suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9434","description":"Mod solid food suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD1","description":"ICD-OERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9050","description":"Injection_ emapalumab-lzsg_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other drugs/medicaments","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9630","description":"Other drugs/medicaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB0","description":"ICD-AGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE1","description":"ICD-EDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC1","description":"ICD-DDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA0","description":"ICD-LIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE1","description":"ICD-AILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indiv pdc > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9512","description":"Indiv pdc > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234U","description":"MECP2 (methyl CpG binding protein 2) (eg_ Rett syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ mobile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA0","description":"ICD-BENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC0","description":"ICD-JDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67015","description":"Release of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins mark abd/pel for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49411","description":"Ins mark abd/pel for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv combination assay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0475","description":"Hiv combination assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF1","description":"ICD-CFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB0","description":"ICD-PARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optx of rib fx w/fixj scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21811","description":"Optx of rib fx w/fixj scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA1","description":"ICD-CFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND1","description":"ICD-NAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary/tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58720","description":"Removal of ovary/tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0541T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC1","description":"ICD-GEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ each separat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0836T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ each separat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27516","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy tubal cautery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58670","description":"Laparoscopy tubal cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA1","description":"ICD-NGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC0","description":"ICD-OHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA0","description":"ICD-FGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker w trunk support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0140","description":"Walker w trunk support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0407","description":"Inpt/tele follow up 25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC1","description":"ICD-NFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC1","description":"ICD-JIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29870","description":"Knee arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD0","description":"ICD-CESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal therapy anterior prim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3230","description":"Pulpal therapy anterior prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61700","description":"Brain aneurysm repr simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0832T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; screening and interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7570","description":"HCPCS-C7570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43772","description":"Lap rmvl gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96366","description":"Ther/proph/diag iv inf addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD0","description":"ICD-LGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX55","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0387","description":"intraoral tomosynthesis - comprehensive series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","description":"HCPCS-M1438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test non-trep quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86593","description":"Syphilis test non-trep quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt falls assess-docd le1/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1101F","description":"Pt falls assess-docd le1/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA0","description":"ICD-KFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96159","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB112","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61616","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE1","description":"ICD-CFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHB1","description":"ICD-NIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61880","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA135","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plt_ aph/pher_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9055","description":"Plt_ aph/pher_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9883","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 16-18 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA0","description":"ICD-OEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90833","description":"Psytx pt&/fam w/e&m 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0554","description":"Receiver (Monitor)_ dedicated_ for use with therapeutic continuous glucose mnitor system.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC1","description":"ICD-AADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE1","description":"ICD-FIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of hypotony","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1326","description":"Patients with a diagnosis of hypotony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16 <=48 sq in w/bordr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6220","description":"Gauze >16 <=48 sq in w/bordr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB0","description":"ICD-MKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1902","description":"HCPCS-C1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67450","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toe joint transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26556","description":"Toe joint transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF1","description":"ICD-FCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB0","description":"ICD-FFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9075","description":"Injection_ casimersen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE0","description":"ICD-KHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of neck/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21550","description":"Biopsy of neck/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME0","description":"ICD-KGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB0","description":"ICD-MJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME1","description":"ICD-MBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF0","description":"ICD-JEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA1","description":"ICD-NIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC1","description":"ICD-OCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC1","description":"ICD-AHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF0","description":"ICD-KDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-tibial shell molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2340","description":"Pre-tibial shell molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther fx nasal inf turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30930","description":"Ther fx nasal inf turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53450","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0501","description":"HCPCS-B0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD1","description":"ICD-FEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF0","description":"ICD-IBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB1","description":"ICD-GDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86832","description":"Hla class i high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB0","description":"ICD-MJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC0","description":"ICD-AETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA0","description":"ICD-GHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC0","description":"ICD-OBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD251","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11101","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; each separate/additional lesion (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level >9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3046F","description":"Hemoglobin a1c level >9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21725","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo supramalleolar custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1907","description":"Afo supramalleolar custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBA0","description":"ICD-GIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD1","description":"ICD-KFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME1","description":"ICD-NFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22556","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC1","description":"ICD-GHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-META1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META1","description":"ICD-META1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB0","description":"ICD-BAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53265","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA1","description":"ICD-NCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF0","description":"ICD-JDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21010","description":"Incision of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF0","description":"ICD-CDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inactivated je vacc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90738","description":"Inactivated je vacc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF1","description":"ICD-AHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB1","description":"ICD-DBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC0","description":"ICD-KBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61571","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE1","description":"ICD-NEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dronabinol 2.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0167","description":"Dronabinol 2.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF0","description":"ICD-CIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB1","description":"ICD-GETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF1","description":"ICD-BCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF1","description":"ICD-DAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96102","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI and WAIS)_ with qualified health","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD1","description":"ICD-DCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0946T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","description":"CPT-0946T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF0","description":"ICD-OCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA0","description":"ICD-JFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED0","description":"ICD-MAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1041","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF0","description":"ICD-GERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA31","description":"ICD-2KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest wall lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19260","description":"Removal of chest wall lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF0","description":"ICD-OEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC0","description":"ICD-PLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ froz/degly/wash","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9054","description":"Blood_ l/r_ froz/degly/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD1","description":"ICD-BGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA1","description":"ICD-NIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC1","description":"ICD-OKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA1","description":"ICD-FHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA0","description":"ICD-IAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home phototherapy visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9098","description":"Home phototherapy visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB0","description":"ICD-OGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC1","description":"ICD-NHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA1","description":"ICD-GCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebound matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4296","description":"Rebound matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBA1","description":"ICD-OCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47556","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt maxil","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5710","description":"Dentures rebase cmplt maxil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/o bag 2-way silicone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4312","description":"Cath w/o bag 2-way silicone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB1","description":"ICD-GGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE1","description":"ICD-HBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTF1","description":"ICD-NCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA1","description":"ICD-OKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52283","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD0","description":"ICD-DBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0162U","description":"Hereditary colon cancer (Lynch syndrome)_ targeted mRNA sequence analysis panel (MLH1_ MSH2_ MSH6_ PMS2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0752T","description":"Digitization of glass microscope slides for level III_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC1","description":"ICD-GCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED1","description":"ICD-IEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD0","description":"ICD-CAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0012","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention_ under skin or into muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND1","description":"ICD-FDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE1","description":"ICD-OJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC1","description":"ICD-IGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Day habil waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2020","description":"Day habil waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52305","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47122","description":"Extensive removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA1","description":"ICD-CHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYE1","description":"ICD-GEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd dilate stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43245","description":"Egd dilate stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic device repair rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7510","description":"Prosthetic device repair rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35271","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB1","description":"ICD-OHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46744","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA0","description":"ICD-KBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC1","description":"ICD-KGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE0","description":"ICD-GDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50553","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC1","description":"ICD-KAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9058","description":"Injection_ pegfilgrastime-bmez_ biosimilar_ (ziextenzo) 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fees w/laryngeal sense test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92616","description":"Fees w/laryngeal sense test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF0","description":"ICD-NHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep corneal endo allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65757","description":"Prep corneal endo allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene expression profiling panel for use in the management of breast cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3854","description":"Gene expression profiling panel for use in the management of breast cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329U","description":"Oncology (neoplasia)_ exome and transcriptome sequence analysis for sequence variants_ gene copy number amplifications and deletions_ gene rearrangements_ microsatellite insta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52315","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA1","description":"ICD-EBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC1","description":"ICD-CEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC1","description":"ICD-KISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5227","description":"Immediate maxillary partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD0","description":"ICD-KGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL26","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154A","description":"IMM ADMN SARSCOV2 BIVALENT 10 MCG/0.2 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20933","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; hemicortical intercalary_ partial (ie_ hemicylindrical) (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD0","description":"ICD-GHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE1","description":"ICD-OHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96931","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55725","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE1","description":"ICD-IAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC114","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA0","description":"ICD-FBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28232","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB1","description":"ICD-PBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto laser tx ureteral calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2070","description":"Cysto laser tx ureteral calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55400","description":"Repair of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77620","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXD0","description":"ICD-KAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA0","description":"ICD-MIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC1","description":"ICD-KCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE1","description":"ICD-KDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Footrest complete assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0045","description":"Footrest complete assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC0","description":"ICD-AFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0537U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","description":"CPT-0537U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF0","description":"ICD-OCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUC0","description":"ICD-NHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD1","description":"ICD-NAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA1","description":"ICD-CHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gammagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4111","description":"Gammagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self care mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97535","description":"Self care mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40812","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND1","description":"ICD-FEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain doc pos and plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8730","description":"Pain doc pos and plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC0","description":"ICD-NFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uppr gi scope w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43236","description":"Uppr gi scope w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD130","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWA0","description":"ICD-KDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC1","description":"ICD-OGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD1","description":"ICD-JHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD1","description":"ICD-BAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upright gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8001","description":"Upright gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23120","description":"Partial removal collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5008","description":"Hearing screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Depression screen annual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0444","description":"Depression screen annual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD1","description":"ICD-CGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1007","description":"HCPCS-L1007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hm preeclamp per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9213","description":"Hm preeclamp per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or wo fol wcon_doppler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8929","description":"Tte w or wo fol wcon_doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arch suprt att to sho longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3070","description":"Arch suprt att to sho longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC1","description":"ICD-BCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB1","description":"ICD-BBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE0","description":"ICD-LGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amino acid single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82127","description":"Amino acid single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD0","description":"ICD-FAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory traction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0830","description":"Ambulatory traction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB1","description":"ICD-BDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical stent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5982","description":"Surgical stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDE1","description":"ICD-OIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF0","description":"ICD-BGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052U","description":"Lipoprotein_ blood_ high resolution fractionation and quantitation of lipoproteins_ including all five major lipoprotein classes and subclasses of HDL_ LDL_ and VLDL by vertic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc spinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61783","description":"Scan proc spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB1","description":"ICD-GICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91111","description":"Esophageal capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA1","description":"ICD-NGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29823","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF0","description":"ICD-GDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable sensor_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9276","description":"Disposable sensor_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE1","description":"ICD-HDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF1","description":"ICD-PFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0558U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","description":"CPT-0558U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/renal strict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52346","description":"Cystouretero w/renal strict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunofix e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86334","description":"Immunofix e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD0","description":"ICD-OKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32140","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Op rad mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9238","description":"Op rad mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin stability screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83068","description":"Hemoglobin stability screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA0","description":"ICD-KHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF0","description":"ICD-MBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enema tube_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1013","description":"Enema tube_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indiv pdc not > 0.8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9513","description":"Indiv pdc not > 0.8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99255","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3425","description":"Injection_ hydroxocobalamin_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDB0","description":"ICD-KDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA1","description":"ICD-PKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE0","description":"ICD-CEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2A","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ allopurinol sodium_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0206","description":"Injection_ allopurinol sodium_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABB0","description":"ICD-GABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iv chelationtherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0300","description":"Iv chelationtherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE1","description":"ICD-ICUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA0","description":"ICD-GADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKB1","description":"ICD-KHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (lh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83002","description":"Assay of gonadotropin (lh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_fixed_peel-away","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1892","description":"Intro/sheath_fixed_peel-away","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5255","description":"Hearing aid_ digit_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67966","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHB0","description":"ICD-FAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF0","description":"ICD-GIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","description":"CPT-01120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1347","description":"Patients who achieved a net increase in pam score of at least 3 points in a 6 to 12 month period (passing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77600","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYC0","description":"ICD-GEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0609U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","description":"CPT-0609U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL16","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE1","description":"ICD-HFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA43","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF0","description":"ICD-AHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0640","description":"Lso s/c shell/panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA1","description":"ICD-OCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0108","description":"Stroke with Motor <26.15 & Age >84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC1","description":"ICD-JBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91318","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 3 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0023","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a patient navigator; 60 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF0","description":"ICD-KISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB1","description":"ICD-NBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0622","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cardiac Catheterization Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove nail plate add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11732","description":"Remove nail plate add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adoptive immunotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2107","description":"Adoptive immunotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief emotional/behav assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96127","description":"Brief emotional/behav assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA1","description":"ICD-GHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA0","description":"ICD-BDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oct breast surg cavity i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354T","description":"Oct breast surg cavity i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD0","description":"ICD-PCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE1","description":"ICD-OFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml acceler phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9124","description":"Onc dx cml acceler phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF0","description":"ICD-KFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin fat pad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15838","description":"Excise excess skin fat pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96171","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole sodium_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2470","description":"Injection_ pantoprazole sodium_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0991T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","description":"CPT-0991T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB1","description":"ICD-OGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF1","description":"ICD-MEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB234","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD1","description":"ICD-JHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA0","description":"ICD-CFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE0","description":"ICD-FEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE0","description":"ICD-FIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC0","description":"ICD-ODQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC0","description":"ICD-KHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad exc lesion up to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7410","description":"Rad exc lesion up to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC1","description":"ICD-BFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD256","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82677","description":"Assay of estriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko double upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1845","description":"Ko double upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE1","description":"ICD-OFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC0","description":"ICD-CERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB0","description":"ICD-JGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA0","description":"ICD-OCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD0","description":"ICD-IDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA11","description":"ICD-3EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF1","description":"ICD-OESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC0","description":"ICD-CBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC0","description":"ICD-MLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3760F","description":"Pt w/dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB1","description":"ICD-OLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil prevoc waiver_ per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2014","description":"Habil prevoc waiver_ per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26471","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67971","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB0","description":"ICD-DIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81406","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl zinc air battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8621","description":"Repl zinc air battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ckd meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8495","description":"Ckd meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409U","description":"Oncology (solid tumor)_ DNA (80 genes) and RNA (36 genes)_ by next-generation sequencing from plasma_ including single nucleotide variants_ insertions/deletions_ copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA0","description":"ICD-JFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFC1","description":"ICD-JDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4C","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA1","description":"ICD-OCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD1","description":"ICD-CCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37282","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","description":"CPT-37282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID0","description":"ICD-JIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement air bubble detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1530","description":"Replacement air bubble detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC1","description":"ICD-KDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC1","description":"ICD-OFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco-use counsel 3-10 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0436","description":"Tobacco-use counsel 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD0","description":"ICD-GIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC1","description":"ICD-FIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE1","description":"ICD-NBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carecoordination prenatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1002","description":"Carecoordination prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte phagocytosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86344","description":"Leukocyte phagocytosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28299","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTA1","description":"ICD-JBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hernia repair preemie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83651","description":"Anesth hernia repair preemie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8011","description":"HCPCS-C8011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF0","description":"ICD-MFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD0","description":"ICD-GBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASE1","description":"ICD-OASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD0","description":"ICD-OJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46261","description":"Remove in/ex hem grps & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach suction cath close sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4605","description":"Trach suction cath close sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay carbamazepine total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80156","description":"Assay carbamazepine total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Miro3D_ per cu cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2025","description":"Miro3D_ per cu cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUD1","description":"ICD-JHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE0","description":"ICD-KCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27445","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD0","description":"ICD-IEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA1","description":"ICD-NBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUE0","description":"ICD-BCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43888","description":"Change gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB111","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81300","description":"Msh6 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA0","description":"ICD-FAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE0","description":"ICD-CESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB1","description":"ICD-MJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABA0","description":"ICD-JABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC0","description":"ICD-GAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA0","description":"ICD-AIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","description":"CPT-00214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33468","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immed max part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5223","description":"Immed max part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB0","description":"ICD-FDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27769","description":"Optx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34401","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA0","description":"ICD-JEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic treatment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8690","description":"Orthodontic treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection into hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46500","description":"Injection into hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Probe/needle_ cryo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2618","description":"Probe/needle_ cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC1","description":"ICD-KCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construct vagina with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57292","description":"Construct vagina with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEA0","description":"ICD-EHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD0","description":"ICD-LIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAB1","description":"ICD-BEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE0","description":"ICD-KHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC0","description":"ICD-BAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99484","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclr rx interstit colloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79300","description":"Nuclr rx interstit colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB1","description":"ICD-FICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31623","description":"Dx bronchoscope/brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20920","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2389","description":"Foam caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Malig tumor > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7441","description":"Malig tumor > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA1","description":"ICD-IAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXA1","description":"ICD-FFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE1","description":"ICD-KEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC0","description":"ICD-OGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laps rmvl nstim array vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313T","description":"Laps rmvl nstim array vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD0","description":"ICD-ADLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 600 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0240","description":"Injection_ casirivimab and imdevimab_ 600 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB0","description":"ICD-MLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15272","description":"Skin sub graft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0C","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8D","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59620","description":"Attempted vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE1","description":"ICD-FBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB1","description":"ICD-OCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","description":"HCPCS-G0544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36481","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine culture/colony count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87086","description":"Urine culture/colony count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp >/= 90 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3080F","description":"Diast bp >/= 90 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0837","description":"Pwc gp 2 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC1","description":"ICD-NBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trichinella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86784","description":"Trichinella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fmr1 gene characterization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81244","description":"Fmr1 gene characterization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1B","description":"Default_ /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8X","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC1","description":"ICD-OGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0913","description":"Improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA0","description":"ICD-FDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC1","description":"ICD-HEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE0","description":"ICD-NKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE1","description":"ICD-FEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dil macular/fundus not perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8398","description":"Dil macular/fundus not perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE1","description":"ICD-BCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/computer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95953","description":"Eeg monitoring/computer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9157","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrotestosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6047","description":"Dihydrotestosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB0","description":"ICD-NLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q12h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9501","description":"Hit antibiotic q12h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splint supplies misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4051","description":"Splint supplies misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPB0","description":"ICD-GFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF1","description":"ICD-OEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF1","description":"ICD-BBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA40","description":"Medium Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB1","description":"ICD-DGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sps elbow device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1801","description":"Sps elbow device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asparaginase_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9020","description":"Asparaginase_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB1","description":"ICD-IBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA1","description":"ICD-GBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD1","description":"ICD-FAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF0","description":"ICD-GAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","description":"HCPCS-Q0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE0","description":"ICD-FEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA0","description":"ICD-OBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc skin abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15830","description":"Exc skin abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF1","description":"ICD-BIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC0","description":"ICD-JHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE1","description":"ICD-FINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC1","description":"ICD-CBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD0","description":"ICD-CECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB1","description":"ICD-FILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB1","description":"ICD-GAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0689U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689U","description":"CPT-0689U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prevocational services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6107","description":"Prevocational services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD1","description":"ICD-PHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22630","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC0","description":"ICD-OGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME0","description":"ICD-EGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF0","description":"ICD-NKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF1","description":"ICD-KBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD0","description":"ICD-NFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE0","description":"ICD-OIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81515","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","description":"CPT-81515","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc compl inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9301","description":"Doc compl inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64859","description":"Nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn scope pt >85y","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9660","description":"Doc med rsn scope pt >85y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior swing band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2335","description":"Anterior swing band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX53","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB0","description":"ICD-CINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair safety vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0980","description":"Wheelchair safety vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME0","description":"ICD-EBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB0","description":"ICD-JEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA0","description":"ICD-KDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE1","description":"ICD-NCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC1","description":"ICD-BGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64658","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","description":"CPT-64658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Testicular imaging w/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78761","description":"Testicular imaging w/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm aud input receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5285","description":"Ald fm/dm aud input receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD1","description":"ICD-MDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB0","description":"ICD-CCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE1","description":"ICD-BBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2617","description":"Stent_ non-cor_ tem w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF0","description":"ICD-KAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50240","description":"Partial removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF1","description":"ICD-OHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF0","description":"ICD-GDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA0","description":"ICD-OIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","description":"HCPCS-M1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28555","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF1","description":"ICD-CFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37606","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spiro no perf or doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8926","description":"Spiro no perf or doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of palm bursas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26030","description":"Drainage of palm bursas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA0","description":"ICD-MITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE0","description":"ICD-JIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5C","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC0","description":"ICD-NLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam/biopsy of vag w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57421","description":"Exam/biopsy of vag w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0096U","description":"Human papillomavirus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ 68)_ male urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB0","description":"ICD-MHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11426","description":"Exc h-f-nk-sp b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96573","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE0","description":"ICD-KFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC1","description":"ICD-LFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD1","description":"ICD-BELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Design custom breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19396","description":"Design custom breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telescop/othr compound lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2615","description":"Telescop/othr compound lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enverse_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4258","description":"Enverse_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF0","description":"ICD-FBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB0","description":"ICD-ACBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen class list a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80301","description":"Drug screen class list a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD0","description":"ICD-FBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess anginal symptom/level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1002F","description":"Assess anginal symptom/level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0137","description":"Intensive outpatient services; weekly bundle_ minimum of 9 services over a 7 contiguous day period_ which can include individual and group therapy with physicians or psycholog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB24","description":"Medium Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF1","description":"ICD-OCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71047","description":"Radiologic examination_ chest; 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPC0","description":"ICD-OAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1348","description":"Patients who achieved a net increase in pam score of at least 6-points in a 6 to 12 month period (excellent)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray measurement of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74710","description":"X-ray measurement of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emer rspns sys serv permonth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5161","description":"Emer rspns sys serv permonth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID0","description":"ICD-ODID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC1","description":"ICD-NCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB1","description":"ICD-GGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46760","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF0","description":"ICD-FIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKA1","description":"ICD-FBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF0","description":"ICD-KFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6083","description":"Implant Supported Crown - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC0","description":"ICD-BGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4532","description":"Ped size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAB0","description":"ICD-FCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74246","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6070","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj ganirelix acetat 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0132","description":"Inj ganirelix acetat 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99483","description":"Assessment of and care planning for a patient with cognitive impairment_ requiring an independent historian_ in the office or other outpatient_ home or domiciliary or rest hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trapezius sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1070","description":"Trapezius sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0831T","description":"Digitization of glass microscope slides for cytopathology_ cervical or vaginal (any reporting system)_ requiring interpretation by physician (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNA0","description":"ICD-CCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA1","description":"ICD-CFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0325U","description":"Oncology (ovarian)_ spheroid cell culture_ poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib_ olaparib_ rucaparib_ velparib)_ tumor response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF0","description":"ICD-NGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61567","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA1","description":"ICD-CDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC0","description":"ICD-CHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC0","description":"ICD-BFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF0","description":"ICD-GEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD205","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE0","description":"ICD-GEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB0","description":"ICD-PJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWD1","description":"ICD-OIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27254","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oversize lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2780","description":"Oversize lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA0","description":"ICD-KDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB1","description":"ICD-EIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA0","description":"ICD-KFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1045T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1045T","description":"CPT-1045T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57300","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUC0","description":"ICD-JCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD1","description":"ICD-HDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis ret-oncogene","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3840","description":"Dna analysis ret-oncogene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB1","description":"ICD-FCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB0","description":"ICD-BHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0945T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","description":"CPT-0945T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD0","description":"ICD-BBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39503","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB0","description":"ICD-PHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE0","description":"ICD-JEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling trach insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8511","description":"Indwelling trach insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB0","description":"ICD-GGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL23","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63017","description":"Remove spine lamina >2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB0","description":"ICD-OKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lateral thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1210","description":"Lateral thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2006","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC1","description":"ICD-KDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE1","description":"ICD-HAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive preoperative assessment performed for cataract surgery with i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0122U","description":"Comprehensive preoperative assessment performed for cataract surgery with i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD0","description":"ICD-NETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB0","description":"ICD-PFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous carboxyhb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88740","description":"Transcutaneous carboxyhb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD1","description":"ICD-BIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC0","description":"ICD-AHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC1","description":"ICD-OLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME0","description":"ICD-JAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD0","description":"ICD-BDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg (Tecentriq)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9483","description":"Injection_ atezolizumab_ 10 mg (Tecentriq)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8702","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand_ finger_ single or double upright(s)_ includes microp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise lesion skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61615","description":"Resect/excise lesion skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA1","description":"ICD-OFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0952T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","description":"CPT-0952T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC1","description":"ICD-FCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF1","description":"ICD-EDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7526","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE0","description":"ICD-OJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF1","description":"ICD-DEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB1","description":"ICD-BABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49186","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","description":"CPT-49186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC01","description":"Medium Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB0","description":"ICD-HAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8F","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC0","description":"ICD-KFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED0","description":"ICD-EIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9358","description":"Injection_ fam-trastuzumab deruxtecan-nxki_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA43","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1006","description":"Clinical Decision Support Mechanism Test Appropriate_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD1","description":"ICD-ODBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of thigh muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27430","description":"Revision of thigh muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6059","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA0","description":"ICD-BGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures maxill part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5213","description":"Dentures maxill part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3C","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD0","description":"ICD-KHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gba gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81251","description":"Gba gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect neck tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21558","description":"Resect neck tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temsirolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9330","description":"Temsirolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE1","description":"ICD-GFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB0","description":"ICD-FCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB0","description":"ICD-AAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD0","description":"ICD-KBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA1","description":"ICD-FCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA1","description":"ICD-OHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF1","description":"ICD-OHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74480","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC1","description":"ICD-GFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brucella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86622","description":"Brucella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L hrt artery/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93458","description":"L hrt artery/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA0","description":"ICD-JGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49187","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","description":"CPT-49187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immed mand part dent metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5224","description":"Immed mand part dent metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54440","description":"Repair of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAF0","description":"ICD-IGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD1","description":"ICD-BBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11771","description":"Remove pilonidal cyst exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE0","description":"ICD-OBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB03","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24365","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1022","description":"Clinical decision support mechanism intermountain clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0741","description":"Injection_ cabotegravir and rilpivirine_ 2 mg/3 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obtaining screen pap smear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0091","description":"Obtaining screen pap smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray assay calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82370","description":"X-ray assay calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF0","description":"ICD-NJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB1","description":"ICD-KFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref for speech lang path","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4552F","description":"Pt ref for speech lang path","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD0","description":"ICD-KDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52450","description":"Incision of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB1","description":"ICD-JEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46280","description":"Remove anal fist complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES215","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid fitting/checking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5011","description":"Hearing aid fitting/checking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood sulfhemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83060","description":"Blood sulfhemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE1","description":"ICD-NEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg elb dis/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6382","description":"Postop dsg cast chg elb dis/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC1","description":"ICD-GIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD0","description":"ICD-IEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF1","description":"ICD-EFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC0","description":"ICD-NDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intens cardiac rehab no exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0423","description":"Intens cardiac rehab no exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pertussis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87265","description":"Pertussis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0495","description":"Skilled services of a registered nurse (RN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95716","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And Mai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA0","description":"ICD-KAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12A","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA0","description":"ICD-PCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0043U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0503","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE0","description":"ICD-BHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collect sweat for test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89230","description":"Collect sweat for test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB1","description":"ICD-CFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA1","description":"ICD-MHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUC0","description":"ICD-AHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/o dye w/ca test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75571","description":"Ct hrt w/o dye w/ca test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC0","description":"ICD-LARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC0","description":"ICD-OLEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF1","description":"ICD-AGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tx decision-mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9051","description":"Oncology tx decision-mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lead pace-defib one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33218","description":"Repair lead pace-defib one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular graft_ synthetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8670","description":"Vascular graft_ synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image congen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75573","description":"Ct hrt w/3d image congen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB221","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF1","description":"ICD-JHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq tx nasoethmoid fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21340","description":"Perq tx nasoethmoid fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC0","description":"ICD-IIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test cran nerv unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95867","description":"Muscle test cran nerv unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE0","description":"ICD-MKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC1","description":"ICD-JAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9169","description":"HCPCS-C9169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF1","description":"ICD-KGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE1","description":"ICD-CBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD1","description":"ICD-JDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB1","description":"ICD-FEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0496","description":"Skilled services of a licensed practical nurse (LPN)_ in the training and/or education of a patient or family member_ in the home health or hospice setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59840","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2360","description":"Percutaneous vertebroplasty_ one vertebral body_ unilateral or bilateral injection; cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA1","description":"ICD-NDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4563","description":"Rectal control system for vaginal insertion_ for long term use_ includes pump and all supplies and accessories_ any type each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4302","description":"Complete aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB1","description":"ICD-JIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1105T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1105T","description":"CPT-1105T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF0","description":"ICD-LISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of torus palatinus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7472","description":"Removal of torus palatinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD0","description":"ICD-AEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap revision perm ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49325","description":"Lap revision perm ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lefamulin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0691","description":"Injection_ lefamulin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Veneer repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2983","description":"Veneer repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0148U","description":"Drug assay_ definitive_ 100 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD1","description":"ICD-CDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB1","description":"ICD-GBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33120","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID1","description":"ICD-MIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous blood op salvage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86891","description":"Autologous blood op salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eyelid lining surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68399","description":"Eyelid lining surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD1","description":"ICD-NCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE1","description":"ICD-NKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB1","description":"ICD-AETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76498","description":"MRI procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB0","description":"ICD-CFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE234","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36860","description":"External cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC1","description":"ICD-DIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fix g/colon tube w/device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49460","description":"Fix g/colon tube w/device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28126","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC0","description":"ICD-CAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB1","description":"ICD-FEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE1","description":"ICD-ECIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC0","description":"ICD-CCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA0","description":"ICD-KBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA0","description":"ICD-CABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB31","description":"ICD-1HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE201","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73120","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE0","description":"ICD-CCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA1","description":"ICD-OEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE1","description":"ICD-CEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69601","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA31","description":"ICD-1DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX17","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90476","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip disart sach laminat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5600","description":"Hip disart sach laminat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7650","description":"Isoetharine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA0","description":"ICD-GFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA0","description":"ICD-FAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0168U","description":"Fetal aneuploidy (trisomy 21_ 18_ and 13) DNA sequence analysis of selected regions using maternal plasma without fetal fraction cutoff_ algorithm reported as a risk score for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB1","description":"ICD-OHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA0","description":"ICD-BBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreserve testicular tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89335","description":"Cryopreserve testicular tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frenuloplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7963","description":"Frenuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","description":"HCPCS-G0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59410","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m sulfur colloid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9541","description":"Tc99m sulfur colloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF0","description":"ICD-GGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dual layer impax membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4262","description":"Dual layer impax membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE0","description":"ICD-BHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD0","description":"ICD-DCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59850","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD0","description":"ICD-NIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep a vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4155F","description":"Hep a vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC1","description":"ICD-JHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD251","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95714","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB0","description":"ICD-OCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"A finding of an incidental pulmonary nodule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9754","description":"A finding of an incidental pulmonary nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF1","description":"ICD-MCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9911","description":"Clinically node negative (T1N0N0 or T2N0N0) invasive breast cancer before or after neoadjuvant systemic therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of 5-hiaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83497","description":"Assay of 5-hiaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB0","description":"ICD-EAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1205","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55200","description":"Incision of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70470","description":"Ct head/brain w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA55","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE0","description":"ICD-BFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvis bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26991","description":"Drainage of pelvis bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC1","description":"ICD-OCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF0","description":"ICD-BDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73115","description":"Contrast x-ray of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96103","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI)_ administered by a computer_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1220","description":"Anterior thoracic extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1212","description":"Hemoglobin a1c level is missing_ or was not performed during the measurement period (12 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC0","description":"ICD-KDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED0","description":"ICD-NKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA0","description":"ICD-BANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2198","description":"Documentation of medical reason(s) for not screening for unhealthy alcohol use using a systematic screening method (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5090","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND0","description":"ICD-BAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA1","description":"ICD-BBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64650","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC0","description":"ICD-NFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA0","description":"ICD-NAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE126","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31750","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95972","description":"Analyze neurostim complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","description":"CPT-01404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA1","description":"ICD-BBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 7.12-20","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2302","description":"Lens sphere trifocal 7.12-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0078","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ do","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF0","description":"ICD-FINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ing hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49520","description":"Rerepair ing hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC1","description":"ICD-FHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD0","description":"ICD-KHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81407","description":"Mopath procedure level 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF1","description":"ICD-NCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE0","description":"ICD-OLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bladder abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51080","description":"Drainage of bladder abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27517","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF0","description":"ICD-JHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD1","description":"ICD-ADAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8647","description":"Fun stat score knee >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0701","description":"HCPCS-C0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0510T","description":"Removal of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidurography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72275","description":"Epidurography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC0","description":"ICD-OGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"T cell absolute count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86361","description":"T cell absolute count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA0","description":"ICD-GFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA0","description":"ICD-BHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA1","description":"ICD-KBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4346","description":"Scaling in the presence of generalized moderate or severe gingival inflammation--full mouth_ after oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen gel/paste wound fil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6011","description":"Collagen gel/paste wound fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care 4 pain docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521F","description":"Plan of care 4 pain docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB0","description":"ICD-KGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye image valid to dx rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2026F","description":"Eye image valid to dx rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD0","description":"ICD-NAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Massage therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97124","description":"Massage therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC0","description":"ICD-OBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB0","description":"ICD-BAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB0","description":"ICD-OGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF0","description":"ICD-EDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC1","description":"ICD-BHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF0","description":"ICD-OGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF1","description":"ICD-OECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA1","description":"ICD-MGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB1","description":"ICD-GAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD1","description":"ICD-MEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC0","description":"ICD-HBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD1","description":"ICD-OJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiemetic rectal/supp nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8498","description":"Antiemetic rectal/supp nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal tissue processing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2785","description":"Corneal tissue processing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2064","description":"Comprehensive Care Management Services For A Single High-Risk Disease_ E.G._ Principal Care Management_ At Least 30 Minutes Of Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inirs each vessel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205T","description":"Inirs each vessel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC1","description":"ICD-AFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93532","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho flex pavlik harns pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1620","description":"Ho flex pavlik harns pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD1","description":"ICD-GIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC0","description":"ICD-CHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC1","description":"ICD-JIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77439","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","description":"CPT-77439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC1","description":"ICD-GBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE0","description":"ICD-AFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sclerotx fluid collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49185","description":"Sclerotx fluid collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27228","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC120","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee detach ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1172","description":"Wheelchair amputee detach ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA1","description":"ICD-OIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9282","description":"Doc medrsn no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD1","description":"ICD-EHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99326","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin for insulin pump use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1817","description":"Insulin for insulin pump use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45005","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1B","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0202","description":"CDT-D0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF1","description":"ICD-GDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSC0","description":"ICD-OLSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9699","description":"Long-acting inhaled bronchodilator not prescribed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC1","description":"ICD-NCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31296","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77316","description":"Brachytx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD0","description":"ICD-BDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIA0","description":"ICD-AFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63302","description":"Remove vert xdrl body thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA1","description":"ICD-GIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB0","description":"ICD-ODEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF0","description":"ICD-KEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung bx plug w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2613","description":"Lung bx plug w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD126","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22214","description":"Incis 1 vertebral seg lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64646","description":"Chemodenerv trunk musc 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facial nerve function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92516","description":"Facial nerve function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE0","description":"ICD-GCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHC0","description":"ICD-BCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID0","description":"ICD-GIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB0","description":"ICD-OJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF0","description":"ICD-OKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ std","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4087","description":"Gastro/jejuno tube_ std","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF1","description":"ICD-JHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA1","description":"ICD-NLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB1","description":"ICD-NKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPC0","description":"ICD-FAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath occlusion cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61624","description":"Transcath occlusion cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA0","description":"ICD-FAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0834T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; extended study involving over 5 slides and/or multiple stains (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267U","description":"Rare constitutional and other heritable disorders_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD1","description":"ICD-KEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC1","description":"ICD-FILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356U","description":"Oncology (oropharyngeal)_ evaluation of 17 DNA biomarkers using droplet digital PCR (ddPCR)_ cell-free DNA_ algorithm reported as a prognostic risk score for cancer recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Counterimmunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86185","description":"Counterimmunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML23","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dimethadione","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6048","description":"Dimethadione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB26","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF0","description":"ICD-NEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0433","description":"Als 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA1","description":"ICD-ECUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB0","description":"ICD-CAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA11","description":"ICD-4CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD1","description":"ICD-OGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB1","description":"ICD-OBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF0","description":"ICD-FGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB1","description":"ICD-BBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF1","description":"ICD-NEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; removal_ each balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550T","description":"Transperineal periurethral balloon continence device; removal_ each balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA0","description":"ICD-HGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD1","description":"ICD-KIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peripheral nerve block (PNB)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9770","description":"Peripheral nerve block (PNB)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED0","description":"ICD-GDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC0","description":"ICD-ODAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","description":"HCPCS-L6038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier solid 4x4 equiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4372","description":"Skin barrier solid 4x4 equiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID1","description":"ICD-NDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision hyperplastic tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7970","description":"Excision hyperplastic tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continent stoma catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5082","description":"Continent stoma catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg w/arrest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56351","description":"Anesth heart surg w/arrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA1","description":"ICD-CFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscp harv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2112","description":"Knee arthroscp harv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF0","description":"ICD-GCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC0","description":"ICD-GBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA0","description":"ICD-KATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF0","description":"ICD-DBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC0","description":"ICD-EBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0B","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA1","description":"ICD-GHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26675","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA0","description":"ICD-EADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC0","description":"ICD-FBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC213","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE0","description":"ICD-KIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB0","description":"ICD-CHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB0","description":"ICD-AHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25441","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC1","description":"ICD-NAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj repair of joint disc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7852","description":"Tmj repair of joint disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ccp antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86200","description":"Ccp antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7169","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated-zhzo (Andexxa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Set up port xray equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0092","description":"Set up port xray equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1368","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","description":"HCPCS-M1407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0978T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","description":"CPT-0978T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE0","description":"ICD-KBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close kidney-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50520","description":"Close kidney-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33364","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF0","description":"ICD-CFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE1","description":"ICD-NKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC1","description":"ICD-BDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tah rad dissect for debulk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58953","description":"Tah rad dissect for debulk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC0","description":"ICD-GBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31298","description":"Nasal/sinus endoscopy_ surgical; with dilation of frontal and sphenoid sinus ostia (eg_ balloon dilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guide nerv destr needle emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95874","description":"Guide nerv destr needle emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iron stain peripheral blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85536","description":"Iron stain peripheral blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for tear sac x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68850","description":"Injection for tear sac x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repr elbw med ligmnt w/tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24345","description":"Repr elbw med ligmnt w/tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27745","description":"Reinforce tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF1","description":"ICD-BBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBC0","description":"ICD-MCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy supply misc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4421","description":"Ostomy supply misc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","description":"CPT-01470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fev<60% pred & no copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8925","description":"Fev<60% pred & no copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2041","description":"Axicabtage neciloleucel_ up to 200 million autologous anti-CD19 CAR T Cells_ including leukapheresis and dose preparation procedures_ per infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA0","description":"ICD-GCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93291","description":"Ilr device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko elastic w/joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1812","description":"Ko elastic w/joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB21","description":"ICD-3HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore limb vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35860","description":"Explore limb vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD250","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0531T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; electrode only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB1","description":"ICD-EDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB0","description":"ICD-BCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA1","description":"ICD-NKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62147","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC1","description":"ICD-ACIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE0","description":"ICD-KCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA1","description":"ICD-CDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC0","description":"ICD-GDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD1","description":"ICD-IGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE1","description":"ICD-JGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hippotherapy per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8940","description":"Hippotherapy per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBB0","description":"ICD-MJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXA0","description":"ICD-NHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC1","description":"ICD-NLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC134","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE0","description":"ICD-CGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7630","description":"Open red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC1","description":"ICD-BIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna sequencing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87153","description":"Dna/rna sequencing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE1","description":"ICD-FBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55535","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6559","description":"Gradient compression stocking_ full length/chap style_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJF1","description":"ICD-GBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE1","description":"ICD-GFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leukacyte transfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86950","description":"Leukacyte transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD226","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap insert tunnel ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49324","description":"Lap insert tunnel ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9309","description":"Injection_ Polatuzumab Vedotin-Piiq_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0545U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","description":"CPT-0545U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin recvd w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4084F","description":"Aspirin recvd w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA0","description":"ICD-GAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5699","description":"Shoulder harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0573T","description":"Removal Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1705","description":"HCPCS-A1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB1","description":"ICD-KELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19300","description":"Removal of breast tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1409","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","description":"HCPCS-M1409","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVD1","description":"ICD-CBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE0","description":"ICD-FFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99306","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0828","description":"Pwc gp 2 xtra hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37295","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","description":"CPT-37295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunosuppressive drug noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7599","description":"Immunosuppressive drug noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB53","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93018","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB1","description":"ICD-MAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam stability fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83662","description":"Foam stability fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6532","description":"Compression stocking bk40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3D","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA0","description":"ICD-OKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB1","description":"ICD-ABHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8C","description":"High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37250","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (list separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE0","description":"ICD-FCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE0","description":"ICD-CCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC0","description":"ICD-CHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB0","description":"ICD-BCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA1","description":"ICD-CFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76145","description":"Medical Physics Dose Evaluation For Radiation Exposure That Exceeds Institutional Review Threshold_ Including Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supply kit premix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4220","description":"Parenteral supply kit premix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES225","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep cadaver renal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50323","description":"Prep cadaver renal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL25","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC NONSM CLL LNG CA ALYS 23","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179U","description":"ONC NONSM CLL LNG CA ALYS 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB0","description":"ICD-DFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1B","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC0","description":"ICD-MBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 known familial variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81318","description":"Pms2 known familial variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF0","description":"ICD-JGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF0","description":"ICD-OIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYF0","description":"ICD-DEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATE1","description":"ICD-EATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC0","description":"ICD-OCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4346","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","description":"HCPCS-Q4346","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF1","description":"ICD-NAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCF1","description":"ICD-KDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC1","description":"ICD-KBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable retainer adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8681","description":"Removable retainer adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA0","description":"ICD-GIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0552U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","description":"CPT-0552U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remov/replc penis pros comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54411","description":"Remov/replc penis pros comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB141","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC1","description":"ICD-KGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power adapter_ combo vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0478","description":"Power adapter_ combo vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4224","description":"Human Health Factor 10 Amniotic Patch (HHF10-P)_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC1","description":"ICD-KGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB1","description":"ICD-KDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53510","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB1","description":"ICD-NJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic incision larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31320","description":"Diagnostic incision larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF0","description":"ICD-NKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc back tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21932","description":"Exc back tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24125","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD0","description":"ICD-OHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF1","description":"ICD-KDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA0","description":"ICD-PIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC1","description":"ICD-NLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE0","description":"ICD-MABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultraviolet therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97028","description":"Ultraviolet therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC1","description":"ICD-JHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF0","description":"ICD-METF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small animal inoculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87003","description":"Small animal inoculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF1","description":"ICD-KABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOC0","description":"ICD-OLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB0","description":"ICD-NGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBF0","description":"ICD-BCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integrated keratoprosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1818","description":"Integrated keratoprosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE0","description":"ICD-FILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC0","description":"ICD-HAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF0","description":"ICD-BIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF1","description":"ICD-BBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA1","description":"ICD-EGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mwc acc_ wheelchair brake","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2228","description":"Mwc acc_ wheelchair brake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF1","description":"ICD-GAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC221","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1740","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1740","description":"HCPCS-C1740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In111 satumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4642","description":"In111 satumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUF1","description":"ICD-AHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1848","description":"Ko dbl upright w/air pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD1","description":"ICD-FBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Narcosynthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90865","description":"Narcosynthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF0","description":"ICD-BCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQB1","description":"ICD-PBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad w/o backup non-inv intfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0470","description":"Rad w/o backup non-inv intfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC1","description":"ICD-LBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient immunocompromised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1062","description":"Patient immunocompromised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB0","description":"ICD-JDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29899","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA1","description":"ICD-GDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splint - intra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4322","description":"Splint - intra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE1","description":"ICD-FGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alginate dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6196","description":"Alginate dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis treatment performed exactly three times per week for > 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8714","description":"Hemodialysis treatment performed exactly three times per week for > 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31633","description":"Bronchoscopy/needle bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB1","description":"ICD-PLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD0","description":"ICD-DIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF1","description":"ICD-NLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA52","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF1","description":"ICD-FFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect enlarged toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28341","description":"Resect enlarged toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES211","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB1","description":"ICD-OHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA1","description":"ICD-NHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404U","description":"Oncology (breast)_ semiquantitative measurement of thymidine kinase activity by immunoassay_ serum_ results reported as risk of disease progression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42410","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5105","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for ESRD on dialysis)_ 100 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD1","description":"ICD-NFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA1","description":"ICD-ABEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC1","description":"ICD-JFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD0","description":"ICD-HBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial four or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33536","description":"Cabg arterial four or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA0","description":"ICD-IAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD0","description":"ICD-KFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"One-way allow prorated trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9604","description":"One-way allow prorated trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70471","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","description":"CPT-70471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA0","description":"ICD-AFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE0","description":"ICD-CEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1604","description":"HCPCS-C1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB13","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC1","description":"ICD-PBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow fair lead cable dir fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6586","description":"Elbow fair lead cable dir fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lungcx bx rpt docs class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9418","description":"Lungcx bx rpt docs class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pcp prophylaxis rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4279F","description":"Pcp prophylaxis rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA0","description":"ICD-OBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB1","description":"ICD-HIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE0","description":"ICD-JIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0509","description":"Telehealth consultation_ critical care_ subsequent_ physicians typically spend 50 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE1","description":"ICD-JIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQE1","description":"ICD-CEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/revise male sling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53442","description":"Remove/revise male sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61735","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB0","description":"ICD-KEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0666","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","description":"HCPCS-J0666","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB0","description":"ICD-IETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE1","description":"ICD-AFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx complx malar w/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21366","description":"Opn tx complx malar w/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9174","description":"Speech lang current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD0","description":"ICD-FDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA0","description":"ICD-GCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate mets no cast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9132","description":"Onc dx prostate mets no cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad dos limts b/4 3d rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520F","description":"Rad dos limts b/4 3d rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLE0","description":"ICD-NFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC1","description":"ICD-CIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD1","description":"ICD-GGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28636","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay thyroid stim hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84443","description":"Assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD1","description":"ICD-BCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC1","description":"ICD-GASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disartic switch contro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6960","description":"Shldr disartic switch contro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78710","description":"Kidney imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD0","description":"ICD-AGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF0","description":"ICD-CAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE0","description":"ICD-CHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screw retained plate","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7292","description":"Screw retained plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB126","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8010","description":"Limited dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF1","description":"ICD-MBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L5-S1 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE0","description":"ICD-METE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF0","description":"ICD-AGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Op rad mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9236","description":"Op rad mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Approp oral rehyd recommd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4056F","description":"Approp oral rehyd recommd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc of neg or man pos tb scn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9359","description":"Doc of neg or man pos tb scn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF1","description":"ICD-DDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB15","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE1","description":"ICD-PKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA0","description":"ICD-OEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF1","description":"ICD-LHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE1","description":"ICD-GDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD1","description":"ICD-NEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9778","description":"Patients who have a diagnosis of pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6524","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33425","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76604","description":"Us exam chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA1","description":"ICD-NFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB1","description":"ICD-OJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr any 30.1-60 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14301","description":"Tis trnfr any 30.1-60 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part remove hip bone super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27070","description":"Part remove hip bone super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE0","description":"ICD-CAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43351","description":"Surgical opening esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA1","description":"ICD-BFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil extend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2523","description":"Cntct lens hydrophil extend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC0","description":"ICD-AIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise max/zygoma b9 tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21030","description":"Excise max/zygoma b9 tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD0","description":"ICD-DIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of selenium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84255","description":"Assay of selenium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27278","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ including placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])_ without place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB1","description":"ICD-BCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF0","description":"ICD-NELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA1","description":"ICD-HGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41115","description":"Excision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD0","description":"ICD-FGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC1","description":"ICD-GIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4336","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","description":"HCPCS-Q4336","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD0","description":"ICD-FGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA1","description":"ICD-OFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF1","description":"ICD-CDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1726","description":"Injection_ hydroxyprogesterone caproate_ (Makena)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUC0","description":"ICD-FIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOCOCCUS NEOFORMANS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87327","description":"IAAD IA CRYPTOCOCCUS NEOFORMANS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incompl donor egg case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4023","description":"Incompl donor egg case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compre audiometry evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212T","description":"Compre audiometry evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB0","description":"ICD-GGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB1","description":"ICD-JCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digit nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64778","description":"Digit nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroconvulsive therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90870","description":"Electroconvulsive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2D","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA160","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47534","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA1","description":"ICD-NHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 xhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0840","description":"Pwc gp2 xhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE1","description":"ICD-BALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF1","description":"ICD-HARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC1","description":"ICD-HDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD1","description":"ICD-LGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27396","description":"Transplant of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA0","description":"ICD-MDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_eptinezumab-jjmr_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9063","description":"Injection_eptinezumab-jjmr_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC1","description":"ICD-KBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA1","description":"ICD-JEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr smpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77385","description":"Ntsty modul rad tx dlvr smpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Service Coordination**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1011","description":"Service Coordination**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FlowerDerm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4179","description":"FlowerDerm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC1","description":"ICD-NAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE1","description":"ICD-IGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHC1","description":"ICD-ODHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD215","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC1","description":"ICD-KGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC0","description":"ICD-MHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF0","description":"ICD-GBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated fundus eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2020F","description":"Dilated fundus eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine flow measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51736","description":"Urine flow measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99156","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB0","description":"ICD-GIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEB0","description":"ICD-JAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF1","description":"ICD-PHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6077","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB1","description":"ICD-MIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD241","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29836","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB1","description":"ICD-FFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE0","description":"ICD-MFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply rigid leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29445","description":"Apply rigid leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD0","description":"ICD-DFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF0","description":"ICD-IFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF0","description":"ICD-FGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no elg phar ther osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8634","description":"Pt no elg phar ther osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF1","description":"ICD-NETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 75 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1850","description":"Kanamycin sulfate 75 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2388","description":"Foam drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61000","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE0","description":"ICD-BDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA0","description":"ICD-EHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB25","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87389","description":"IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD1","description":"ICD-HBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2081","description":"Patients Age 66 And Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With A Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLC0","description":"ICD-MKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93151","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hrt surg w/pmp age 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56251","description":"Anesth hrt surg w/pmp age 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF0","description":"ICD-PGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF0","description":"ICD-GCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of lymph channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38308","description":"Incision of lymph channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cer post col occ/man sup adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0180","description":"Cer post col occ/man sup adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC1","description":"ICD-CGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE0","description":"ICD-MJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-noprogress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9074","description":"Onc dx brst stg3-noprogress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND1","description":"ICD-GCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC244","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB1","description":"ICD-EGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB1","description":"ICD-IBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paricalcitol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2501","description":"Paricalcitol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD1","description":"ICD-CGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB0","description":"ICD-CAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD111","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2066","description":"Interrogation Device Evaluation(S)_ (Remote) Up To 30 Days; Implantable Cardiovascular Physiologic Monitor System_ Implantable Loop Recorder System_ Or Subcutaneous Cardiac Rh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7700","description":"Gasket or seal_ for use with prosthetic socket insert_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB53","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB0","description":"ICD-OJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF0","description":"ICD-MDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA0","description":"ICD-CCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF1","description":"ICD-NLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2163","description":"Patient Received An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7677","description":"REvenfenacin inhalation solution_ FDA-approved final product_ noncompounded_administered through DME_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF0","description":"ICD-NCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD0","description":"ICD-IICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC0","description":"ICD-OBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB0","description":"ICD-KDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC0","description":"ICD-FEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF1","description":"ICD-CIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","description":"HCPCS-J8541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB0","description":"ICD-KFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB1","description":"ICD-MACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50620","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD1","description":"ICD-BIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC21","description":"ICD-4JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA0","description":"ICD-PEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND0","description":"ICD-CCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen micrarray copy nmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81228","description":"Cytogen micrarray copy nmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit immunotherapy diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9338","description":"Hit immunotherapy diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC0","description":"ICD-OKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD1","description":"ICD-JAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3252","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50810","description":"Fusion of ureter & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD0","description":"ICD-OIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tablo Hemodialysis System For The Billable Dialysis Service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1629","description":"Tablo Hemodialysis System For The Billable Dialysis Service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB0","description":"ICD-KCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE1","description":"ICD-KGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF1","description":"ICD-LFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33259","description":"Ablate atria w/bypass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Restorigin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4191","description":"Restorigin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBF1","description":"ICD-NHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orth scottish r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1730","description":"Legg perthes orth scottish r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mattress innerspring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0271","description":"Mattress innerspring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC1","description":"ICD-KFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF1","description":"ICD-JDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro w/addl implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52442","description":"Cystourethro w/addl implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ra measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8490","description":"Ra measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE150","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF1","description":"ICD-LHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC21","description":"ICD-1DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7520","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC46","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC1","description":"ICD-GINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI upper extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73219","description":"MRI upper extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1003","description":"HCPCS-A1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25300","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9196","description":"Injection_ gemcitabine hydrochloride (accord)_ not therapeutically equivalent to j9201_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1601","description":"HCPCS-B1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF0","description":"ICD-NLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA0","description":"ICD-CIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC0","description":"ICD-KAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esano aaa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4273","description":"Esano aaa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF1","description":"ICD-JCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgimend_ fetal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9358","description":"Surgimend_ fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE1","description":"ICD-BENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4125","description":"Arthroflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28011","description":"Incision of toe tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene other bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81208","description":"Bcr/abl1 gene other bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF0","description":"ICD-EHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Micro w exam of surg margins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0474","description":"Micro w exam of surg margins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF1","description":"ICD-BFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF0","description":"ICD-OHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0406U","description":"Oncology (lung)_ flow cytometry_ sputum_ 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP]_ CD206_ CD66b_ CD3_ CD19)_ algorithm reported as likelihood of lung cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE0","description":"ICD-GBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB11","description":"ICD-4FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC1","description":"ICD-FEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA0","description":"ICD-ADHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0202","description":"HCPCS-A0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 50NCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91306","description":"SARSCOV2 VAC 50NCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDA1","description":"ICD-MBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8X","description":"Medium Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zenith Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4253","description":"Zenith Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31240","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gel cap for trach voice pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8512","description":"Gel cap for trach voice pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX06","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJC0","description":"ICD-GFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC0","description":"ICD-DCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJD0","description":"ICD-GIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED0","description":"ICD-KGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81182","description":"ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD106","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE0","description":"ICD-DDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spring-ass rot wrst w/ latch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6623","description":"Spring-ass rot wrst w/ latch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB1","description":"ICD-MAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA1","description":"ICD-BGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF1","description":"ICD-OAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB0","description":"ICD-BEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXD0","description":"ICD-JCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA0","description":"ICD-KAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE0","description":"ICD-OKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ hemodialysis_long-term","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1750","description":"Cath_ hemodialysis_long-term","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF0","description":"ICD-BFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF1","description":"ICD-KDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082A","description":"ADM SARSCV2 3MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD1","description":"ICD-DEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB131","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF1","description":"ICD-KDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD1","description":"ICD-KDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93304","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE1","description":"ICD-LFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC1","description":"ICD-BCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF1","description":"ICD-ODOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD0","description":"ICD-NKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA0","description":"ICD-KIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0925T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","description":"CPT-0925T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC0","description":"ICD-GBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90589","description":"Chikungunya virus vaccine_ live attenuated_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28531","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen handling pt-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99001","description":"Specimen handling pt-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF0","description":"ICD-FGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27612","description":"Exploration of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE1","description":"ICD-CDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF0","description":"ICD-NKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28111","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD1","description":"ICD-DGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332U","description":"Oncology (pan-tumor)_ genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR)_ whole blood_ reported as a high or low proba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tacrine hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0014","description":"Tacrine hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13100","description":"Cmplx rpr trunk 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","description":"HCPCS-J3403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43850","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj ceftazidime per 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0713","description":"Inj ceftazidime per 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVE0","description":"ICD-NBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF0","description":"ICD-GAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF1","description":"ICD-CEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect distal finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26262","description":"Resect distal finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67110","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA1","description":"ICD-CAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95990","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00103","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","description":"CPT-00103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bladder calculi irrig sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2004","description":"Bladder calculi irrig sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45341","description":"Sigmoidoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE1","description":"ICD-MIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF0","description":"ICD-OIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE0","description":"ICD-GANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXD1","description":"ICD-GFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE0","description":"ICD-CICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB1","description":"ICD-OEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48551","description":"Prep donor pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD0","description":"ICD-NIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close nephrovisceral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50525","description":"Close nephrovisceral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1324","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g._ triamcinolone_ preservative-free triamcinolone_ dexamethasone_ dexamethasone intravitreal implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA1","description":"ICD-OILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC0","description":"ICD-OAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD0","description":"ICD-CHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC0","description":"ICD-KCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED1","description":"ICD-JAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lanreotide_ (Cipla)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1932","description":"Injection_ lanreotide_ (Cipla)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD0","description":"ICD-MHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1026T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1026T","description":"CPT-1026T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rear whl compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0070","description":"Rear whl compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD0","description":"ICD-CDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8710","description":"Pt pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE1","description":"ICD-IADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA0","description":"ICD-EFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF0","description":"ICD-IFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antinuclear antibodies (ana)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86039","description":"Antinuclear antibodies (ana)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF0","description":"ICD-GEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC0","description":"ICD-FATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc rn e&m plan svs_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0162","description":"Hhc rn e&m plan svs_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45135","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOA0","description":"ICD-OLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMA0","description":"ICD-ODMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAC0","description":"ICD-FCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD1","description":"ICD-OJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cine/video x-rays add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76125","description":"Cine/video x-rays add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC1","description":"ICD-KIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Born 1945-1965","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9448","description":"Born 1945-1965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA0","description":"ICD-EACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantable pump replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0786","description":"Implantable pump replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ergonovine maleate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1330","description":"Ergonovine maleate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64832","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC1","description":"ICD-DBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD0","description":"ICD-OLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95852","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1450","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","description":"HCPCS-M1450","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTB1","description":"ICD-OKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD1","description":"ICD-LIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67108","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE0","description":"ICD-EALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC1","description":"ICD-CEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9057","description":"Injection_ cetirizine hydrochloride_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA0","description":"ICD-IABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKC0","description":"ICD-OEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24A","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB0","description":"ICD-CEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCA0","description":"ICD-OFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD1","description":"ICD-OFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1A","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0510","description":"Non-prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0604","description":"HCPCS-A0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD1","description":"ICD-IGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin reuse pen 3 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5561","description":"Insulin reuse pen 3 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD1","description":"ICD-ODFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3399","description":"Injection_ onasemnogene abeparvovec-xioi_ per treatment_ up to 5x10^15 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40700","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21440","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rectum surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45999","description":"Rectum surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate pleura w/ imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32555","description":"Aspirate pleura w/ imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25915","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36450","description":"Bl exchange/transfuse nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC0","description":"ICD-JDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444U","description":"Oncology (solid organ neoplasia)_ targeted genomic sequence analysis panel of 361 genes_ interrogation for gene fusions_ translocations_ or other rearrangements_ using DNA fro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD1","description":"ICD-IABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74415","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC1","description":"ICD-CBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77437","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","description":"CPT-77437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62304","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33681","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA0","description":"ICD-ICDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF1","description":"ICD-CARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8X","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXA0","description":"ICD-OHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No surg site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9311","description":"No surg site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA14","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54304","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77078","description":"Ct bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL15","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA0","description":"ICD-NAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC246","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255U","description":"Andrology (infertility)_ sperm-capacitation assessment of ganglioside GM1 distribution patterns_ fluorescence microscopy_ fresh/ frozen specimen_ reported as % of capacitated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA0","description":"ICD-FDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF1","description":"ICD-JAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB1","description":"ICD-CBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275U","description":"Hematology (heparin-induced thrombocytopenia)_ platelet antibody reactivity by flow cytometry_ serum (Versiti™ Heparin-Induced Thrombocytopenia Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical supplies and equipme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9061","description":"Medical supplies and equipme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduct simple facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7680","description":"Reduct simple facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c antiviral started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9205","description":"Hep c antiviral started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0517U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","description":"CPT-0517U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94762","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81292","description":"Mlh1 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD0","description":"ICD-GBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13101","description":"Cmplx rpr trunk 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF0","description":"ICD-OLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","description":"HCPCS-J3391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF0","description":"ICD-OFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Megestrol 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0179","description":"Megestrol 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90963","description":"Esrd home pt serv p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped complete soy based","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4159","description":"Ef ped complete soy based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE0","description":"ICD-KBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8858","description":"Not ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2159","description":"Patient Did Not Receive Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provisional splint extracoro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4321","description":"Provisional splint extracoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF1","description":"ICD-MJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea not screened","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3452F","description":"Dyspnea not screened","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE0","description":"ICD-OIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1527","description":"Space maintainer_ removable bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0049U","description":"NPM1 (nucleophosmin) (eg_ acute myeloid leukemia) gene analysis_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1757","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1757","description":"HCPCS-J1757","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip/thigh fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27025","description":"Incision of hip/thigh fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0886","description":"Injection_ epoetin alfa_ 1000 units (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF0","description":"ICD-CADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients admitted to a skilled nursing facility (snf)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1266","description":"Patients admitted to a skilled nursing facility (snf)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA42","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF0","description":"ICD-GCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXE0","description":"ICD-CGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85461","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD0","description":"ICD-CFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB0","description":"ICD-KEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair pt wt >300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1039","description":"Transport chair pt wt >300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4162","description":"WoundEx Flow_ BioSkin Flow_ 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD0","description":"ICD-BFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA1","description":"ICD-CCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No rsk fac or 1 mod risk te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8970","description":"No rsk fac or 1 mod risk te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABD1","description":"ICD-FABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD0","description":"ICD-KEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3919","description":"Ho w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE1","description":"ICD-BDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB1","description":"ICD-LHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB0","description":"ICD-MKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast based metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6781","description":"Crown 3/4 cast based metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9625","description":"Bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33288","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ire abltj 1+tum organ perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0600T","description":"Ire abltj 1+tum organ perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31578","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMC0","description":"ICD-NIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9880","description":"The MDPP b eneficiary achieved at least 5% weight loss (WL) from his/he r baseline weight in months 1-12 of the MDPP services period under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD0","description":"ICD-MDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD0","description":"ICD-GASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA0","description":"ICD-NIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA0","description":"ICD-FCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD1","description":"ICD-PEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gen_ neuro_ hf_ rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1822","description":"Gen_ neuro_ hf_ rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL43","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF0","description":"ICD-FIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interphalangeal joint repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8659","description":"Interphalangeal joint repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Reusable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4436","description":"Irrigation Supply; Sleeve_ Reusable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/graph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47563","description":"Laparo cholecystectomy/graph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB1","description":"ICD-NJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","description":"HCPCS-J2516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0489T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting_ isolation and preparation of harvested cells including incubation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD0","description":"ICD-NKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93041","description":"Rhythm ecg tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA1","description":"ICD-EDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70260","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF1","description":"ICD-GFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25105","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL02","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE0","description":"ICD-JHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove prostate regrowth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52630","description":"Remove prostate regrowth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1501","description":"HCPCS-B1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE1","description":"ICD-OHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB0","description":"ICD-KFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1702","description":"CDT-D1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD1","description":"ICD-NDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26483","description":"Transplant/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF0","description":"ICD-MELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB1","description":"ICD-FHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB0","description":"ICD-LEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6013","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins mark thor for rt perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32553","description":"Ins mark thor for rt perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA0","description":"ICD-FBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA254","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD1","description":"ICD-MCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD1","description":"ICD-LGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB0","description":"ICD-FBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA0","description":"ICD-OKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA0","description":"ICD-HDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj anesthetic per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4737","description":"Inj anesthetic per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99380","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB1","description":"ICD-NATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8A","description":"Very High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC1","description":"ICD-KDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0202","description":"HCPCS-B0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92993","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5646","description":"Below knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72197","description":"MRI pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30124","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC1","description":"ICD-BCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 50MCG/0.25MLBST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064A","description":"ADM SARSCOV2 50MCG/0.25MLBST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQB1","description":"ICD-PJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCA0","description":"ICD-NLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF1","description":"ICD-CBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC1","description":"ICD-LAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28008","description":"Incision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1457","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","description":"HCPCS-M1457","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topical app of fluoride","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1208","description":"Topical app of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20690","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND1","description":"ICD-NIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE1","description":"ICD-OBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB32","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA1","description":"ICD-OLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC1","description":"ICD-CHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE1","description":"ICD-GGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC0","description":"ICD-IEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Astigmatism-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2787","description":"Astigmatism-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1283","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF0","description":"ICD-NIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE1","description":"ICD-OJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD216","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLC1","description":"ICD-NKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect fibula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27646","description":"Resect fibula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA0","description":"ICD-IHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE205","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD1","description":"ICD-EATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelv & thor control gluteal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2650","description":"Pelv & thor control gluteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj cutting into joint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7860","description":"Tmj cutting into joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28220","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB11","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHC1","description":"ICD-NHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF1","description":"ICD-MKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIF0","description":"ICD-FEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23465","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA1","description":"ICD-BFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD1","description":"ICD-JCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ixabepilone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9207","description":"Ixabepilone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD0","description":"ICD-CCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE1","description":"ICD-IEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","description":"HCPCS-Q4379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC0","description":"ICD-GENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB1","description":"ICD-CELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Membrane wrap-hydro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4290","description":"Membrane wrap-hydro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXB1","description":"ICD-CFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA0","description":"ICD-OFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB1","description":"ICD-OEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I & d of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56405","description":"I & d of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC0","description":"ICD-CHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0090","description":"Professional services_ initial visit_ for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXA0","description":"ICD-BGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA1","description":"ICD-MCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC0","description":"ICD-LASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE1","description":"ICD-LISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove&replace pm gen singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33227","description":"Remove&replace pm gen singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC1","description":"ICD-OKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE0","description":"ICD-CCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant semi-imp hear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2230","description":"Implant semi-imp hear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC0","description":"ICD-KIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81236","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms) gene analysis_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD1","description":"ICD-LFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10C","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD0","description":"ICD-OLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB1","description":"ICD-CCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19086","description":"Bx breast add lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC1","description":"ICD-NIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE0","description":"ICD-OEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC0","description":"ICD-BDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj ilio-ing/hypogi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64425","description":"N block inj ilio-ing/hypogi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27176","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE0","description":"ICD-MCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC1","description":"ICD-FGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal m1 w/mets prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9094","description":"Onc dx rectal m1 w/mets prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peroneal straps pair pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0980","description":"Peroneal straps pair pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0057U","description":"Oncology (solid organ neoplasia)_ mRNA_ gene expression profiling by massively parallel sequencing for analysis of 51 genes_ utilizing formalin-fixed paraffin-embedded tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX01","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB1","description":"ICD-KHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD0","description":"ICD-EBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE0","description":"ICD-GBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE0","description":"ICD-OGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB1","description":"ICD-ADAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC0","description":"ICD-NIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC1","description":"ICD-BFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0174","description":"Dolasetron 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1556","description":"Removal Of Fixed Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap resect s/intestine addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44203","description":"Lap resect s/intestine addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10121","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74019","description":"Radiologic examination_ abdomen; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBF0","description":"ICD-MHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHD0","description":"ICD-BHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF0","description":"ICD-ODEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB116","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC1","description":"ICD-IIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61770","description":"Incise skull for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92557","description":"Comprehensive hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75756","description":"Artery x-rays chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27372","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF1","description":"ICD-AHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF1","description":"ICD-GGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27177","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stimulation of spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63610","description":"Stimulation of spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86658","description":"Enterovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSF1","description":"ICD-HDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB0","description":"ICD-PASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB1","description":"ICD-KFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA11","description":"ICD-3IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA1","description":"ICD-DHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE0","description":"ICD-OEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Critical care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99292","description":"Critical care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99375","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth larynx/trach < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32651","description":"Anesth larynx/trach < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromend nerve wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9361","description":"Neuromend nerve wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA0","description":"ICD-KDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial strain imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399T","description":"Myocardial strain imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43212","description":"Esophagoscop stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC1","description":"ICD-MKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77299","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE1","description":"ICD-NEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90646","description":"Hemophilus influenza b vaccine (hib)_ prp-d conjugate_ for booster use only_ intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE1","description":"ICD-MECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB1","description":"ICD-CANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1449","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","description":"HCPCS-M1449","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF0","description":"ICD-KIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit anti-hemophil diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9345","description":"Hit anti-hemophil diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic deluxe shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5508","description":"Diabetic deluxe shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE1","description":"ICD-FCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB251","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA0","description":"ICD-GBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7554","description":"Cystourethroscopy with adjunctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKC0","description":"ICD-NAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA0","description":"ICD-KANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA0","description":"ICD-NEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High risk recurrence pro ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8465","description":"High risk recurrence pro ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pelvis contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58240","description":"Removal of pelvis contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iv tubing extension set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1015","description":"Iv tubing extension set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD0","description":"ICD-CIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF0","description":"ICD-EDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED0","description":"ICD-CAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE1","description":"ICD-AAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB1","description":"ICD-AAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA1","description":"ICD-ACEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB1","description":"ICD-MKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF1","description":"ICD-LIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0315T","description":"Rmvl vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA230","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31512","description":"Removal of larynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB1","description":"ICD-IGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE0","description":"ICD-IHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Signature APatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4260","description":"Signature APatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72069","description":"Radiologic examination_ spine_ thoracolumbar_ standing (scoliosis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC0","description":"ICD-CIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retain crown resin w hi nble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6720","description":"Retain crown resin w hi nble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF1","description":"ICD-KIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ metronidazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0030","description":"Injection_ metronidazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB1","description":"ICD-IBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF0","description":"ICD-PKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB204","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF1","description":"ICD-MBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE1","description":"ICD-NIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8C","description":"High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE1","description":"ICD-OKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD0","description":"ICD-OLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB1","description":"ICD-NFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF0","description":"ICD-JDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9687","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00144","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","description":"CPT-00144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD1","description":"ICD-HEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF1","description":"ICD-NJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB56","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ertapenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1335","description":"Ertapenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF1","description":"ICD-NLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD1","description":"ICD-NACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERD0","description":"ICD-OERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA1","description":"ICD-BEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB1","description":"ICD-MDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB1","description":"ICD-OAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suprv interfac trnsport addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99486","description":"Suprv interfac trnsport addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE1","description":"ICD-GINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9381","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC1","description":"ICD-JBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF1","description":"ICD-DGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE0","description":"ICD-MIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE1","description":"ICD-ACLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:15)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1741","description":"Employment - Employment Skills Development (1:15)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC1","description":"ICD-HASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE0","description":"ICD-OKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehab rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4033F","description":"Pulmonary rehab rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90966","description":"Esrd home pt serv p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB0","description":"ICD-OFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC0","description":"ICD-KCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC1","description":"ICD-OKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pcp prophylax rxd 3mon low %","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4280F","description":"Pcp prophylax rxd 3mon low %","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF0","description":"ICD-KEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD1","description":"ICD-HCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA0","description":"ICD-GILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE1","description":"ICD-JCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF0","description":"ICD-PGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC0","description":"ICD-FDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWB1","description":"ICD-OLWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88140","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27356","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB1","description":"ICD-NFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF0","description":"ICD-JBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion radioulnar jnt/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25830","description":"Fusion radioulnar jnt/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC1","description":"ICD-GIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair special seat dept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1297","description":"Wheelchair special seat dept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA1","description":"ICD-OGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISA1","description":"ICD-KISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME0","description":"ICD-OHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB224","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF0","description":"ICD-GDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE0","description":"ICD-FEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC1","description":"ICD-NKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27429","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB1","description":"ICD-OLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pap prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8850","description":"No pap prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA50","description":"Ultra High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert silicone gel eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3003","description":"Foot insert silicone gel eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11421","description":"Exc h-f-nk-sp b9+marg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB1","description":"ICD-LIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9985","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB55","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE1","description":"ICD-ABAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Florbetapir f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9586","description":"Florbetapir f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE0","description":"ICD-OEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXA0","description":"ICD-KIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE0","description":"ICD-CFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88162","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12013","description":"Rpr f/e/e/n/l/m 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE0","description":"ICD-JAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUD1","description":"ICD-OJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0101","description":"HCPCS-A0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xray place prox ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75958","description":"Xray place prox ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC215","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 10 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1642","description":"Inj heparin sodium per 10 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 23+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP23","description":"Auto test panel pricing code_ 23+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87517","description":"Hepatitis b dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prol intubation req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8569","description":"Prol intubation req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD0","description":"ICD-GDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD0","description":"ICD-EDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC0","description":"ICD-EGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB1","description":"ICD-IEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD1","description":"ICD-KDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bso omentectomy w/tah","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58956","description":"Bso omentectomy w/tah","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47605","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig minidose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90385","description":"Rh ig minidose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 18-39","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99395","description":"Prev visit est age 18-39","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF1","description":"ICD-JDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extension drainage tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4331","description":"Extension drainage tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC31","description":"ICD-1JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stimulated iui case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4035","description":"Stimulated iui case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE0","description":"ICD-BEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2D","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA0","description":"ICD-CFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC0","description":"ICD-FBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2151","description":"Patients With Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Language screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5363","description":"Language screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB0","description":"ICD-BEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0912","description":"Hd trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC0","description":"ICD-BHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE1","description":"ICD-GILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC0","description":"ICD-AEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBE1","description":"ICD-MBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC43","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50574","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29825","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA1","description":"ICD-GHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37248","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opps/php; train & educ serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0177","description":"Opps/php; train & educ serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81422","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg_ DiGeorge syndrome_ Cri-du-chat syndrome)_ circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE1","description":"ICD-KFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9944","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Barrera sl or barrera dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4281","description":"Barrera sl or barrera dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB0","description":"ICD-MCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE126","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA1","description":"ICD-FHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger jnt add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26861","description":"Fusion of finger jnt add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41250","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE0","description":"ICD-FDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME1","description":"ICD-JDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD1","description":"ICD-CCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA0","description":"ICD-KGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA1","description":"ICD-CCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on eye; iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0121U","description":"Anesthesia for procedures on eye; iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF1","description":"ICD-OGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA1","description":"ICD-JIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8994","description":"Sub pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9626","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB1","description":"ICD-ODHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC0","description":"ICD-CHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA0","description":"ICD-NEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42972","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB1","description":"ICD-NJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57513","description":"Laser surgery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27428","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA0","description":"ICD-KIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB0","description":"ICD-BHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE1","description":"ICD-HHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reeva FT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4314","description":"Reeva FT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9788","description":"Opto-acoustic imaging_ breast (including axilla when performed)_ unilateral_ with image documentation_ analysis and report_obtained with ultrasound examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB0","description":"ICD-CCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22A","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA251","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE1","description":"ICD-MGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1036","description":"Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70130","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0315","description":"Immunization counseling by a physician or other qualified health care professional for COVID-19_ ages under 21_ 5-15 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA0","description":"ICD-GIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood freeze/thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86932","description":"Frozen blood freeze/thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB0","description":"ICD-EGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF1","description":"ICD-FIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scratch resistant coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2760","description":"Scratch resistant coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF1","description":"ICD-CEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB0","description":"ICD-BHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture screen only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87081","description":"Culture screen only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78429","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed)_ Single S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Balloon dilate urtrl strix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50706","description":"Balloon dilate urtrl strix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE0","description":"ICD-CBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF0","description":"ICD-KDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD1","description":"ICD-FCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC1","description":"ICD-IHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preop anes or proxy b/4 surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9497","description":"Preop anes or proxy b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC0","description":"ICD-OLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL15","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC1","description":"ICD-MEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC1","description":"ICD-JFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal contract stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59020","description":"Fetal contract stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB1","description":"ICD-KGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB1","description":"ICD-GEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE220","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36906","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB0","description":"ICD-OITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext amb infusn pump insulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0784","description":"Ext amb infusn pump insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA0","description":"ICD-CGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55605","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"JR GNOTYP ABCG2 EXONS 2-26","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0193U","description":"JR GNOTYP ABCG2 EXONS 2-26","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35371","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC1","description":"ICD-OHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl bat t.e.n.s. own by pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4630","description":"Repl bat t.e.n.s. own by pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE1","description":"ICD-CDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57335","description":"Repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA0","description":"ICD-MHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF0","description":"ICD-IEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB31","description":"ICD-3EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI brain done w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3111F","description":"CT/MRI brain done w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA1","description":"ICD-ICCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB1","description":"ICD-AHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB1","description":"ICD-CIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck t3-4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9110","description":"Onc dx head/neck t3-4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect back tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21936","description":"Resect back tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF1","description":"ICD-DESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD0","description":"ICD-CBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA0","description":"ICD-EDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE1","description":"ICD-PAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ziconotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2278","description":"Ziconotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Certolizumab pegol inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0717","description":"Certolizumab pegol inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9494","description":"Hit antibiotic total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD0","description":"ICD-CGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc abdm/per/oment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49329","description":"Laparo proc abdm/per/oment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD0","description":"ICD-DESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA1","description":"ICD-OKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain image 4+ views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78605","description":"Brain image 4+ views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50728","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt has docd immun to hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3515F","description":"Pt has docd immun to hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA33","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48145","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYC1","description":"ICD-DAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy lesion ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43229","description":"Esophagoscopy lesion ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA0","description":"ICD-HFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE0","description":"ICD-GCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenytoin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1165","description":"Phenytoin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF0","description":"ICD-JBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA0","description":"ICD-PGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD0","description":"ICD-EBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA1","description":"ICD-NECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD0","description":"ICD-FDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC0","description":"ICD-FCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC0","description":"ICD-BGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8I","description":"Low Rehab_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF1","description":"ICD-NAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA0","description":"ICD-FDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of ankle and/or ft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29540","description":"Strapping of ankle and/or ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC1","description":"ICD-MKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic fine wire emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96003","description":"Dynamic fine wire emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37202","description":"Transcatheter therapy_ infusion other than for thrombolysis_ any type (eg_ spasmolytic_ vasoconstrictive)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1749","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","description":"HCPCS-J1749","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB1","description":"ICD-MCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC1","description":"ICD-JDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34711","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm_ false aneurysm_ dissection_ endoleak_ or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid check one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92592","description":"Hearing aid check one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monosuspension arm/hand supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2630","description":"Monosuspension arm/hand supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED1","description":"ICD-ABED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair mngment training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97542","description":"Wheelchair mngment training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc ot assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0158","description":"Hhc ot assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55865","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8E","description":"Medium Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB241","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69910","description":"Remove inner ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27441","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF1","description":"ICD-OARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27830","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52284","description":"Cystourethroscopy_ with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis_ male_ including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual acuity screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99173","description":"Visual acuity screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB0","description":"ICD-BEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7612","description":"Levalbuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp prob 1+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87501","description":"Influenza dna amp prob 1+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB0","description":"ICD-AGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0490","description":"Face-To-Face Hh Nsg Vst Rhc/Fqhc Area Shtg Hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex 1 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87274","description":"Herpes simplex 1 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFA0","description":"ICD-CFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB11","description":"ICD-1LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair pul venous stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33726","description":"Repair pul venous stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","description":"CPT-01260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splice spleen/kidney veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37181","description":"Splice spleen/kidney veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD1","description":"ICD-NLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA0","description":"ICD-JCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE1","description":"ICD-KGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA31","description":"ICD-2AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF0","description":"ICD-NCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB1","description":"ICD-IECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC31","description":"ICD-2KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmnioTX_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4324","description":"AmnioTX_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain breast lesion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19001","description":"Drain breast lesion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB140","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE0","description":"ICD-JCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF1","description":"ICD-BCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE0","description":"ICD-DCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB0","description":"ICD-MHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE1","description":"ICD-OLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE0","description":"ICD-DGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immed max part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5221","description":"Immed max part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"KEL GNOTYP KEL EXON 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0194U","description":"KEL GNOTYP KEL EXON 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Car seat/bed test 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94780","description":"Car seat/bed test 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB230","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8A","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25240","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD0","description":"ICD-NBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC0","description":"ICD-CCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB0","description":"ICD-OCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj subq impltbl dfb elctrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33271","description":"Insj subq impltbl dfb elctrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE1","description":"ICD-IECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF1","description":"ICD-NLVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB0","description":"ICD-GIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of uterus lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58100","description":"Biopsy of uterus lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace chest compress vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7025","description":"Replace chest compress vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB0","description":"ICD-EITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD0","description":"ICD-MFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPC0","description":"ICD-BHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cath repair kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5518","description":"Hit cath repair kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC1","description":"ICD-BBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF1","description":"ICD-JEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create passage to kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52334","description":"Create passage to kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe suscept macrobroth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87188","description":"Microbe suscept macrobroth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0313U","description":"Oncology (pancreas)_ DNA and mRNA next-generation sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression_ pancreatic cyst fluid_ algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE0","description":"ICD-JGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC21","description":"ICD-1GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC1","description":"ICD-DEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE1","description":"ICD-PHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rsect hip tum incl femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27078","description":"Rsect hip tum incl femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF0","description":"ICD-OKWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL14","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA0","description":"ICD-DDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8699","description":"Re-Cement Or Re-Bond Fixed Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9394","description":"Injection_ fulvestrant (fresenius kabi) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treponema pallidum ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87285","description":"Treponema pallidum ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unsched dialysis esrd pt hos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0257","description":"Unsched dialysis esrd pt hos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38225","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","description":"CPT-38225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast noble metal inlay 2 sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6606","description":"Cast noble metal inlay 2 sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA13","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA0","description":"ICD-FCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","description":"CPT-98012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB1","description":"ICD-OKGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB0","description":"ICD-FHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA1","description":"ICD-PJSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA0","description":"ICD-JBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB1","description":"ICD-ABAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF1","description":"ICD-KEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0056U","description":"Hematology (acute myelogenous leukemia)_ DNA_ whole genome next-generation sequencing to detect gene rearrangement(s)_ blood or bone marrow_ report of specific gene rearrangem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41100","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0842","description":"Pwc gp2 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA1","description":"ICD-GHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE1","description":"ICD-OHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEC0","description":"ICD-FCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE0","description":"ICD-OLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81375","description":"Hla ii typing ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS or NRAS) gene mutation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9843","description":"RAS (KRAS or NRAS) gene mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza a ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87276","description":"Influenza a ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc active inj drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9518","description":"Doc active inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE0","description":"ICD-CACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA1","description":"ICD-OGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE0","description":"ICD-CEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC0","description":"ICD-CDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA0","description":"ICD-KBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE0","description":"ICD-MCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33465","description":"Replace tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB150","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8090","description":"Compre dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND1","description":"ICD-JAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA0","description":"ICD-NGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD0","description":"ICD-NBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00848","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","description":"CPT-00848","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND1","description":"ICD-ODND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB0","description":"ICD-JFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/fast/dir lab ldl-c >190","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9675","description":"Pt w/fast/dir lab ldl-c >190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF1","description":"ICD-GHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282U","description":"Red blood cell antigen typing_ DNA_ genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes (Versiti™ Red Cell Genotyping Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97001","description":"Pt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0079","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53420","description":"Reconstruct urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE0","description":"ICD-GIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD1","description":"ICD-DBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF0","description":"ICD-ODVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC1","description":"ICD-OLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5286","description":"Removable Unilateral Partial Denture - One Piece Resin - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD1","description":"ICD-CGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE1","description":"ICD-MAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB0","description":"ICD-PDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27676","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Teflon or equal cable lining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6665","description":"Teflon or equal cable lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA0","description":"ICD-BHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD1","description":"ICD-FCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","description":"CPT-00210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6700","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","description":"HCPCS-L6700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXF1","description":"ICD-KEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA0","description":"ICD-DHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8B","description":"Low Rehab_ ADL Index 0-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF0","description":"ICD-EFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42180","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB0","description":"ICD-CDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA1","description":"ICD-MLEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF1","description":"ICD-JDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA1","description":"ICD-OHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-heu tc-99m add-on/dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9969","description":"Non-heu tc-99m add-on/dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFA1","description":"ICD-GFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB0","description":"ICD-CIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dent therapeutic drug inject","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9610","description":"Dent therapeutic drug inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1332","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68750","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE0","description":"ICD-PGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0942T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","description":"CPT-0942T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD1","description":"ICD-OJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE1","description":"ICD-GASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot press off load supp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9283","description":"Foot press off load supp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Single transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26553","description":"Single transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF1","description":"ICD-HCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD1","description":"ICD-OLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tourniquet for dialysis_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4929","description":"Tourniquet for dialysis_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","description":"HCPCS-A2037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE0","description":"ICD-MAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC0","description":"ICD-ADLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB0","description":"ICD-NAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE0","description":"ICD-CFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB1","description":"ICD-NCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKE0","description":"ICD-NEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML45","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove mastoid air cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69670","description":"Remove mastoid air cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB26","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC250","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE1","description":"ICD-MKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXD0","description":"ICD-NAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB1","description":"ICD-KFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroestradiol f18_ diagnostic_ 1 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9060","description":"Fluoroestradiol f18_ diagnostic_ 1 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE0","description":"ICD-PIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE1","description":"ICD-FBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB1","description":"ICD-GFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD0","description":"ICD-NHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE0","description":"ICD-AFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC0","description":"ICD-BBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office visit after hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9440","description":"Office visit after hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE1","description":"ICD-NBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF0","description":"ICD-NLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84586","description":"Assay of vip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA0","description":"ICD-NICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA0","description":"ICD-KFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF1","description":"ICD-NJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGD1","description":"ICD-BDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpower mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0371","description":"Nonpower mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise tendon forearm/wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25109","description":"Excise tendon forearm/wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glasses air conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5070","description":"Glasses air conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD1","description":"ICD-KFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC56","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA0","description":"ICD-GICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80340","description":"Antiepileptics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alerting device_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5269","description":"Alerting device_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB1","description":"ICD-CIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of brain tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61545","description":"Excision of brain tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD0","description":"ICD-IDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF1","description":"ICD-EAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7327","description":"Monovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","description":"HCPCS-M1410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36456","description":"Partial exchange transfusion_ blood_ plasma or crystalloid necessitating the skill of a physician or other qualified health care professional_ newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC31","description":"ICD-4FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF1","description":"ICD-OBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft t/a/l addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15151","description":"Cult skin grft t/a/l addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81354","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","description":"CPT-81354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB0","description":"ICD-BAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECB0","description":"ICD-FECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23532","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB11","description":"ICD-4CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBA0","description":"ICD-JBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC1","description":"ICD-GAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC1","description":"ICD-NDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD1","description":"ICD-OJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81285","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED1","description":"ICD-EGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA0","description":"ICD-IEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion ball br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2090","description":"Hkafo unilat torsion ball br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC0","description":"ICD-JIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD0","description":"ICD-MKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0019","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC1","description":"ICD-KICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE1","description":"ICD-LIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD0","description":"ICD-MBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC0","description":"ICD-GHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJB1","description":"ICD-JDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA0","description":"ICD-FFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE1","description":"ICD-GDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA0","description":"ICD-CCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ sculptra_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2028","description":"Inj_ sculptra_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oseltamivir phosp_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9035","description":"Oseltamivir phosp_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trichogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96902","description":"Trichogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9974","description":"Dilated macular exam performed_ including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degenerat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC0","description":"ICD-KEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot external keel sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5970","description":"Foot external keel sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc (colorectal)_ quant assess of three urine metabolites by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002U","description":"Onc (colorectal)_ quant assess of three urine metabolites by liq chromatography w tandem mass spectro (LC-MS/MS) using multireaction monitoring acquisition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB0","description":"ICD-ODAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94690","description":"Exhaled air analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD1","description":"ICD-KEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rocking bed w/ or w/o side r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0462","description":"Rocking bed w/ or w/o side r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59510","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caster pin lock each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0073","description":"Caster pin lock each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental prophylaxis adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1110","description":"Dental prophylaxis adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0434","description":"Portable liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF1","description":"ICD-BCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34709","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or ili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF0","description":"ICD-CFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8020","description":"Mastectomy form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardioassist external","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92971","description":"Cardioassist external","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF0","description":"ICD-CALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB1","description":"ICD-NAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1325","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g._ inadequate time for follow-up_ patients who received a prior intravitreal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cover bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5704","description":"Custom shape cover bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOF0","description":"ICD-ODOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5B","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA1","description":"ICD-LIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF0","description":"ICD-OAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1035","description":"Adults who are deliberately phased out of medication assisted treatment (MAT) prior to 180 days of continuous treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE0","description":"ICD-GDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC0","description":"ICD-NBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine maleate 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0164","description":"Prochlorperazine maleate 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC1","description":"ICD-NCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","description":"CPT-00215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Padding for comprssn bdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8430","description":"Padding for comprssn bdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE1","description":"ICD-CBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of silica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84285","description":"Assay of silica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC1","description":"ICD-BFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ retifanlimab-dlwr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9345","description":"Injection_ retifanlimab-dlwr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1101","description":"HCPCS-A1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78800","description":"Tumor imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA12","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flexible brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43200","description":"Esophagoscopy flexible brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conductive gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4558","description":"Conductive gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC1","description":"ICD-GDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE0","description":"ICD-PARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43045","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC1","description":"ICD-OLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA1","description":"ICD-GBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWB0","description":"ICD-GBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of tibia epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27730","description":"Repair of tibia epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE1","description":"ICD-LDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94774","description":"Ped home apnea rec compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have had a hysterectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9774","description":"Patients who have had a hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465T","description":"Suprachoroidal injection of a pharmacologic agent (does not include supply of medication)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38129","description":"Laparoscope proc spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26650","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD1","description":"ICD-GFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0D","description":"Very High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80304","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0222","description":"IV Injection_ bebtelovimab_ includes injection and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1403","description":"HCPCS-B1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64742","description":"Incision of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost sknbar w/o conv<=4 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4414","description":"Ost sknbar w/o conv<=4 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0515U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","description":"CPT-0515U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYD0","description":"ICD-LFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF0","description":"ICD-BCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB0","description":"ICD-JGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD1","description":"ICD-MKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22860","description":"Total disc arthroplasty (artificial disc)_ anterior approach_ including discectomy to prepare interspace (other than for decompression); second interspace_ lumbar (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA1","description":"ICD-ODLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Txmnts 2 phys/qhp by 1 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5020F","description":"Txmnts 2 phys/qhp by 1 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB146","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC1","description":"ICD-PHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC0","description":"ICD-AAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC1","description":"ICD-NHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA1","description":"ICD-IHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplj hematopoietic boost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38243","description":"Transplj hematopoietic boost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Male external catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4326","description":"Male external catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1005","description":"Clinical Decision Support Mechanism National Imaging Associates_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF1","description":"ICD-EFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90889","description":"Preparation of report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA11","description":"ICD-1DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53270","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40251","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDE0","description":"ICD-CEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic intern lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6350","description":"Thoracic intern lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE1","description":"ICD-KIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGD1","description":"ICD-NKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB1","description":"ICD-OHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reloc skin pocket pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416T","description":"Reloc skin pocket pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD1","description":"ICD-OEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA0","description":"ICD-ODDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB1","description":"ICD-IGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE0","description":"ICD-OBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coccidioidomycosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86490","description":"Coccidioidomycosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD230","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE110","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28118","description":"Removal of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53621","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6576","description":"Gradient compression arm sleeve_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enlargemnt of eye prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2625","description":"Enlargemnt of eye prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENF0","description":"ICD-KENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE0","description":"ICD-OFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37263","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","description":"CPT-37263","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB1","description":"ICD-HISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC1","description":"ICD-GIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF0","description":"ICD-KICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF0","description":"ICD-HCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/medstnl bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39401","description":"Mediastinoscpy w/medstnl bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC0","description":"ICD-CIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2A","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE0","description":"ICD-JILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF1","description":"ICD-GHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1269","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB1","description":"ICD-NBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0105","description":"HCPCS-B0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31601","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFB0","description":"ICD-GGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2079","description":"Take-Home Supply Of Buprenorphine (Oral); Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB0","description":"ICD-FEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB1","description":"ICD-BHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA0","description":"ICD-NHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35875","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA0","description":"ICD-PISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us guide tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76940","description":"Us guide tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB1","description":"ICD-OBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast high noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2790","description":"Crown full cast high noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lamellas xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4291","description":"Lamellas xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA1","description":"ICD-IFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE0","description":"ICD-BIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lidocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80176","description":"Assay of lidocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54430","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD1","description":"ICD-NIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD1","description":"ICD-IHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0948T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","description":"CPT-0948T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE0","description":"ICD-OKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA0","description":"ICD-JFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB150","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE1","description":"ICD-JBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE0","description":"ICD-GGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8686","description":"Implt nrostm pls gen sng non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID1","description":"ICD-AEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA0","description":"ICD-JGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE0","description":"ICD-JDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB0","description":"ICD-NKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67445","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD0","description":"ICD-OBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF0","description":"ICD-CFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC0","description":"ICD-FBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0045U","description":"Oncology (breast ductal carcinoma in situ)_ mRNA_ gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla open reduct simple","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7610","description":"Maxilla open reduct simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5B","description":"Default_ /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BellaCell HD or Surederm_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4220","description":"BellaCell HD or Surederm_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD0","description":"ICD-NALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL25","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472T","description":"Device evaluation_ interrogation_ and initial programming of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ with iterative adjustment of the implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF0","description":"ICD-OKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motion test w/ft press meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96001","description":"Motion test w/ft press meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC1","description":"ICD-NIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD1","description":"ICD-NLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA0","description":"ICD-FDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA0","description":"ICD-CDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1225","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA1","description":"ICD-MDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD1","description":"ICD-OCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF0","description":"ICD-HFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80336","description":"Antidepressant tricyclic 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57220","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66740","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE0","description":"ICD-MATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile duct dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74363","description":"X-ray bile duct dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRA1","description":"ICD-PCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD221","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99223","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD0","description":"ICD-KFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF1","description":"ICD-OJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","description":"HCPCS-Q4373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2149","description":"Documentation Of Medical Reason(S) For Not Using Multimodal Pain Management (E.G._ Allergy To Multiple Classes Of Analgesics_ Intubated Patient_ Hepatic Failure_ Patient Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATA1","description":"ICD-GATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHD1","description":"ICD-NFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA0","description":"ICD-OGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC0","description":"ICD-OFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cholinesterase challenge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95857","description":"Cholinesterase challenge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC1","description":"ICD-JGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB1","description":"ICD-PIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-1 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21141","description":"Lefort i-1 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0480","description":"Cytopath smear prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0553U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","description":"CPT-0553U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF1","description":"ICD-JBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant trans coil repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8617","description":"Coch implant trans coil repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62305","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF0","description":"ICD-OGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraction coronal remnants","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7111","description":"Extraction coronal remnants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF0","description":"ICD-KFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis be antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86707","description":"Hepatitis be antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD0","description":"ICD-NEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB1","description":"ICD-IFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC254","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC1","description":"ICD-MGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0402","description":"CDT-D0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF0","description":"ICD-HAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74742","description":"X-ray fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE1","description":"ICD-FFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF0","description":"ICD-FDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-H0052","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","description":"HCPCS-H0052","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro/pos cus<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2624","description":"Adj skin pro/pos cus<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC1","description":"ICD-KHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko w/adj jt rot cntrl molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1844","description":"Ko w/adj jt rot cntrl molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME0","description":"ICD-KEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA0","description":"ICD-HGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD0","description":"ICD-OFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB1","description":"ICD-OBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"H2o stat docd dehydrated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2031F","description":"H2o stat docd dehydrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE0","description":"ICD-FHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24579","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procenta_ per 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4244","description":"Procenta_ per 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33866","description":"Aortic hemiarch graft including isolation and control of the arch vessels_ beveled open distal aortic anastomosis extending under one or more of the arch vessels_ and total ci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac fb remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32658","description":"Thoracoscopy w/sac fb remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB46","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repriza_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4143","description":"Repriza_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27245","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD0","description":"ICD-IDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA1","description":"ICD-BDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4023","description":"Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Refitting of obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5933","description":"Refitting of obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA1","description":"ICD-LIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD1","description":"ICD-GBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBC1","description":"ICD-IIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98004","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","description":"CPT-98004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of chloramphenicol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82415","description":"Assay of chloramphenicol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB1","description":"ICD-FAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cushioned headrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0955","description":"Cushioned headrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Silicone gel insert or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6692","description":"Silicone gel insert or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD0","description":"ICD-NKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2119","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC0","description":"ICD-OHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF1","description":"ICD-OKSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF1","description":"ICD-DFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL35","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC0","description":"ICD-AIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE0","description":"ICD-JCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9949","description":"Repair of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88199","description":"Cytopathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"History of preoperative posterior capsule rupture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9759","description":"History of preoperative posterior capsule rupture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0019","description":"Community health integration services performed by certified or trained auxiliary personnel_ including a community health worker_ under the direction of a physician or other p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cva lumen obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75902","description":"Remove cva lumen obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE0","description":"ICD-KBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA1","description":"ICD-KBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44626","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Large size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0041","description":"Large size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61581","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA42","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB41","description":"Low Rehab_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vedolizumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80280","description":"Vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","description":"CPT-00938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF0","description":"ICD-FFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC0","description":"ICD-ABIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE0","description":"ICD-GFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMD1","description":"ICD-NKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD1","description":"ICD-GEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft f/n/hf/g add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15136","description":"Derm autograft f/n/hf/g add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92934","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE0","description":"ICD-OLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE0","description":"ICD-NDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE1","description":"ICD-FIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE1","description":"ICD-FADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF0","description":"ICD-NIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME0","description":"ICD-OGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYD0","description":"ICD-GIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit new patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0466","description":"Fqhc visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYB0","description":"ICD-LHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE0","description":"ICD-IEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC0","description":"ICD-ODCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o preop order iv ab pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8918","description":"Pt w/o preop order iv ab pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Additional spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22585","description":"Additional spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA1","description":"ICD-GCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD1","description":"ICD-KDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF0","description":"ICD-PCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj suprascapular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64418","description":"N block inj suprascapular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB1","description":"ICD-EAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD120","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF0","description":"ICD-HEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC0","description":"ICD-OBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00862","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","description":"CPT-00862","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA1","description":"ICD-FAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD1","description":"ICD-MHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD1","description":"ICD-BAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/bx & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31536","description":"Laryngoscopy w/bx & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA1","description":"ICD-GFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDND0","description":"ICD-FDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15821","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB1","description":"ICD-GFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE1","description":"ICD-JBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect femur/knee tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27365","description":"Resect femur/knee tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9088","description":"Instillation_ Bupivacaine And Meloxicam_ 1 Mg/0.03 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation supply sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4397","description":"Irrigation supply sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90639","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90639","description":"CPT-90639","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2110","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA0","description":"ICD-GBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD0","description":"ICD-FHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC117","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNF1","description":"ICD-BGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis bra & form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8001","description":"Breast prosthesis bra & form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA1","description":"ICD-OCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD0","description":"ICD-JEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC220","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC0","description":"ICD-NJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA0","description":"ICD-KETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1004","description":"HCPCS-B1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD1","description":"ICD-CCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXC0","description":"ICD-CDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC0","description":"ICD-NCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF1","description":"ICD-BFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC1","description":"ICD-IHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA1","description":"ICD-JECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD0","description":"ICD-JGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC0","description":"ICD-JHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43831","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERA0","description":"ICD-KERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix/repair pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57545","description":"Remove cervix/repair pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco non-user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1036F","description":"Tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA1","description":"ICD-KHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD1","description":"ICD-DEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA1","description":"ICD-GCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF1","description":"ICD-KHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD0","description":"ICD-MFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0718T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance_ unilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC144","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD1","description":"ICD-IIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43810","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD0","description":"ICD-BDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF1","description":"ICD-GGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj occipital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64405","description":"N block inj occipital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB0","description":"ICD-MAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of bronchus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31770","description":"Repair/graft of bronchus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytomegalovirus dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87271","description":"Cytomegalovirus dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of arm infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73092","description":"X-ray exam of arm infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF1","description":"ICD-CHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA1","description":"ICD-CIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC24","description":"High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC36","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF0","description":"ICD-MDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 loc hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81382","description":"Hla ii typing 1 loc hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE116","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow up home visit/prental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1004","description":"Follow up home visit/prental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB0","description":"ICD-IBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFD1","description":"ICD-JEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA1","description":"ICD-OBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD0","description":"ICD-GDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ piperacillin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0081","description":"Injection_ piperacillin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA0","description":"ICD-NBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5450","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE1","description":"ICD-OCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD0","description":"ICD-KABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC1","description":"ICD-CFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electric breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0603","description":"Electric breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0464","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with non-invasive interface (e.g. mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB0","description":"ICD-CHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic salivary reflex s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0755","description":"Electronic salivary reflex s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD0","description":"ICD-KCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97552","description":"Group caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165U","description":"Peanut allergen specific IgE and quantitative assessment of 64 epitopes using enzyme-linked immunosorbent assay (ELISA)_ blood_ individual epitope results and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5147","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","description":"HCPCS-Q5147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2561","description":"Injection_ phenobarbital sodium (sezaby)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferential stim 2 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8130","description":"Interferential stim 2 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB1","description":"ICD-BBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34701","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Memory goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9169","description":"Memory goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87798","description":"Detect agent nos dna amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBB1","description":"ICD-FGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest compression gen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0483","description":"Chest compression gen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC1","description":"ICD-AHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amikacin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0278","description":"Amikacin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical chemistry test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84999","description":"Clinical chemistry test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess hghlymalig doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3345F","description":"Mammo assess hghlymalig doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneum drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2381","description":"Pneum drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES213","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWF1","description":"ICD-OKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp multidisipln evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2000","description":"Comp multidisipln evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comb art/venous blood tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4755","description":"Comb art/venous blood tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD0","description":"ICD-CEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA1","description":"ICD-LCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD0","description":"ICD-JIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specialized Medical Equipment and Supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0137","description":"Specialized Medical Equipment and Supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA07","description":"Ultra High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24685","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC1","description":"ICD-NBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF1","description":"ICD-EFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue to lip surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41510","description":"Tongue to lip surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB0","description":"ICD-OEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9439","description":"P2y inhib not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC0","description":"ICD-IFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0562U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","description":"CPT-0562U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144A","description":"IMM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD0","description":"ICD-EGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27734","description":"Repair lower leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF0","description":"ICD-JECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC1","description":"ICD-MDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB1","description":"ICD-KBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF0","description":"ICD-KIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB0","description":"ICD-OGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD1","description":"ICD-EGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD1","description":"ICD-HGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE0","description":"ICD-PHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81171","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5930","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5930","description":"CDT-D5930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj dobutamine hcl/250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1250","description":"Inj dobutamine hcl/250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC1","description":"ICD-AIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0549","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","description":"HCPCS-G0549","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66720","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2069","description":"Medication Assisted Treatment_ Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA0","description":"ICD-CCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA0","description":"ICD-OBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX06","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99404","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25065","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool non-portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1310","description":"Whirlpool non-portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD0","description":"ICD-MCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59812","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0062U","description":"Autoimmune (systemic lupus erythematosus)_ IgG and IgM analysis of 80 biomarkers_ utilizing serum_ algorithm reported with a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE1","description":"ICD-OCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC0","description":"ICD-DAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0892T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent motor threshold re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy ureterolithotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50945","description":"Laparoscopy ureterolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD1","description":"ICD-NDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA0","description":"ICD-NJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA1","description":"ICD-JCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens gas permeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2531","description":"Contact lens gas permeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES346","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27580","description":"Fusion of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC0","description":"ICD-GBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25355","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF1","description":"ICD-MBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUB0","description":"ICD-OJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA0","description":"ICD-FELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph fundoplasty thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43328","description":"Esoph fundoplasty thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA1","description":"ICD-FITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD0","description":"ICD-DBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD0","description":"ICD-GBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE0","description":"ICD-BEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA1","description":"ICD-LAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Barbiturates_ not elsewhere specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6043","description":"Barbiturates_ not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC1","description":"ICD-GCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA1","description":"ICD-OCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx incubj drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86975","description":"Rbc serum pretx incubj drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psysoc rehab svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2018","description":"Psysoc rehab svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kcentra_ per i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9132","description":"Kcentra_ per i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME0","description":"ICD-NDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2351","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open aortoiliac prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34831","description":"Open aortoiliac prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD0","description":"ICD-OKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88012","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA0","description":"ICD-NCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD1","description":"ICD-OALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD1","description":"ICD-CAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1020","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at 12 months as demons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0711T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Preparation And Transmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenobarbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80184","description":"Assay of phenobarbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feed sup kit grav by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4036","description":"Enteral feed sup kit grav by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26105","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0954","description":"Wheelchair accessory_ foot box_ any type_ includes attachment and mounting hardware_ each foot.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF0","description":"ICD-NFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace high roll cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4060","description":"Replace high roll cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKD1","description":"ICD-JFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ramucirumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9308","description":"Injection_ ramucirumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-expandable controller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2375","description":"Non-expandable controller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE1","description":"ICD-IAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD1","description":"ICD-CCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF0","description":"ICD-NDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11971","description":"Remove tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44361","description":"Small bowel endoscopy/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv >=10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4194F","description":"Pt rcv >=10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF1","description":"ICD-JEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLD0","description":"ICD-EBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB0","description":"ICD-GGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/pat by hc prof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99366","description":"Team conf w/pat by hc prof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA0","description":"ICD-GGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB0","description":"ICD-FFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove external ear partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69110","description":"Remove external ear partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB0","description":"ICD-OEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA20","description":"High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYC0","description":"ICD-DBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2193","description":"Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB1","description":"ICD-AGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE0","description":"ICD-FHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE1","description":"ICD-KAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25525","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF1","description":"ICD-ACEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pml/raralpha 1 breakpoint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81316","description":"Pml/raralpha 1 breakpoint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procalcitonin (pct)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84145","description":"Procalcitonin (pct)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monoclonal antibodies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7505","description":"Monoclonal antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA1","description":"ICD-EGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78306","description":"Bone imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF1","description":"ICD-OGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx beta-lactam abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9558","description":"Tx beta-lactam abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0136","description":"Injection_ acetaminophen (b braun) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0201","description":"HCPCS-B0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1738","description":"Injection_ meloxicam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8H","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dsg<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6231","description":"Hydrogel dsg<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33966","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC0","description":"ICD-GBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0042","description":"Referral To Physical_ Occupational_ Speech_ Or Recreational Therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE1","description":"ICD-EILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD1","description":"ICD-PHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain 2 piece system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4426","description":"Ost pch drain 2 piece system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4038","description":"Vascular Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shank ft w vert load pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5987","description":"Shank ft w vert load pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35881","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC116","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bowel lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44111","description":"Excision of bowel lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0233","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","description":"HCPCS-M0233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTD0","description":"ICD-CCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD1","description":"ICD-HHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2C","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tildrakizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3245","description":"Injection_ tildrakizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF0","description":"ICD-PAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB1","description":"ICD-OLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC1","description":"ICD-OENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled breath condensate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83987","description":"Exhaled breath condensate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE113","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB1","description":"ICD-FAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelogphy 2/> spine regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72270","description":"Myelogphy 2/> spine regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAA0","description":"ICD-ABAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF1","description":"ICD-OEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC0","description":"ICD-JFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD0","description":"ICD-PGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cutaquig)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1551","description":"Injection_ immune globulin (Cutaquig)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 5-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99393","description":"Prev visit est age 5-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE1","description":"ICD-MLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB1","description":"ICD-EHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD0","description":"ICD-NDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 15 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175U","description":"PSYC GEN ALYS PANEL 15 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0903","description":"HCPCS-C0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9975","description":"Documentation of medical reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD1","description":"ICD-GDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD1","description":"ICD-MHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA1","description":"ICD-KDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD0","description":"ICD-NFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77402","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF1","description":"ICD-FIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDF1","description":"ICD-NBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF1","description":"ICD-PLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB1","description":"ICD-GFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB0","description":"ICD-KDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1242","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rabies vaccine id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90676","description":"Rabies vaccine id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85044","description":"Manual reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE0","description":"ICD-MGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFA0","description":"ICD-OKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD0","description":"ICD-EAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF1","description":"ICD-IADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE0","description":"ICD-EBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cylinder tank carrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2208","description":"Cylinder tank carrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRA1","description":"ICD-OBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF1","description":"ICD-GDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0815T","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (REMS)_ bone-density study and fracture-risk assessment_ 1 or more sites_ hips_ pelvis_ or spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB1","description":"ICD-EILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastro/jejuno tube_ low-pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4088","description":"Gastro/jejuno tube_ low-pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF0","description":"ICD-MIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB1","description":"ICD-CAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endo perq dx w/speci","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47552","description":"Biliary endo perq dx w/speci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE0","description":"ICD-MKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29907","description":"Subtalar arthro w/fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME0","description":"ICD-EHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD1","description":"ICD-GBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD1","description":"ICD-BBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of hydroxyapatite regeneration medicament - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2991","description":"Application of hydroxyapatite regeneration medicament - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE0","description":"ICD-GDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB1","description":"ICD-OKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27200","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF0","description":"ICD-GHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF0","description":"ICD-ODXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue not image intraop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8874","description":"Tissue not image intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12017","description":"Rpr fe/e/en/l/m 20.1-30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect tarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28171","description":"Resect tarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA1","description":"ICD-OEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD0","description":"ICD-NJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA1","description":"ICD-NBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA1","description":"ICD-CGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE1","description":"ICD-KACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8697","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8697","description":"HCPCS-L8697","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB0","description":"ICD-AHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOC0","description":"ICD-GIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOA1","description":"ICD-KAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special eye exam subsequent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92226","description":"Special eye exam subsequent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF0","description":"ICD-OKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42842","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bedside drainage bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4357","description":"Bedside drainage bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF0","description":"ICD-CFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad pump ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33981","description":"Replace vad pump ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF0","description":"ICD-CIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9984","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96111","description":"Developmental testing_ (includes assessment of motor_ language_ social_ adaptive_ and/or cognitive functioning by standardized developmental instruments) with interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE1","description":"ICD-CDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC11","description":"ICD-3IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of scrotum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55120","description":"Removal of scrotum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTC0","description":"ICD-ADTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD1","description":"ICD-ACBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repr per/vag pouch sngl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46710","description":"Repr per/vag pouch sngl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA135","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD0","description":"ICD-NDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD224","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEA1","description":"ICD-CAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE0","description":"ICD-NICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA0","description":"ICD-ODVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1A","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0565T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Tissue Harvesting And Cellular Implant Creation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4090F","description":"Pt rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb blker <3mos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4481F","description":"Pt rcvng ace/arb blker <3mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD0","description":"ICD-BBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC1","description":"ICD-OBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29435","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA0","description":"ICD-OFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF1","description":"ICD-NLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","description":"HCPCS-J1809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE0","description":"ICD-CIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78428","description":"Cardiac shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon beta-1a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1826","description":"Interferon beta-1a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMC0","description":"ICD-MKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD1","description":"ICD-FCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair with detacharm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0165","description":"Commode chair with detacharm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7613","description":"Albuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corplex_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4232","description":"Corplex_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70380","description":"X-ray exam of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15130","description":"Derm autograft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0654T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with insertion of intraluminal tube or catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE1","description":"ICD-FFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE0","description":"ICD-JAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB0","description":"ICD-MJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF0","description":"ICD-LGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF1","description":"ICD-CHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA1","description":"ICD-JFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj tbo filgrastim 1 microg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1447","description":"Inj tbo filgrastim 1 microg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE1","description":"ICD-AITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB1","description":"ICD-FCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC1","description":"ICD-OGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF0","description":"ICD-PCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND0","description":"ICD-GDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Taking statin or recd order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9664","description":"Taking statin or recd order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1034","description":"Provision of COVID-19 test_ nonprescription self-administered and self-collected use_ FDA approved_ authorized or cleared_ one test count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE0","description":"ICD-AGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA0","description":"ICD-LHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE0","description":"ICD-CBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEC1","description":"ICD-KEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC156","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4334","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","description":"HCPCS-Q4334","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87810","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Chlamydia trachomatis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy comp/disp serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9430","description":"Pharmacy comp/disp serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA246","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB0","description":"ICD-CIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB1","description":"ICD-OAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF0","description":"ICD-KHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE1","description":"ICD-LDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Color vision examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92283","description":"Color vision examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0712T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Quantification Of The Structure And Composition O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB0","description":"ICD-OFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE0","description":"ICD-JFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC1","description":"ICD-JHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC1","description":"ICD-CISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA54","description":"Default_ /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE1","description":"ICD-OCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC0","description":"ICD-PBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urea nitrogen semi-quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84525","description":"Urea nitrogen semi-quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26562","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Primary closure sinus perf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7261","description":"Primary closure sinus perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC31","description":"ICD-4KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC1","description":"ICD-GIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incontinent rectal insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4337","description":"Incontinent rectal insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF0","description":"ICD-GGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB20","description":"High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB244","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD0","description":"ICD-NICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA1","description":"ICD-OJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhs/hospice of rn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0299","description":"Hhs/hospice of rn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA1","description":"ICD-OALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQC1","description":"ICD-GAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA1","description":"ICD-CFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33280","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oritavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2407","description":"Injection_ oritavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD0","description":"ICD-GBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74430","description":"Contrast x-ray bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Singl visn sphere 7.12-20.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2102","description":"Singl visn sphere 7.12-20.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2004","description":"HCPCS-B2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF0","description":"ICD-GBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87183","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","description":"CPT-87183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA1","description":"ICD-IBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert semi-rigid prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54400","description":"Insert semi-rigid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncoprotein her-2/neu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83950","description":"Oncoprotein her-2/neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB0","description":"ICD-NJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF0","description":"ICD-NJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screen cerv/vag thin layer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0123","description":"Screen cerv/vag thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND0","description":"ICD-GFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE0","description":"ICD-ECUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA0","description":"ICD-OLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB1","description":"ICD-KBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6003","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB1","description":"ICD-FDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc harness_ expand control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2313","description":"Pwc harness_ expand control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma fresh frozen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86927","description":"Plasma fresh frozen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 11 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP11","description":"Auto.test pane pricing code_ 11 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8624","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor_ ear level_ replacement_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC1","description":"ICD-CFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonfamily homecare train/15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5115","description":"Nonfamily homecare train/15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA1","description":"ICD-CIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC0","description":"ICD-IHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44363","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98979","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","description":"CPT-98979","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analysis of saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0418","description":"Analysis of saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB0","description":"ICD-BIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC1","description":"ICD-JHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ear impression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5275","description":"Ear impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home std case rate 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0270","description":"Home std case rate 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0974","description":"Tlso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0882","description":"Darbepoetin alfa_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67911","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB1","description":"ICD-EEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAF0","description":"ICD-JDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE0","description":"ICD-BCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE1","description":"ICD-NJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plan 2 main dr by 1 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5050F","description":"Plan 2 main dr by 1 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC1","description":"ICD-KDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE0","description":"ICD-CETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB21","description":"ICD-2KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose ped/adol im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90744","description":"Hepb vacc 3 dose ped/adol im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93784","description":"Ambulatory bp monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc w burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8908","description":"Pt doc w burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2005","description":"HCPCS-B2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83788","description":"Mass spectrometry and tandem mass spectrometry (ms_ ms/ms)_ analyte notelsewhere specified; qualitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC1","description":"ICD-OJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-47384","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","description":"CPT-47384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB0","description":"ICD-CDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC0","description":"ICD-CBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0401","description":"HCPCS-B0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB0","description":"ICD-GHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE0","description":"ICD-MLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth blepharoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10351","description":"Anesth blepharoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA0","description":"ICD-OJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Renal function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80069","description":"Renal function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc iliac repr w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34900","description":"Endovasc iliac repr w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB0","description":"ICD-CDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - motivational interviewing","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9993","description":"Dental case management - motivational interviewing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIE1","description":"ICD-EBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic donning sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7600","description":"Prosthetic donning sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo cap design w/o jnt cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3975","description":"Sewhfo cap design w/o jnt cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC1","description":"ICD-AEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA1","description":"ICD-BCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME0","description":"ICD-JGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF1","description":"ICD-ABLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA41","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQF0","description":"ICD-LHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt below e/w disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6883","description":"Replc sockt below e/w disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB1","description":"ICD-CCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","description":"HCPCS-Q4370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPC0","description":"ICD-BFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD1","description":"ICD-GIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD0","description":"ICD-JGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD0","description":"ICD-CBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF0","description":"ICD-OHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD0","description":"ICD-CFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA1","description":"ICD-OAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49566","description":"Rerepair ventrl hern block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable liner/shield/pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4535","description":"Disposable liner/shield/pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine pregnancy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81025","description":"Urine pregnancy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB1","description":"ICD-CIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE0","description":"ICD-DBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68020","description":"Incise/drain eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA1","description":"ICD-BEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL14","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB0","description":"ICD-JEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF0","description":"ICD-GBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspiration orbital contents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67415","description":"Aspiration orbital contents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC0","description":"ICD-KCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80422","description":"Glucagon tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF1","description":"ICD-BAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB0","description":"ICD-DDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGD1","description":"ICD-GIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crisis interven waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2034","description":"Crisis interven waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE117","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID0","description":"ICD-IHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA0","description":"ICD-EDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD1","description":"ICD-EEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of metanephrines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83835","description":"Assay of metanephrines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKS","description":"late eposode 0-13 therapies_clinical severity level 1_ functional sererity level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15271","description":"Skin sub graft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD1","description":"ICD-OLGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB0","description":"ICD-JEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA1","description":"ICD-OKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not disch home day#2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8833","description":"Pt not disch home day#2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD0","description":"ICD-OGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11401","description":"Exc tr-ext b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA1","description":"ICD-KHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX51","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specialty care transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0434","description":"Specialty care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA0","description":"ICD-LCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA0","description":"ICD-FADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB0","description":"ICD-PFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1320","description":"Thoracic_ pectus carinatum orthosis_ sternal compression_ rigid circumferential frame with anterior and posterior rigid pads_ custom fabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA1","description":"ICD-JFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC11","description":"ICD-2EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27766","description":"Optx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF0","description":"ICD-DHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB1","description":"ICD-OJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osseous surgery per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4260","description":"Osseous surgery per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxacillin sodium injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2700","description":"Oxacillin sodium injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD234","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE1","description":"ICD-KGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX24","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal therapy posterior pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3240","description":"Pulpal therapy posterior pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair throat esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42953","description":"Repair throat esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA1","description":"ICD-PBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC0","description":"ICD-OKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB0","description":"ICD-CAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0872T","description":"Replacement of indwelling bladder and peritoneal catheters_ including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump_ including imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microcapillary tube sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4652","description":"Microcapillary tube sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC0","description":"ICD-IBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB1","description":"ICD-IELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hf mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8551","description":"Hf mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA1","description":"ICD-OABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB1","description":"ICD-OEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID0","description":"ICD-AGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1551","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev cardrehab qualcardevent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4510F","description":"Prev cardrehab qualcardevent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11750","description":"Removal of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abrasion lesion single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15786","description":"Abrasion lesion single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee disart_ sach ft_ endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5312","description":"Knee disart_ sach ft_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35879","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC1","description":"ICD-GHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA32","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD0","description":"ICD-JFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62291","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB0","description":"ICD-OIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67930","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308U","description":"Cardiology (coronary artery disease [CAD])_ analysis of 3 proteins (high sensitivity [hs] troponin_ adiponectin_ and kidney injury molecule-1 [KIM-1])_ plasma_ algorithm repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD0","description":"ICD-OCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE1","description":"ICD-BFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maintenance 5% WL from baseline weight in months 7-12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9888","description":"Maintenance 5% WL from baseline weight in months 7-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF0","description":"ICD-NJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Report_ diabetes measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8485","description":"Report_ diabetes measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med serv eve/wkend/holiday","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99051","description":"Med serv eve/wkend/holiday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE0","description":"ICD-FGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna/rna hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87902","description":"Genotype dna/rna hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC1","description":"ICD-PCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB1","description":"ICD-HHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID1","description":"ICD-JCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB1","description":"ICD-MECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF1","description":"ICD-AGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYTOG CONST ALYS INTERROG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209U","description":"CYTOG CONST ALYS INTERROG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC1","description":"ICD-BBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF1","description":"ICD-CBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49429","description":"Removal of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE0","description":"ICD-CBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nesiritide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2325","description":"Nesiritide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26670","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF0","description":"ICD-HBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9682","description":"Onsite Ac Tx Nsg Fac Res W/Skn Inf Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB1","description":"ICD-NGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD0","description":"ICD-CCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90674","description":"Influenza virus vaccine_ quadrivalent (ccIIV4)_ derived from cell cultures_ subunit_ preservative and antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25630","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE0","description":"ICD-LIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1302","description":"CDT-D1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1004","description":"Pwr seat recline mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD0","description":"ICD-GIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9898","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC1","description":"ICD-DFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23140","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd endoscopic stent place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43266","description":"Egd endoscopic stent place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport lodgng recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0180","description":"Noner transport lodgng recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD126","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87804","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB1","description":"ICD-KGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC1","description":"ICD-GBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD1","description":"ICD-OIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33976","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC0","description":"ICD-NBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB1","description":"ICD-MDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB0","description":"ICD-EGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA1","description":"ICD-BHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC1","description":"ICD-ICTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig bmi calculation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8422","description":"Pt inelig bmi calculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6523","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFD1","description":"ICD-FDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral stomach tube levine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4083","description":"Enteral stomach tube levine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB1","description":"ICD-NBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF0","description":"ICD-NBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust max prost appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5992","description":"Adjust max prost appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD1","description":"ICD-OGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC0","description":"ICD-FGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC1","description":"ICD-GFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD0","description":"ICD-GIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB0","description":"ICD-KHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUA0","description":"ICD-GCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE0","description":"ICD-EDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB0","description":"ICD-AFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC0","description":"ICD-BGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA1","description":"ICD-OIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB1","description":"ICD-FGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1737","description":"HCPCS-C1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of chin nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64736","description":"Incision of chin nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatoid factor test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86430","description":"Rheumatoid factor test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD1","description":"ICD-OLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEC0","description":"ICD-NAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB1","description":"ICD-BBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF1","description":"ICD-OAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ naxitamab-gqgk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9348","description":"Injection_ naxitamab-gqgk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8809","description":"Rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test one limb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95860","description":"Muscle test one limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5938","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5938","description":"CDT-D5938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0579U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","description":"CPT-0579U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pessary_ disposable_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4564","description":"Pessary_ disposable_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE0","description":"ICD-JAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1502","description":"HCPCS-B1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0188","description":"Synthetic sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5110","description":"Injection_ filgrastim-aafi_ biosimilar_ (Nivestym)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9515","description":"Choline c-11_ diagnostic_ per study dose up to 20 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435U","description":"Oncology_ chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs)_ from cultured CSCs and primary tumor cells_ categorical drug response reported based on cytotox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4649","description":"Surgical supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF1","description":"ICD-KCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28H","description":"Special Care High _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7562","description":"HCPCS-C7562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF1","description":"ICD-LFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID0","description":"ICD-MGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB0","description":"ICD-JIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459T","description":"Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device_ mechano-electrical skin interface and electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93792","description":"Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88037","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA15","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw w/advance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21199","description":"Reconstr lwr jaw w/advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF1","description":"ICD-OFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA1","description":"ICD-NJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB0","description":"ICD-KDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC1","description":"ICD-EILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357U","description":"Oncology (melanoma)_ artificial intelligence (AI)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments_ plasma_ prognostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE0","description":"ICD-OCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC1","description":"ICD-KDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA0","description":"ICD-EAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC1","description":"ICD-AICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE1","description":"ICD-GCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB1","description":"ICD-PGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF0","description":"ICD-NGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD1","description":"ICD-NIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD1","description":"ICD-GGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen metacarpal/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26568","description":"Lengthen metacarpal/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB21","description":"ICD-2JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE1","description":"ICD-GDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr capsid vca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86665","description":"Epstein-barr capsid vca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection jaw joint x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21116","description":"Injection jaw joint x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD1","description":"ICD-DHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB1","description":"ICD-MCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD1","description":"ICD-PARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB0","description":"ICD-GFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC1","description":"ICD-LHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE1","description":"ICD-OHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF0","description":"ICD-BBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC0","description":"ICD-GIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0152","description":"Walker_ battery powered_ wheeled_ folding_ adjustable or fixed height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC0","description":"ICD-FGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","description":"CPT-01320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA56","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX17","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0654","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","description":"HCPCS-J0654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36218","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sutures same surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15850","description":"Remove sutures same surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPE1","description":"ICD-OJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE0","description":"ICD-BAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD1","description":"ICD-CGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD0","description":"ICD-FFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk joint covers pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5678","description":"Bk joint covers pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE1","description":"ICD-BBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC0","description":"ICD-GEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6561","description":"Gradient compression stocking_ full length/chap style_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE1","description":"ICD-AFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mental/Behavioral Health Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4013","description":"Mental/Behavioral Health Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC31","description":"ICD-1BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF1","description":"ICD-OCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB1","description":"ICD-NACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD1","description":"ICD-FAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVF0","description":"ICD-KIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5711","description":"Dentures rebase cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE1","description":"ICD-GFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB0","description":"ICD-BFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHA0","description":"ICD-NHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio upr extrm w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73206","description":"Ct angio upr extrm w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD0","description":"ICD-AHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC112","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSE0","description":"ICD-CBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE0","description":"ICD-EEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31624","description":"Dx bronchoscope/lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ phylogenetic-based report of strain relatedness_ per submitted isolate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8F","description":"High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF0","description":"ICD-FBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder fb deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23333","description":"Remove shoulder fb deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD0","description":"ICD-JCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0027","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF1","description":"ICD-GHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20703","description":"Removal Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93227","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove rectum w/reservoir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45119","description":"Remove rectum w/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m exametazime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9521","description":"Tc99m exametazime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE0","description":"ICD-OCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD1","description":"ICD-ECMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML05","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF0","description":"ICD-GGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA1","description":"ICD-JFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42821","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA0","description":"ICD-KGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARD1","description":"ICD-HARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","description":"CPT-64474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/prst8 commissurotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0619T","description":"Cysto w/prst8 commissurotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abo rh blood typing docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3293F","description":"Abo rh blood typing docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB0","description":"ICD-ECBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53215","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88025","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF1","description":"ICD-CGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC1","description":"ICD-AIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB1","description":"ICD-EBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45346","description":"Sigmoidoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB1","description":"ICD-GHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23680","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct extra finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26587","description":"Reconstruct extra finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE0","description":"ICD-FFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA0","description":"ICD-NEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF1","description":"ICD-NCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA1","description":"ICD-OBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anorectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45108","description":"Removal of anorectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1137F","description":"Epsd bk pain for >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF1","description":"ICD-OGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Swallow current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8996","description":"Swallow current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","description":"HCPCS-Q4417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE0","description":"ICD-GIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap rmvl gastr adj all parts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43774","description":"Lap rmvl gastr adj all parts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA31","description":"ICD-1GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Sandwich","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1761","description":"Home Delivered Meals-Sandwich","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screen c/v thin layer by md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0124","description":"Screen c/v thin layer by md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD1","description":"ICD-OGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD0","description":"ICD-CFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED1","description":"ICD-MGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surv score no improv w/tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9605","description":"Surv score no improv w/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had one or less emergency department visits in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9851","description":"Patient had one or less emergency department visits in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB1","description":"ICD-GBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA0","description":"ICD-GIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1712","description":"Janssen Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE1","description":"ICD-HFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray spleen/liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75810","description":"Vein x-ray spleen/liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF1","description":"ICD-PEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0706T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Interpretation And Report By Physician Or Other Qualified Health Care Professional_ Per Calendar Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE0","description":"ICD-GHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB0","description":"ICD-JHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB110","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB0","description":"ICD-CBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil one surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2410","description":"Dental gold foil one surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77065","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD1","description":"ICD-GCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87476","description":"Lyme dis dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21A","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID0","description":"ICD-FFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26045","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF0","description":"ICD-KFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC0","description":"ICD-BEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD1","description":"ICD-BAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB1","description":"ICD-FADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD0","description":"ICD-NCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3933","description":"Fo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE1","description":"ICD-NAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB0","description":"ICD-CGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26843","description":"Fusion of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1018","description":"Clinical decision support mechanism Infinx_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF1","description":"ICD-NFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA1","description":"ICD-JGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc agent rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4016F","description":"Anti-inflm/anlgsc agent rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA1","description":"ICD-EFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1805","description":"HCPCS-A1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21920","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB11","description":"ICD-3FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE1","description":"ICD-NDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9334","description":"Injection_ efgartigimod alfa_ 2 mg and hyaluronidase-qvfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9317","description":"No doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10010","description":"Fine needle aspiration biopsy_ including CT guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB1","description":"ICD-OBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEC1","description":"ICD-NLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 3_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8X","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF1","description":"ICD-BBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB1","description":"ICD-CGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93596","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal Nativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSE0","description":"ICD-PKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE1","description":"ICD-GBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dress & 1 cast chg bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5400","description":"Postop dress & 1 cast chg bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of idh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83570","description":"Assay of idh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA1","description":"ICD-HEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE1","description":"ICD-ADBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87467","description":"Infectious agent antigen detection by immunoassay technique_ (eg_ enzyme immunoassay [EIA]_ enzyme-linked immunosorbent assay [ELISA]_ fluorescence immunoassay [FIA]_ immunoch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB1","description":"ICD-IEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC0","description":"ICD-GHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE231","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0532U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","description":"CPT-0532U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Out-of-hosp on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99027","description":"Out-of-hosp on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC0","description":"ICD-CIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF0","description":"ICD-OAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB0","description":"ICD-FFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA114","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF1","description":"ICD-OEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE1","description":"ICD-FFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12016","description":"Rpr fe/e/en/l/m 12.6-20.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelet pheresis irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9036","description":"Platelet pheresis irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDerm glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2017","description":"PermeaDerm glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE0","description":"ICD-ADUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC1","description":"ICD-HGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB0","description":"ICD-LGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","description":"HCPCS-G0553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA1","description":"ICD-IBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bicarbonate conc sol per gal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4706","description":"Bicarbonate conc sol per gal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/reline occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9942","description":"Repair/reline occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 14 targets (adenovirus_ coronavirus_ human metapneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOD1","description":"ICD-DCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exposure impact tooth orthod","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7280","description":"Exposure impact tooth orthod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC1","description":"ICD-FGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27161","description":"Incision of neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1039","description":"Patients with a diagnosis of lumbar spine region infection at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA1","description":"ICD-EAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA0","description":"ICD-CBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC1","description":"ICD-NDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE1","description":"ICD-AIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD1","description":"ICD-AHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditory function + 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92621","description":"Auditory function + 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26480","description":"Transplant hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB1","description":"ICD-GAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31050","description":"Exploration sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE0","description":"ICD-FGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor ix ptc/chrstmas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85250","description":"Clot factor ix ptc/chrstmas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA1","description":"ICD-AGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE1","description":"ICD-ODPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELE0","description":"ICD-NELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB0","description":"ICD-NKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF1","description":"ICD-PAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXD0","description":"ICD-OAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0860T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ for screening for peripheral arterial disease_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF0","description":"ICD-AIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splint - extra-coronal; natural teeth or prosthetic crowns","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4323","description":"Splint - extra-coronal; natural teeth or prosthetic crowns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB1","description":"ICD-CBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect apical lung tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32503","description":"Resect apical lung tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76377","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB1","description":"ICD-GEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8G","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84550","description":"Assay of blood/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE1","description":"ICD-CEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB0","description":"ICD-LGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block spenopalatine gangl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64505","description":"N block spenopalatine gangl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back school visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9117","description":"Back school visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fragmenting of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50590","description":"Fragmenting of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF0","description":"ICD-GGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver and spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78215","description":"Liver and spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","description":"HCPCS-J9183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF0","description":"ICD-CDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA1","description":"ICD-FCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB1","description":"ICD-JAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF1","description":"ICD-KCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265U","description":"Rare constitutional and other heritable disorders_ whole genome and mitochondrial DNA sequence analysis_ blood_ frozen & formalin-fixed paraffin-embedded (FFPE) tissue_ saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDE1","description":"ICD-MCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test socket hip disarticulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5626","description":"Test socket hip disarticulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst incl t/o complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58291","description":"Vag hyst incl t/o complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision/drain abscess intra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7511","description":"Incision/drain abscess intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9113","description":"Onc dx ovarian stg1a-b no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creatinine clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82575","description":"Creatinine clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE0","description":"ICD-KABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81269","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46040","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adrenalin epinephrine inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0171","description":"Adrenalin epinephrine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1037","description":"Patients with a diagnosis of lumbar spine region cancer at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9407","description":"Iodine I-131 iobenguane_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp geriatr assmt team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0250","description":"Comp geriatr assmt team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC35","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo by other than infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0083","description":"Chemo by other than infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67710","description":"Incision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC0","description":"ICD-ABLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME0","description":"ICD-GFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57284","description":"Repair paravag defect open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86817","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA0","description":"ICD-OJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker platform attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0154","description":"Walker platform attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv cancer screen docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3015F","description":"Cerv cancer screen docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHB0","description":"ICD-NFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA0","description":"ICD-MFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB0","description":"ICD-OCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE1","description":"ICD-KCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA1","description":"ICD-KEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA1","description":"ICD-PEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFB0","description":"ICD-JFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close bronchial fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32815","description":"Close bronchial fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0845T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; initial single antibody stain procedure (List separately in addition to code for primary procedur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF0","description":"ICD-FFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37253","description":"Intrvasc us noncoronary addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF1","description":"ICD-CIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay chondroitin sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82485","description":"Assay chondroitin sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36575","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7333","description":"Hyaluronan or derivative_ Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF1","description":"ICD-AECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF1","description":"ICD-GFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD0","description":"ICD-GFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD1","description":"ICD-NGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33510","description":"Cabg vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","description":"HCPCS-Q4413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8E","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD1","description":"ICD-OHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87806","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; HIV-1 antigen(s)_ with HIV-1 and HIV-2 antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery bypass/reop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33530","description":"Coronary artery bypass/reop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6558","description":"Gradient compression stocking_ thigh length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles monofocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92340","description":"Fit spectacles monofocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine patch nonlegend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4991","description":"Nicotine patch nonlegend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB0","description":"ICD-OIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF1","description":"ICD-NKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35571","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF1","description":"ICD-GGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","description":"HCPCS-M1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy excise lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58662","description":"Laparoscopy excise lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56625","description":"Complete removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA0","description":"ICD-HCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437T","description":"Impltj Nonbiol/Synth Implt Fasc Rnfcmt Abdl Wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA1","description":"ICD-KFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA1","description":"ICD-DCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB0","description":"ICD-OACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE0","description":"ICD-FECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75896","description":"Transcatheter therapy_ infusion_ any method (eg_ thrombolysis other than coronary)_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr extnd =4sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4411","description":"Ost skn barr extnd =4sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD0","description":"ICD-OJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB1","description":"ICD-CCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA0","description":"ICD-PFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB1","description":"ICD-FDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0603U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","description":"CPT-0603U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA0","description":"ICD-BBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2194","description":"Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5913","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sensorineural acuity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92575","description":"Sensorineural acuity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEA0","description":"ICD-BFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL33","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pad water circulating heat u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0249","description":"Pad water circulating heat u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE0","description":"ICD-JDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC10","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19082","description":"Bx breast add lesion strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEC1","description":"ICD-MLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50961","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92972","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc bla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51999","description":"Laparoscope proc bla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUE1","description":"ICD-KFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF0","description":"ICD-IIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31646","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ subsequent_ same hospital stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA1","description":"ICD-BDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGE0","description":"ICD-FFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ peramivir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2547","description":"Injection_ peramivir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE246","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE0","description":"ICD-OALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0514T","description":"Intraoperative visual axis identification using patient fixation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC0","description":"ICD-OHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA0","description":"ICD-GEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina tissue part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57107","description":"Remove vagina tissue part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD0","description":"ICD-CBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE0","description":"ICD-CCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF0","description":"ICD-BBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF0","description":"ICD-OCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0678T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD0","description":"ICD-KDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE1","description":"ICD-MGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB0","description":"ICD-FITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kne-shin exo sng axi mnl loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5710","description":"Kne-shin exo sng axi mnl loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occupational multifocal lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2786","description":"Occupational multifocal lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE1","description":"ICD-KGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBE0","description":"ICD-FCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD0","description":"ICD-OCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB1","description":"ICD-AEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC0","description":"ICD-MFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX46","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin_ drug-coat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2623","description":"Cath_ translumin_ drug-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9347","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC1","description":"ICD-CDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26785","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io anal gast n-stim init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95980","description":"Io anal gast n-stim init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE0","description":"ICD-EEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5731","description":"Denture reln cmplt mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB1","description":"ICD-KERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA1","description":"ICD-FEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr pack base elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0488","description":"Pwr pack base elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureteral reflux study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78740","description":"Ureteral reflux study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9062","description":"Injection_ daratumumab 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC03","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15820","description":"Revision of lower eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE1","description":"ICD-FAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF1","description":"ICD-GCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Expandable controller_ initl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2377","description":"Expandable controller_ initl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50432","description":"Plmt nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy pouch liq deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4394","description":"Ostomy pouch liq deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90651","description":"Human Papillomavirus vaccine types 6_ 11_ 16_ 18_ 31_ 33_ 45_ 52_ 58_ nonavalent (9vHPV)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES341","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE1","description":"ICD-KCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43500","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD1","description":"ICD-FIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB1","description":"ICD-CDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2142","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 22 Or Functional Status M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALA0","description":"ICD-AALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD1","description":"ICD-PKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50974","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32852","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF0","description":"ICD-FENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB0","description":"ICD-NJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC0","description":"ICD-KDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED0","description":"ICD-CFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB1","description":"ICD-GINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE1","description":"ICD-BICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6087","description":"Implant Supported Crown - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE0","description":"ICD-MLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249U","description":"Oncology (Breast)_ Semiquantitative Analysis Of 32 Phosphoproteins And Protein Analytes_ Includes Laser Capture Microdissection_ With Algorithmic Analysis And Interpretative R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHD0","description":"ICD-NEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE1","description":"ICD-FBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15823","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLC0","description":"ICD-KCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJC1","description":"ICD-FFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad w backup invasive intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0472","description":"Rad w backup invasive intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD0","description":"ICD-CFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automatic ext defibrillator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0617","description":"Automatic ext defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF1","description":"ICD-GIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Idet single level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22526","description":"Idet single level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60522","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB0","description":"ICD-JDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE0","description":"ICD-AHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92623","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; each additional 15 minutes (List separately in addition to code fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPC1","description":"ICD-JGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE0","description":"ICD-CBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE1","description":"ICD-OBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC1","description":"ICD-CGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB1","description":"ICD-FBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB1","description":"ICD-BGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124U","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy_ soft tissu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA1","description":"ICD-BDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD1","description":"ICD-OGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINA0","description":"ICD-GINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA0","description":"ICD-ECHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB1","description":"ICD-IIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE0","description":"ICD-NHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lith-ion batt elec/pneum vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0506","description":"Lith-ion batt elec/pneum vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE1","description":"ICD-NIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF0","description":"ICD-CHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE1","description":"ICD-BGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED0","description":"ICD-EAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD205","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82044","description":"Albumin; urine (eg_ microalbumin)_ semiquantitative (eg_ reagent strip assay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLE0","description":"ICD-FBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted px small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44799","description":"Unlisted px small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64818","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90837","description":"Psytx pt&/family 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cr51 chromate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9553","description":"Cr51 chromate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86738","description":"Mycoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5120","description":"Injection_ pegfilgrastim-bmez_ biosimilar_ (ziextenzo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC0","description":"ICD-OKLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB21","description":"ICD-1HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC22","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF0","description":"ICD-ECLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic prop tire insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2213","description":"Pneumatic prop tire insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF1","description":"ICD-NHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95715","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF0","description":"ICD-ADDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE1","description":"ICD-MAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC0","description":"ICD-GGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC0","description":"ICD-KBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD0","description":"ICD-JBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC1","description":"ICD-ODJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thrombin time titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85675","description":"Thrombin time titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21470","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE0","description":"ICD-KFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6069","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap proctopexy w/sig resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45402","description":"Lap proctopexy w/sig resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE1","description":"ICD-EETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65093","description":"Revise eye with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF0","description":"ICD-BAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXC0","description":"ICD-BIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0505","description":"HCPCS-B0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF0","description":"ICD-GBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA0","description":"ICD-OHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"F2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81240","description":"F2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD1","description":"ICD-DGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF0","description":"ICD-MIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE1","description":"ICD-FGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC0","description":"ICD-CDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corticotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0800","description":"Corticotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE1","description":"ICD-EAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25025","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF0","description":"ICD-CEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395U","description":"Oncology (lung)_ multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay)_ plasma_ algorithm reported as m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60600","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl 5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0161","description":"Chlorpromazine hcl 5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOF0","description":"ICD-LFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5A","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054A","description":"Imm admin by intramusc inj of (SARS-CoV-2) (coronavirus disease [COVID-19]) vacc_ mRNA-LNP_ spike protein_ preserv free_ 30mcg/0.3 mL dose_ tris-sucrose formula_ booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01716","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","description":"CPT-01716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC234","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJF0","description":"ICD-KEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft hip bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27067","description":"Remove/graft hip bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Morcellator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1782","description":"Morcellator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB0","description":"ICD-BEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF0","description":"ICD-CAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv unsure baby of hiv+moms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3491F","description":"Hiv unsure baby of hiv+moms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9730","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped size brief/diaper sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4529","description":"Ped size brief/diaper sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA0","description":"ICD-ADLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE1","description":"ICD-GFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE0","description":"ICD-PKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF0","description":"ICD-MKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF1","description":"ICD-JIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA1","description":"ICD-BGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF1","description":"ICD-BFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF1","description":"ICD-OEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98985","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","description":"CPT-98985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA0","description":"ICD-FIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diaphragm surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39599","description":"Diaphragm surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD1","description":"ICD-GHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD0","description":"ICD-ADUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD1","description":"ICD-NHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing rbc antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86905","description":"Blood typing rbc antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF1","description":"ICD-AIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYB1","description":"ICD-KAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ brst_ un","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8905","description":"MRI w/o fol w/cont_ brst_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF0","description":"ICD-KBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422U","description":"Oncology (pan-solid tumor)_ analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA_ biomarker comparison to a previous baseline pre-treatmen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD1","description":"ICD-BDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC0","description":"ICD-NITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41114","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHC1","description":"ICD-IEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33412","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE0","description":"ICD-HCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74420","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diab shoe w/metatarsal bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5505","description":"Diab shoe w/metatarsal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair extra toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28344","description":"Repair extra toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYD0","description":"ICD-DFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE1","description":"ICD-DGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF1","description":"ICD-AAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of hemoglobin heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83065","description":"Assay of hemoglobin heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD0","description":"ICD-ABBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5A","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE0","description":"ICD-JBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYB0","description":"ICD-CBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meniscal trnspl knee w/scpe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29868","description":"Meniscal trnspl knee w/scpe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0680T","description":"Insertion Or Replacement Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC0","description":"ICD-ECEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood other sources","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82271","description":"Occult blood other sources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE1","description":"ICD-OBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE0","description":"ICD-GFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of CHA2DS2-VASc risk score of 0 or 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9931","description":"Documentation of CHA2DS2-VASc risk score of 0 or 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close chest after drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32810","description":"Close chest after drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB0","description":"ICD-BIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE0","description":"ICD-LDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Misc sup/acc ext vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0507","description":"Misc sup/acc ext vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXB1","description":"ICD-BAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA1","description":"ICD-BALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","description":"HCPCS-M1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA1","description":"ICD-AICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rollabout chair with casters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1031","description":"Rollabout chair with casters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7650","description":"Open red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF1","description":"ICD-LIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11451","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB1","description":"ICD-GHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF1","description":"ICD-OLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9259","description":"Injection_ paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF0","description":"ICD-OKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF0","description":"ICD-MALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB0","description":"ICD-ABEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB0","description":"ICD-JHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA0","description":"ICD-HIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6015F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF0","description":"ICD-CCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC0","description":"ICD-MJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine cerv/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62310","description":"Inject spine cerv/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB1","description":"ICD-MFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE0","description":"ICD-HESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF1","description":"ICD-GGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27600","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA0","description":"ICD-OBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA1","description":"ICD-GGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Housing & integrated adhesiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7508","description":"Housing & integrated adhesiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMB0","description":"ICD-FEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIID0","description":"ICD-MIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD0","description":"ICD-BFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bath conductivity meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1550","description":"Bath conductivity meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fxnl status assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1170F","description":"Fxnl status assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2005","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA1","description":"ICD-ABLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC1","description":"ICD-AGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA0","description":"ICD-ODKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA0","description":"ICD-DIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD1","description":"ICD-PFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB15","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56633","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF0","description":"ICD-GDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21502","description":"Drain chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50760","description":"Fusion of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE0","description":"ICD-OHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enlarge breast with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19325","description":"Enlarge breast with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sotalol hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9482","description":"Injection_ sotalol hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA0","description":"ICD-KECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA1","description":"ICD-KIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE0","description":"ICD-JAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27808","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD1","description":"ICD-MBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE0","description":"ICD-CGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB0","description":"ICD-IFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft brchl-ulnr-rdl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35523","description":"Art byp grft brchl-ulnr-rdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC1","description":"ICD-NDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31254","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; partial (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF0","description":"ICD-FBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVA1","description":"ICD-OCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9438","description":"P2y inhib presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1002","description":"Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician_ reason not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC0","description":"ICD-BFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complement total (ch50)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86162","description":"Complement total (ch50)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6711","description":"Ped term dev_ hook_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD236","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD0","description":"ICD-FDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUB0","description":"ICD-OGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii reltd antgn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85244","description":"Clot factor viii reltd antgn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inhaled bronchodilator rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4025F","description":"Inhaled bronchodilator rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD145","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFB0","description":"ICD-NGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj ferric pyrophosphate cit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1443","description":"Inj ferric pyrophosphate cit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/comput","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88361","description":"Tumor immunohistochem/comput","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284U","description":"von Willebrand factor (VWF)_ type 2N_ factor VIII and VWF binding evaluation_ enzyme-linked immunosorbent assays (ELISA)_ plasma (Versiti™ VWD Type 2N Binding)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF1","description":"ICD-FHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED1","description":"ICD-MHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64454","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Genicular Nerve Branches_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE1","description":"ICD-JHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24100","description":"Biopsy elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder universal joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6650","description":"Shoulder universal joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA1","description":"ICD-FHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA1","description":"ICD-CDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj trigger point 1/2 muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20552","description":"Inj trigger point 1/2 muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0152U","description":"Infectious disease (bacteria_ fungi_ parasites_ and DNA viruses)_ DNA_ PCR and next-generation sequencing_ plasma_ detection of >1_000 potential microbial organisms for signif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA11","description":"ICD-1CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69955","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28725","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC1","description":"ICD-BGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX32","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0979T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","description":"CPT-0979T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q8h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9502","description":"Hit antibiotic q8h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0533T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; includes set-up_ patient training_ configuration o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1902","description":"HCPCS-B1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0086","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domicil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINE0","description":"ICD-GINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mild osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8848","description":"Mild osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB1","description":"ICD-KINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD1","description":"ICD-IHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho flex frejka w/cov pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1600","description":"Ho flex frejka w/cov pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOC0","description":"ICD-OKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epi etiol synd rvwd and docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1205F","description":"Epi etiol synd rvwd and docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ZZZZZ","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ZZZZZ","description":"ICD-ZZZZZ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE1","description":"ICD-JFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt has no resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1505F","description":"Pt has no resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC1","description":"ICD-MLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD1","description":"ICD-GFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Staggered spondaic word test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92572","description":"Staggered spondaic word test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB1","description":"ICD-GAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF1","description":"ICD-BFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD0","description":"ICD-MDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD1","description":"ICD-KDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE156","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Congo red blood test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2029","description":"Congo red blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC1","description":"ICD-NADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0671","description":"Pressure pneum appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF1","description":"ICD-GCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB0","description":"ICD-KIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC1","description":"ICD-CDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC0","description":"ICD-CHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Derm-Maxx_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4238","description":"Derm-Maxx_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67570","description":"Decompress optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSE0","description":"ICD-KGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHD0","description":"ICD-FEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF0","description":"ICD-EHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6447","description":"Conform band s w >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52214","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA1","description":"ICD-OLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE0","description":"ICD-NIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD1","description":"ICD-MKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF0","description":"ICD-FAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQD1","description":"ICD-OIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND1","description":"ICD-CGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDD0","description":"ICD-JHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA0","description":"ICD-FAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No neuropsych symptoms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8948","description":"No neuropsych symptoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA0","description":"ICD-LERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQC1","description":"ICD-PDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42220","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0734T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24420","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual therapy 1/> regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97140","description":"Manual therapy 1/> regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED1","description":"ICD-MKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC1","description":"ICD-BGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath place cardio brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92974","description":"Cath place cardio brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA0","description":"ICD-EEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE226","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJE0","description":"ICD-OHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9326","description":"Norsn no ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCB1","description":"ICD-FDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27637","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Azithromycin dihydrate_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0144","description":"Azithromycin dihydrate_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF1","description":"ICD-KFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC1","description":"ICD-MCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","description":"HCPCS-Q4397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27450","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF1","description":"ICD-AHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Etoposide oral 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8560","description":"Etoposide oral 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61540","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received bone marrow transplant any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1157","description":"Patient received bone marrow transplant any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF0","description":"ICD-KADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF1","description":"ICD-BAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB0","description":"ICD-OEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2003","description":"HCPCS-B2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC0","description":"ICD-CIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidural lysis on single day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62264","description":"Epidural lysis on single day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ven blood coll snf/hha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0471","description":"Ven blood coll snf/hha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; subdural taps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0131U","description":"Anesthesia for intracranial procedures; subdural taps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD0","description":"ICD-KDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frozen ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4016","description":"Frozen ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD1","description":"ICD-ODJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475U","description":"Hereditary prostate cancer-related disorders_ genomic sequence analysis panel using next-generation sequencing (NGS)_ Sanger sequencing_ multiplex ligation-dependent probe amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rib fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21812","description":"Treatment of rib fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy microsurg graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15842","description":"Nerve palsy microsurg graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No elig tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8601","description":"No elig tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB1","description":"ICD-JCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1384","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","description":"HCPCS-M1384","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVD1","description":"ICD-NJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC0","description":"ICD-FIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","description":"HCPCS-J7356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF0","description":"ICD-NHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1A","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF0","description":"ICD-DASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC0","description":"ICD-NDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9932","description":"Documentation of patient reason(s) for not having records of negative or managed positive TB screen (e.g._ patient does not return for Mantoux (PPD) skin test evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph balloon distension tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91040","description":"Esoph balloon distension tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0100","description":"Residential Habilitation 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA1","description":"ICD-GBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low-level laser trmt 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8948","description":"Low-level laser trmt 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE0","description":"ICD-JBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii ahg 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85240","description":"Clot factor viii ahg 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC0","description":"ICD-CDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59857","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARA0","description":"ICD-LARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0613","description":"Injection_ calcium gluconate (wg critical care)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5054","description":"Clsd ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB0","description":"ICD-GEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18D","description":"Special Care Low _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE0","description":"ICD-KDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBC0","description":"ICD-OKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD106","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99336","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC0","description":"ICD-OLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7209","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ (Nuwiq)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF1","description":"ICD-CAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB1","description":"ICD-OBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28060","description":"Partial removal foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE1","description":"ICD-JIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61534","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD0","description":"ICD-KHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC1","description":"ICD-NELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA0","description":"ICD-CEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC0","description":"ICD-DCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ceftaroline fosamil inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0712","description":"Ceftaroline fosamil inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC0","description":"ICD-JFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF1","description":"ICD-OJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit int pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9327","description":"Hit int pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA0","description":"ICD-JBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA0","description":"ICD-MLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraabdominal pressure test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51797","description":"Intraabdominal pressure test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33933","description":"Prepare donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95115","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAC0","description":"ICD-JIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC254","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE0","description":"ICD-LFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj pantoprazole sodium_ via","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9113","description":"Inj pantoprazole sodium_ via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFE1","description":"ICD-JAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC0","description":"ICD-FIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF0","description":"ICD-IGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD0","description":"ICD-CGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUE1","description":"ICD-GDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0586T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD1","description":"ICD-FDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sleep study attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95807","description":"Sleep study attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUF1","description":"ICD-NJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB1","description":"ICD-GHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE0","description":"ICD-CEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9538","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1122","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA211","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB0","description":"ICD-KGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0871","description":"HCPCS-J0871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB25","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72190","description":"X-ray exam of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52260","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA1","description":"ICD-AGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA0","description":"ICD-ACDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal kidney open radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50230","description":"Removal kidney open radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ciprofloxacin iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0744","description":"Ciprofloxacin iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB1","description":"ICD-NCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE1","description":"ICD-MCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA0","description":"ICD-CITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKE1","description":"ICD-CHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE0","description":"ICD-KGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA1","description":"ICD-HHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA0","description":"ICD-KCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breast pump shield","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4284","description":"Replcmnt breast pump shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ibutilide fumarate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1742","description":"Ibutilide fumarate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD1","description":"ICD-OELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant/graft palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26489","description":"Transplant/graft palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD1","description":"ICD-FICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2310","description":"Lens sphc trifocal 4.25-7/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9072","description":"Injection_ cyclophosphamide_ (dr. reddy_s)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF0","description":"ICD-NILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD0","description":"ICD-FDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF0","description":"ICD-FECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0535U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","description":"CPT-0535U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admin pneumococcal vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0009","description":"Admin pneumococcal vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0643T","description":"Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed_ arterial approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE1","description":"ICD-GDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99204","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4527","description":"Adult size pull-on lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25425","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0569U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","description":"CPT-0569U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27306","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD1","description":"ICD-NBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cst noble mtl inlay >=3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6607","description":"Cst noble mtl inlay >=3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE1","description":"ICD-CEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF1","description":"ICD-NKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41822","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA0","description":"ICD-AITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB1","description":"ICD-CGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB0","description":"ICD-CCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA0","description":"ICD-OEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92274","description":"Electroretinography (ERG)_ with interpretation and report; multifocal (mfERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSE0","description":"ICD-HHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene minor bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81207","description":"Bcr/abl1 gene minor bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD0","description":"ICD-GBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE0","description":"ICD-JCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC0","description":"ICD-CCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Choline C 11_ diagnostic_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9461","description":"Choline C 11_ diagnostic_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26765","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA1","description":"ICD-MBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral prescrip drug non chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8499","description":"Oral prescrip drug non chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD1","description":"ICD-FATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF1","description":"ICD-AGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD1","description":"ICD-BEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF0","description":"ICD-PIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICA1","description":"ICD-BICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Swallow d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8998","description":"Swallow d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of vulva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56620","description":"Partial removal of vulva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF0","description":"ICD-BIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC0","description":"ICD-PGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE0","description":"ICD-PFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE0","description":"ICD-AIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERA1","description":"ICD-LERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostate laser enucleation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52649","description":"Prostate laser enucleation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAE0","description":"ICD-IIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","description":"HCPCS-M1398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma symptoms evaluate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1005F","description":"Asthma symptoms evaluate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tinzaparin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1655","description":"Tinzaparin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF0","description":"ICD-CCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9824","description":"Endometrial sampling or hysteroscopy with biopsy and results not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA1","description":"ICD-JBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94760","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD1","description":"ICD-CAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2093","description":"Documentation Of Medical Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Hypotensive Patients Who Are At Immediate Risk Of Cardiogenic Shock_ Hospita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF0","description":"ICD-JCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5B","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67145","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Image not std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9319","description":"Image not std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker rigid adjust/fixed ht","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0130","description":"Walker rigid adjust/fixed ht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD1","description":"ICD-NBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imterprete diagnostic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0391","description":"Imterprete diagnostic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD1","description":"ICD-METD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1202","description":"HCPCS-B1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC0","description":"ICD-DFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB0","description":"ICD-LFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE0","description":"ICD-JHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD1","description":"ICD-CGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesions 2 to 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11056","description":"Trim skin lesions 2 to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0823T","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PermeaDerm C_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2018","description":"PermeaDerm C_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF0","description":"ICD-IEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC0","description":"ICD-FEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99363","description":"Anticoagulant mgmt initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF0","description":"ICD-DCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC21","description":"ICD-2GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0811T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC0","description":"ICD-EGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD1","description":"ICD-KCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6710","description":"Crown-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Loudness balance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92562","description":"Loudness balance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30545","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC0","description":"ICD-CARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX42","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB0","description":"ICD-KFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8480","description":"Pros sock single ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axill-fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35654","description":"Art byp axill-fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93573","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ bilateral (List sep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLF1","description":"ICD-AHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB0","description":"ICD-FFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso trnk sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0454","description":"Tlso trnk sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA1","description":"ICD-GDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF1","description":"ICD-FAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91299","description":"Gastroenterology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA1","description":"ICD-MKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA1","description":"ICD-GBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF0","description":"ICD-DAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE0","description":"ICD-EFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of rectal narrowing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45910","description":"Dilation of rectal narrowing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","description":"HCPCS-J3392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81294","description":"Mlh1 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perphenazine injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3310","description":"Perphenazine injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5260","description":"Hearing aid_ digit_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB1","description":"ICD-IDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42225","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22632","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73521","description":"X-ray exam hips bi 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE1","description":"ICD-OITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3762F","description":"Patient is dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65755","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF1","description":"ICD-CBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB0","description":"ICD-KBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA1","description":"ICD-CBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC236","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA1","description":"ICD-FDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit declotting kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5517","description":"Hit declotting kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE0","description":"ICD-GHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD1","description":"ICD-JATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA1","description":"ICD-GCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27488","description":"Removal of knee prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA1","description":"ICD-OGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0681U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681U","description":"CPT-0681U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advncd care plan 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99497","description":"Advncd care plan 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD0","description":"ICD-BCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE0","description":"ICD-CGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0522T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55040","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35112","description":"Repair artery rupture spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF1","description":"ICD-BAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD0","description":"ICD-OKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8I","description":"Medium Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2711","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","description":"HCPCS-J2711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; each additional 30 minutes of technician time (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv eccrine glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64653","description":"Chemodenerv eccrine glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4036","description":"Cast sup lngleg cylndr ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analysis tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88358","description":"Analysis tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA0","description":"ICD-PCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE155","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF1","description":"ICD-KGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASB0","description":"ICD-GASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening cocaine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80353","description":"Drug screening cocaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBD1","description":"ICD-CCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE0","description":"ICD-NHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA1","description":"ICD-MCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD1","description":"ICD-OIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD0","description":"ICD-KIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD0","description":"ICD-EFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1602","description":"HCPCS-A1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME0","description":"ICD-MCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALE1","description":"ICD-GALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED0","description":"ICD-FEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diag laparo separate proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49320","description":"Diag laparo separate proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA1","description":"ICD-JGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB0","description":"ICD-ICIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXD1","description":"ICD-BHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML26","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial custom socket insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5683","description":"Initial custom socket insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE0","description":"ICD-OLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA1","description":"ICD-MGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> mus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64644","description":"Chemodenerv 1 extrem 5/> mus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF0","description":"ICD-GDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC1","description":"ICD-AILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD0","description":"ICD-LFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80051","description":"Electrolyte panel this panel must include the following: carbon dioxide (82374) chloride (82435) potassium (84132) sodium (84295)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cancer treatment plan change","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0354","description":"Cancer treatment plan change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38571","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5521","description":"Hit midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA1","description":"ICD-NHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD0","description":"ICD-DAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF1","description":"ICD-NKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8A","description":"High Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ sock above elb/dis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6688","description":"Frame typ sock above elb/dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF0","description":"ICD-NLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients on immune checkpoint inhibitor therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1180","description":"Patients on immune checkpoint inhibitor therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86648","description":"Diphtheria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tmp manipulation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7820","description":"Closed tmp manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psych diag eval w/med srvcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90792","description":"Psych diag eval w/med srvcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD1","description":"ICD-GEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic image jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70336","description":"Magnetic image jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9901","description":"Endoscopic defect closure within the entire gastrointestinal tract_ including upper endoscopy (including diagnostic_ if performed) or colonoscopy (including diagnostic_ if per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cover eye w/membrane","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65778","description":"Cover eye w/membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect mediastinal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39220","description":"Resect mediastinal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF0","description":"ICD-EAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA56","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9078","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of small int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2053","description":"Transplantation of small int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guided tissue regeneration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3432","description":"Guided tissue regeneration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE1","description":"ICD-MCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ etelcalcetide_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0606","description":"Injection_ etelcalcetide_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0648T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA1","description":"ICD-CGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC0","description":"ICD-EDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD1","description":"ICD-JACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1302","description":"Screening_ diagnostic_ film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert pessary/other device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57160","description":"Insert pessary/other device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPA0","description":"ICD-FEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64760","description":"Incision of vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA0","description":"ICD-OJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lateral trochanteric pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1290","description":"Lateral trochanteric pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF1","description":"ICD-JITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB0","description":"ICD-ADMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt simple w/comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77522","description":"Proton trmt simple w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB1","description":"ICD-OLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELA1","description":"ICD-AELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnanediol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84135","description":"Assay of pregnanediol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD0","description":"ICD-JBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA0","description":"ICD-FIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD0","description":"ICD-AAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA1","description":"ICD-CBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43641","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj same drug adon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96376","description":"Tx/pro/dx inj same drug adon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2361","description":"Each additional cervical vertebral body (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA1","description":"ICD-GEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCF1","description":"ICD-EHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB0","description":"ICD-ODGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump portab hom modl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0600","description":"Suction pump portab hom modl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC42","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB0","description":"ICD-NILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC0","description":"ICD-FEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB1","description":"ICD-FCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD1","description":"ICD-ODKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022A","description":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 2nd dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE236","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDF0","description":"ICD-NEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASC1","description":"ICD-DASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ diclofenac sodium_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1130","description":"Injection_ diclofenac sodium_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC1","description":"ICD-NCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE1","description":"ICD-NLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1357","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing dr/dq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86816","description":"Hla typing dr/dq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACD0","description":"ICD-JACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63056","description":"Decompress spinal cord lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA0","description":"ICD-OKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hexa gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81255","description":"Hexa gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61867","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair valve femoral vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34501","description":"Repair valve femoral vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","description":"HCPCS-M1393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27041","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 pc ost pouch w filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5056","description":"1 pc ost pouch w filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC0","description":"ICD-KFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB14","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC1","description":"ICD-OCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC245","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE1","description":"ICD-CBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPE0","description":"ICD-CEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTC1","description":"ICD-OHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD1","description":"ICD-CACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE0","description":"ICD-JACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC31","description":"ICD-3HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE1","description":"ICD-EFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metal frame recipro hip & ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2628","description":"Metal frame recipro hip & ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4C","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL44","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound exam follow-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76970","description":"Ultrasound exam follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETD1","description":"ICD-NETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whchr h-duty det arm leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1280","description":"Whchr h-duty det arm leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB0","description":"ICD-CGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9951","description":"Limited occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA1","description":"ICD-NANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF0","description":"ICD-GFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE0","description":"ICD-CFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC0","description":"ICD-KFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2777","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess dyspnea not present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1018F","description":"Assess dyspnea not present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26080","description":"Explore/treat finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA16","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHA0","description":"ICD-FFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC1","description":"ICD-KHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac guide differs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9062","description":"Onc prac guide differs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Furnsh initial orthosis only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1200","description":"Furnsh initial orthosis only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43246","description":"Egd place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Torsion ank & half solid sti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2375","description":"Torsion ank & half solid sti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA145","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE0","description":"ICD-OLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB1","description":"ICD-OERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA0","description":"ICD-FCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES324","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA1","description":"ICD-KHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heel spur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28119","description":"Removal of heel spur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE1","description":"ICD-NFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF0","description":"ICD-FAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9600","description":"Perc drug-el cor stent sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69643","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF0","description":"ICD-CBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pentobarbital sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2515","description":"Pentobarbital sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD1","description":"ICD-NHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC0","description":"ICD-OJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD0","description":"ICD-NDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt screened for depression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1220F","description":"Pt screened for depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC0","description":"ICD-JABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5246","description":"Hearing aid_ prog_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB1","description":"ICD-BFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE1","description":"ICD-AEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF0","description":"ICD-CCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB1","description":"ICD-JINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC31","description":"ICD-4JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22842","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - patient education to improve oral health literacy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9994","description":"Dental case management - patient education to improve oral health literacy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37265","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","description":"CPT-37265","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csit on pt any reas 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8962","description":"Csit on pt any reas 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Haberman feeder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8265","description":"Haberman feeder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27290","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE0","description":"ICD-ODSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home uterine monitor with or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9001","description":"Home uterine monitor with or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth amputation of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93251","description":"Anesth amputation of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF1","description":"ICD-OJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNC0","description":"ICD-OKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE0","description":"ICD-JHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA0","description":"ICD-KINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27477","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95117","description":"Immunotherapy injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extra-oral posterior dental radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0705","description":"Extra-oral posterior dental radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29875","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC1","description":"ICD-MLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0073","description":"Injection_ aztreonam_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF0","description":"ICD-CHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC0","description":"ICD-FDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC0","description":"ICD-JEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB1","description":"ICD-OEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 6-11 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87632","description":"Resp virus 6-11 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change ureter stent percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50382","description":"Change ureter stent percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC0","description":"ICD-BHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF0","description":"ICD-ODAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB1","description":"ICD-KHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24340","description":"Repair of biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFB0","description":"ICD-CFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD0","description":"ICD-LBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYD0","description":"ICD-CEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Basic support routine suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0382","description":"Basic support routine suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC0","description":"ICD-LGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD0","description":"ICD-AGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES344","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC1","description":"ICD-KGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE1","description":"ICD-GBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE0","description":"ICD-ODRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC0","description":"ICD-AHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA0","description":"ICD-OIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb skin bone at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11012","description":"Deb skin bone at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mental health service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0046","description":"Mental health service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0132U","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC211","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA0","description":"ICD-PAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6634","description":"Onlay titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF1","description":"ICD-OBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD0","description":"ICD-OJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA0","description":"ICD-KASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0293","description":"Hosp bed var ht w/o rail w/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71250","description":"Ct thorax w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC21","description":"ICD-4GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61250","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDD1","description":"ICD-OBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD0","description":"ICD-OFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0622U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","description":"CPT-0622U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES160","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6453","description":"Self-adher band w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD1","description":"ICD-OAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC1","description":"ICD-CICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","description":"HCPCS-Q4385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE0","description":"ICD-KFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6073","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68705","description":"Revise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0179T","description":"64 lead ecg w/tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEC1","description":"ICD-JDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA1","description":"ICD-ODPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB1","description":"ICD-CCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine/urea-n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84540","description":"Assay of urine/urea-n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj antiemetic diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9370","description":"Ht inj antiemetic diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40651","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero w/up stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52345","description":"Cysto/uretero w/up stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF1","description":"ICD-LCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB1","description":"ICD-KGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE211","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Y set tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4719","description":"Y set tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Womans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3224","description":"Womans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC0","description":"ICD-PLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer fxd unilat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1510","description":"Space maintainer fxd unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED0","description":"ICD-OKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANE1","description":"ICD-GANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF1","description":"ICD-GGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA51","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50715","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC21","description":"Medium Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0076","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ domic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37258","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","description":"CPT-37258","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC0","description":"ICD-IFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55860","description":"Surgical exposure prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provisional retainer crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6793","description":"Provisional retainer crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thiamine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3411","description":"Thiamine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","description":"HCPCS-J2313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Charger and base station for intraurethral activation device_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1012","description":"Charger and base station for intraurethral activation device_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC1","description":"ICD-NAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Vedolizumab_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9026","description":"Injection_ Vedolizumab_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Swingaway detach footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0052","description":"Swingaway detach footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj beta interferon sq 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3028","description":"Inj beta interferon sq 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE1","description":"ICD-HDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9785","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) sent from the pathologist/dermatopathologist to the biopsyin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE0","description":"ICD-OISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD0","description":"ICD-OLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF1","description":"ICD-CILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01432","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","description":"CPT-01432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot c activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85303","description":"Clot inhibit prot c activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB0","description":"ICD-OFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","description":"HCPCS-M1424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc visceral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235T","description":"Trluml perip athrc visceral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1014","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC0","description":"ICD-BDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE1","description":"ICD-LEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF0","description":"ICD-LAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9752","description":"Emergency surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB1","description":"ICD-BFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans care mgmt 7 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99496","description":"Trans care mgmt 7 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD206","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace afo soft interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4392","description":"Replace afo soft interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1075T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1075T","description":"CPT-1075T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5140","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","description":"HCPCS-Q5140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE1","description":"ICD-JHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval risk vte card 30d prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9298","description":"Eval risk vte card 30d prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81306","description":"NUDT15 (nudix hydrolase 15) (eg_ drug metabolism) gene analysis_ common variant(s) (eg_ *2_ *3_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6602","description":"Gradient compression bandaging supply_ high density foam roll for bandage_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1358","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC1","description":"ICD-NEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr rem hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49550","description":"Rpr rem hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA1","description":"ICD-OGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE1","description":"ICD-GHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC0","description":"ICD-CCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEED0","description":"ICD-IEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC255","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE0","description":"ICD-OAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFB0","description":"ICD-FAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of orbit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21256","description":"Reconstruction of orbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical traction therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97012","description":"Mechanical traction therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Function stat assessed rvwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1175F","description":"Function stat assessed rvwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99241","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Max MRI capture & interprete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0369","description":"Max MRI capture & interprete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0907T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","description":"CPT-0907T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes alg risk recr urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013M","description":"ONC MRNA 5 genes alg risk recr urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNB1","description":"ICD-JDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0079U","description":"Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs)_ urine and buccal DNA_ for specimen identity verification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE0","description":"ICD-OIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE0","description":"ICD-LARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33261","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD1","description":"ICD-OGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD1","description":"ICD-KCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD0","description":"ICD-JGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth w/o gen/neurax anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4560F","description":"Anesth w/o gen/neurax anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWC0","description":"ICD-GDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Posterior Chamber Of Eye_ Medication","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0699T","description":"Injection_ Posterior Chamber Of Eye_ Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF0","description":"ICD-GDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE1","description":"ICD-JGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB0","description":"ICD-CCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD0","description":"ICD-BFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27725","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33340","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant_ including fluoroscopy_ transseptal puncture_ catheter placement(s)_ left atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPA1","description":"ICD-GAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC0","description":"ICD-BBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB1","description":"ICD-AELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9917","description":"Documentation of medical reason(s) for not performing functional status (e.g._ patient is severely impaired and caregiver knowledge is limited_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB0","description":"ICD-ECTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF0","description":"ICD-CGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC1","description":"ICD-ADEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC51","description":"Very High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gr27 non-sealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2372","description":"Gr27 non-sealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE1","description":"ICD-GHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE0","description":"ICD-PLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harness figure of 8 sing con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6675","description":"Harness figure of 8 sing con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGE1","description":"ICD-CCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze<=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6216","description":"Non-sterile gauze<=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus aug w bone/bone sup","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7951","description":"Sinus aug w bone/bone sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetes prev standard curr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403T","description":"Diabetes prev standard curr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGC1","description":"ICD-OAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bio mtrls to aid soft/os reg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4265","description":"Bio mtrls to aid soft/os reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE1","description":"ICD-MGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA245","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Full mouth debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4355","description":"Full mouth debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB0","description":"ICD-MADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE0","description":"ICD-JCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKE0","description":"ICD-FBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3348","description":"Retreat root canal molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5130","description":"Injection_ pegfilgrastim-pbbk (fylnetra)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD1","description":"ICD-GGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFC0","description":"ICD-FBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF1","description":"ICD-CDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation syringe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4322","description":"Irrigation syringe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines1-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80346","description":"Benzodiazepines1-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED1","description":"ICD-MIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB221","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test electric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86923","description":"Compatibility test electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA0","description":"ICD-BHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21556","description":"Exc neck tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC0","description":"ICD-FGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8F","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF0","description":"ICD-GAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rho d immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2790","description":"Rho d immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC0","description":"ICD-EDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph egd dilation <30 mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43249","description":"Esoph egd dilation <30 mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11B","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec hand ind art digits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6880","description":"Elec hand ind art digits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap part colectomy w/stoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44206","description":"Lap part colectomy w/stoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0504T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak 4 bar ling w/hydraul swig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5613","description":"Ak 4 bar ling w/hydraul swig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE1","description":"ICD-LDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE0","description":"ICD-OCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supportive care for neurodegenerative conditions mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0004","description":"Supportive care for neurodegenerative conditions mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.12-7.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2301","description":"Lens sphere trifocal 4.12-7.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE1","description":"ICD-BDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE0","description":"ICD-MBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA1","description":"ICD-GBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis of a patient-specific panel_ cell-free DNA_ subsequent assessment with comparison to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o pseudobulbaffect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3757F","description":"Pt w/o pseudobulbaffect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPC0","description":"ICD-NLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cltx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27267","description":"Cltx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC0","description":"ICD-ABAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD1","description":"ICD-FHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9280","description":"Mitomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVD0","description":"ICD-JIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0765T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWE0","description":"ICD-CBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF1","description":"ICD-NLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF1","description":"ICD-GGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE1","description":"ICD-GACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC52","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA1","description":"ICD-CHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC0","description":"ICD-BIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE206","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens variab asphericity sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2410","description":"Lens variab asphericity sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA1","description":"ICD-OBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA130","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allogen_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4212","description":"Allogen_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1209","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay for phencyclidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83992","description":"Assay for phencyclidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0280U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen IV binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen IV bin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND1","description":"ICD-JCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF0","description":"ICD-CCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF0","description":"ICD-MEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF0","description":"ICD-IFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft xt_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4269","description":"Surgraft xt_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88142","description":"Cytopath c/v thin layer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86277","description":"Growth hormone antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sio rig pnl pelv/sac pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0623","description":"Sio rig pnl pelv/sac pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC1","description":"ICD-JDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m oxidronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9561","description":"Tc99m oxidronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Freeing of bowel adhesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44005","description":"Freeing of bowel adhesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90386","description":"Rh ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tooth socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41874","description":"Repair tooth socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17261","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA1","description":"ICD-FBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE1","description":"ICD-NHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc of non tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9275","description":"Doc of non tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGD0","description":"ICD-BAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF0","description":"ICD-IEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA31","description":"ICD-2DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36560","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate sol test kit_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4760","description":"Dialysate sol test kit_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maternity care procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59899","description":"Maternity care procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB1","description":"ICD-NCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF1","description":"ICD-KHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Current tobacco smoker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1034F","description":"Current tobacco smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC33","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC1","description":"ICD-ODXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pyruvate kinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84220","description":"Assay of pyruvate kinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","description":"HCPCS-M1419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD0","description":"ICD-MDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA0","description":"ICD-IHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISF1","description":"ICD-DISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML01","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXC1","description":"ICD-FAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0789T","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp cont lens eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0592","description":"Comp cont lens eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHF0","description":"ICD-OFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC0","description":"ICD-JBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peripheral vascular rehab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93668","description":"Peripheral vascular rehab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Igh vari regional mutation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81263","description":"Igh vari regional mutation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWC0","description":"ICD-DHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93000","description":"Electrocardiogram complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA1","description":"ICD-BFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pegademase bovine_ 25 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2504","description":"Pegademase bovine_ 25 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF1","description":"ICD-FAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporin parenteral 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7516","description":"Cyclosporin parenteral 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE1","description":"ICD-PEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE0","description":"ICD-BHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJD1","description":"ICD-OKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC1","description":"ICD-IBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE1","description":"ICD-FAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE0","description":"ICD-HGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of beta-2 protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82232","description":"Assay of beta-2 protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEF1","description":"ICD-ODEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC111","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA0","description":"ICD-FAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA0","description":"ICD-FFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLF1","description":"ICD-EDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3A","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9773","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy_ and transluminal stent placement(s)_ includes angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD0","description":"ICD-CEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYF0","description":"ICD-OLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD0","description":"ICD-LEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acp discuss-no dscnmkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1124F","description":"Acp discuss-no dscnmkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUB0","description":"ICD-JCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE0","description":"ICD-OJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto fluid redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88175","description":"Cytopath c/v auto fluid redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB1","description":"ICD-ADCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE0","description":"ICD-HIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME1","description":"ICD-FBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3371","description":"Injection_ vancomycin hcl (mylan) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA1","description":"ICD-EFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF0","description":"ICD-JHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m disofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9510","description":"Tc99m disofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB1","description":"ICD-AEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradation quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85379","description":"Fibrin degradation quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx distal radial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25606","description":"Treat fx distal radial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYD1","description":"ICD-DIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colostomy with biopsies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44322","description":"Colostomy with biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9036","description":"Injection_ bendamustine hydrochloride_ (Belrapzo)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0402","description":"HCPCS-B0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polishing artifical eye","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2624","description":"Polishing artifical eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99384","description":"Prev visit new age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phakic iol refractive error","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0596","description":"Phakic iol refractive error","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23485","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB1","description":"ICD-EBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4318","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","description":"HCPCS-A4318","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria x10sv endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33266","description":"Ablate atria x10sv endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF0","description":"ICD-KDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE1","description":"ICD-CGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20934","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; intercalary_ complete (ie_ cylindrical) (List separately in addition to code for prim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt shldr dis/interc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6885","description":"Replc sockt shldr dis/interc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups_ utilizing whole blood_ common RBC alleles reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD0","description":"ICD-EDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTB0","description":"ICD-NJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4369","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","description":"HCPCS-Q4369","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inc thyr node <1.0 in rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9552","description":"Inc thyr node <1.0 in rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF0","description":"ICD-DFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVE1","description":"ICD-KBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4335","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","description":"HCPCS-Q4335","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SYPHILIS TST ANTB IA QUAN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210U","description":"SYPHILIS TST ANTB IA QUAN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provision splnt intracoronal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4320","description":"Provision splnt intracoronal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF0","description":"ICD-FCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis delta agent antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86692","description":"Hepatitis delta agent antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD0","description":"ICD-NLXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE0","description":"ICD-EGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL21","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD1","description":"ICD-KCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE1","description":"ICD-DCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF0","description":"ICD-FBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain ostomy pouch w/flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5063","description":"Drain ostomy pouch w/flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0C","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD0","description":"ICD-DBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX60","description":"High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSA0","description":"ICD-HBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE1","description":"ICD-JDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate lower leg at knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27598","description":"Amputate lower leg at knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB1","description":"ICD-MLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87880","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC0","description":"ICD-BGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF0","description":"ICD-NEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB0","description":"ICD-MJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA1","description":"ICD-LFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE1","description":"ICD-JGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFE1","description":"ICD-JIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral everolimus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7527","description":"Oral everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51050","description":"Removal of bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA1","description":"ICD-KBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove maxilla cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21048","description":"Remove maxilla cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE1","description":"ICD-OGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0828T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; simple filter method with interpretation (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF0","description":"ICD-OJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA1","description":"ICD-OCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUD0","description":"ICD-IDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental suture wound to 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7911","description":"Dental suture wound to 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC0","description":"ICD-PDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0201","description":"HCPCS-C0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim other than wound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0283","description":"Elec stim other than wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilio-celiac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35632","description":"Art byp ilio-celiac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33895","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Not Crossing Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC0","description":"ICD-MLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0635U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0635U","description":"CPT-0635U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl monofocl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92352","description":"Fit aphakia spectcl monofocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74425","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC0","description":"ICD-BAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC21","description":"ICD-1KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93896","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","description":"CPT-93896","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPF1","description":"ICD-KEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF0","description":"ICD-CAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denileukin diftitox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9160","description":"Denileukin diftitox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB23","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42226","description":"Lengthening of palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB1","description":"ICD-OJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA1","description":"ICD-CIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9052","description":"Injection_ carmustine (accord)_ not therapeutically equivalent to j9050_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reminder serv per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5185","description":"Med reminder serv per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"(Blincyto)Injection_ Blinatumomab_ 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9449","description":"(Blincyto)Injection_ Blinatumomab_ 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7504","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE1","description":"ICD-BAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD1","description":"ICD-KGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA0","description":"ICD-FDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93588","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating below the heart (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND1","description":"ICD-OAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA1","description":"ICD-EFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB1","description":"ICD-GBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB1","description":"ICD-CAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21651","description":"Anesth head vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD0","description":"ICD-KESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED0","description":"ICD-NAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnioexcel or biodexcel_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4137","description":"Amnioexcel or biodexcel_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF1","description":"ICD-CEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF0","description":"ICD-NIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND0","description":"ICD-BFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42810","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXE0","description":"ICD-NJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Free fascial flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15758","description":"Free fascial flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3031","description":"Injection_ fremanezumab-vfrm_ 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician_ not for use when drug is self-administere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE1","description":"ICD-MBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43605","description":"Biopsy of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 xhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0855","description":"Pwc gp 3 xhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20611","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98005","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","description":"CPT-98005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86701","description":"Hiv-1antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54332","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC0","description":"ICD-JFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGD1","description":"ICD-KDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respite care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9125","description":"Respite care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA1","description":"ICD-OBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF1","description":"ICD-EIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES317","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc no comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9270","description":"Doc no comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA1","description":"ICD-MHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA1","description":"ICD-CIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL23","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD0","description":"ICD-NFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITC0","description":"ICD-MITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1327","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt w out cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9241","description":"Doc pt w out cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD1","description":"ICD-BHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGB1","description":"ICD-CEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5939","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5939","description":"CDT-D5939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD0","description":"ICD-JIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB1","description":"ICD-GGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSE0","description":"ICD-OLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90748","description":"Hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of breath ethanol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82075","description":"Assay of breath ethanol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB02","description":"Low Rehab_ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0547","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","description":"HCPCS-G0547","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo assay seven anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81506","description":"Endo assay seven anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE130","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sinus tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20500","description":"Injection of sinus tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transverse aortic arch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33870","description":"Transverse aortic arch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixed appliance therapy habt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8220","description":"Fixed appliance therapy habt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFB0","description":"ICD-JIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMA0","description":"ICD-AGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC31","description":"ICD-3JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA31","description":"ICD-1FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplt allo hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38240","description":"Transplt allo hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX23","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC0","description":"ICD-FFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE0","description":"ICD-OBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKA1","description":"ICD-ODKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC0","description":"ICD-DARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA0","description":"ICD-HIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC0","description":"ICD-GARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES216","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF0","description":"ICD-NFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC0","description":"ICD-NIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/o del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1875","description":"Stent_ coated/cov w/o del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0688T","description":"Treatment Of Amblyopia Using An Online Digital Program; Assessment Of Patient Performance And Program Data By Physician Or Other Qualified Health Care Professional_ With Repor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC0","description":"ICD-CAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7179","description":"Injection_ von Willebrand factor (recombinant)_ (Vonvendi)_ 1 IU VWF:RCo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPF0","description":"ICD-BBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0582U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","description":"CPT-0582U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj filgrastim gcsf biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5101","description":"Inj filgrastim gcsf biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC0","description":"ICD-LFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF0","description":"ICD-NJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC0","description":"ICD-LAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess negative docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3341F","description":"Mammo assess negative docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB0","description":"ICD-KHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8E","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD0","description":"ICD-OKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Devlopment test interpt&rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0451","description":"Devlopment test interpt&rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC1","description":"ICD-CBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2524","description":"Contact lens_ hydrophilic_ spherical_ photochromic additive_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl donor search management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38204","description":"Bl donor search management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDA1","description":"ICD-ABDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF1","description":"ICD-KIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF0","description":"ICD-PKYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8A","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA0","description":"ICD-FEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE0","description":"ICD-MJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No transfercare chklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584F","description":"No transfercare chklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA1","description":"ICD-GGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Female patients unable to bear children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1016","description":"Female patients unable to bear children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD1","description":"ICD-GBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF0","description":"ICD-IBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD0","description":"ICD-EDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB1","description":"ICD-NCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHE0","description":"ICD-FBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD0","description":"ICD-NFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0756T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group I_ for microorganisms (eg_ acid fast_ methenamine silver) (List separatel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB16","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBB1","description":"ICD-BCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF1","description":"ICD-FHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2high risk med ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9367","description":"2high risk med ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF1","description":"ICD-BGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiograph pelv w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72191","description":"Ct angiograph pelv w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA30","description":"High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE0","description":"ICD-NAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA0","description":"ICD-CIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFE0","description":"ICD-OEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE1","description":"ICD-CAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD0","description":"ICD-NDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD1","description":"ICD-BCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 45 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90836","description":"Psytx pt&/fam w/e&m 45 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81293","description":"Mlh1 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow deb/attch open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24359","description":"Repair elbow deb/attch open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29846","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96120","description":"Neuropsychological testing (eg_ Wisconsin Card Sorting Test)_ administered by a computer_ with qualified health care professional interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Filtered nebulizer admin set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7006","description":"Filtered nebulizer admin set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalist visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0310","description":"Hospitalist visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC0","description":"ICD-PKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC11","description":"ICD-1AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES135","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA0","description":"ICD-LHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct simpl maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7620","description":"Clsd reduct simpl maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of dibucaine number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82638","description":"Assay of dibucaine number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0574","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0574","description":"HCPCS-G0574","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8004","description":"HCPCS-C8004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c vent tray gimbaled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1030","description":"W/c vent tray gimbaled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD1","description":"ICD-FAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palifermin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2425","description":"Palifermin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate/fx repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31630","description":"Bronchoscopy dilate/fx repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE1","description":"ICD-JCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93312","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49621","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; reducibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCD0","description":"ICD-GHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27257","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD1","description":"ICD-CEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65220","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKC0","description":"ICD-KHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27093","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD116","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap close enterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44227","description":"Lap close enterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL32","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB1","description":"ICD-JETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81195","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","description":"CPT-81195","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB1","description":"ICD-NIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4196","description":"PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay glucose blood quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82947","description":"Assay glucose blood quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD0","description":"ICD-BHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF0","description":"ICD-JCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC0","description":"ICD-GALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD0","description":"ICD-KBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD0","description":"ICD-IATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED1","description":"ICD-AAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9026","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","description":"HCPCS-J9026","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA0","description":"ICD-NIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE0","description":"ICD-OCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA1","description":"ICD-FDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC101","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio not given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4042F","description":"Doc antibio not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular fomivirsen na","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1452","description":"Intraocular fomivirsen na","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA0","description":"ICD-GBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD1","description":"ICD-MHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE214","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93282","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assert comm tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0040","description":"Assert comm tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB1","description":"ICD-EDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC0","description":"ICD-KIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE1","description":"ICD-FFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB0","description":"ICD-BENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE0","description":"ICD-GBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc plan hybrid/stage proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9640","description":"Doc plan hybrid/stage proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB0","description":"ICD-DGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA0","description":"ICD-BIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB11","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF1","description":"ICD-HERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB246","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PreTRM®_ Sera Prognostics_ Sera Prognostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0247U","description":"PreTRM®_ Sera Prognostics_ Sera Prognostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE1","description":"ICD-CCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD0","description":"ICD-NBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63280","description":"Bx/exc idrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal allograft pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48556","description":"Removal allograft pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Expose behav assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362T","description":"Expose behav assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct malrotation of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44055","description":"Correct malrotation of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13152","description":"Cmplx rpr e/n/e/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00562","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","description":"CPT-00562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cranial cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61001","description":"Remove cranial cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palate/uvula surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42299","description":"Palate/uvula surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC0","description":"ICD-DHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96165","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Torsion mechanism wrist/elbo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3891","description":"Torsion mechanism wrist/elbo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0A","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9051","description":"Injection_ bortezomib (MAIA)_ not therapeutically equivalent to J9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE1","description":"ICD-OGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB1","description":"ICD-GISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sirolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80195","description":"Assay of sirolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYA1","description":"ICD-KIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF1","description":"ICD-KHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA1","description":"ICD-JBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC0","description":"ICD-BETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF0","description":"ICD-KBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF0","description":"ICD-IIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD0","description":"ICD-OFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5818","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21183","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD0","description":"ICD-HHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC1","description":"ICD-NBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB11","description":"ICD-4DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED1","description":"ICD-IAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB0","description":"ICD-OIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLF1","description":"ICD-NLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE1","description":"ICD-KHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC1","description":"ICD-AATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID0","description":"ICD-MJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE1","description":"ICD-GBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD0","description":"ICD-OFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF1","description":"ICD-EEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB1","description":"ICD-CIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXB0","description":"ICD-NFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grp b strep screening docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3294F","description":"Grp b strep screening docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD0","description":"ICD-KGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair vagina/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57210","description":"Repair vagina/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96118","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ per hour of the psychologist_s or physicia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC0","description":"ICD-BGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87164","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","description":"CPT-00626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5612","description":"repair resin partial denture base_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA0","description":"ICD-NILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv col sr foam 2pc pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0172","description":"Cerv col sr foam 2pc pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0477U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","description":"CPT-0477U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt biliary drainage cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47533","description":"Plmt biliary drainage cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB0","description":"ICD-DIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of arm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23931","description":"Drainage of arm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC1","description":"ICD-DERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PAS (Consumer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1792","description":"PAS (Consumer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84133","description":"Assay of urine potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC0","description":"ICD-DDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2312","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","description":"HCPCS-J2312","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIC0","description":"ICD-CGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18B","description":"Special Care Low _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9144","description":"Injection_ daratumumab_ 10 mg and hyaluronidase-fihj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD117","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB1","description":"ICD-MBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA1","description":"ICD-JILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel thomas with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3465","description":"Shoe heel thomas with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB0","description":"ICD-NDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEC0","description":"ICD-JGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject congenital card cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93563","description":"Inject congenital card cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4570","description":"Splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB1","description":"ICD-FDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF1","description":"ICD-ODRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF1","description":"ICD-KEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA0","description":"ICD-FHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB31","description":"ICD-2FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit inj interferon diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9559","description":"Hit inj interferon diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95725","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB1","description":"ICD-ECLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA0","description":"ICD-OINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recd f/u w/in 30d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9402","description":"Recd f/u w/in 30d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0450","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with invasive interface (e.g._ tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0767T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCD0","description":"ICD-BGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLA1","description":"ICD-JCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor four anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81511","description":"Ftl cgen abnor four anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn cervl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63285","description":"Bx/exc idrl imed lesn cervl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"marsupialization of odontogenic cyst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7509","description":"marsupialization of odontogenic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11307","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82978","description":"Assay of glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8865","description":"Doc med reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC1","description":"ICD-MBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9218","description":"Leuprolide acetate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52270","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3671","description":"So cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF0","description":"ICD-CGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA1","description":"ICD-OHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB0","description":"ICD-EFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND1","description":"ICD-OIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92637","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","description":"CPT-92637","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92531","description":"Spontaneous nystagmus study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combo ankle/foot prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5975","description":"Combo ankle/foot prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE1","description":"ICD-PLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF0","description":"ICD-PFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC1","description":"ICD-OBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD1","description":"ICD-EBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD0","description":"ICD-CBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE1","description":"ICD-KDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA0","description":"ICD-MADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB21","description":"ICD-2DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB1","description":"ICD-IAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDB1","description":"ICD-OEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA0","description":"ICD-GIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mens shoes hightop depth inl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3222","description":"Mens shoes hightop depth inl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWF0","description":"ICD-OHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99226","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE1","description":"ICD-MJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND0","description":"ICD-BHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2D","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mnt subs tx for change dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0270","description":"Mnt subs tx for change dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC1","description":"ICD-GBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE1","description":"ICD-CDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE0","description":"ICD-CIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0303","description":"HCPCS-C0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81201","description":"Apc gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITC1","description":"ICD-NITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76497","description":"Ct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB1","description":"ICD-CCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29700","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD1","description":"ICD-OKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF0","description":"ICD-CHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE0","description":"ICD-KISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8H","description":"Low Rehab_ ADL Index 0-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rgd ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1237","description":"Rgd ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prism lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2715","description":"Prism lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9140","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTA0","description":"ICD-BFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9224","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9224","description":"CDT-D9224","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1074","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31087","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF1","description":"ICD-GBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36468","description":"Injection(s) of sclerosant for spider veins (telangiectasia)_ limb or trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC0","description":"ICD-GDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF0","description":"ICD-OCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3273F","description":"High risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0014","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0014","description":"HCPCS-J0014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD0","description":"ICD-GGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6895","description":"Custom glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9362","description":"Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE1","description":"ICD-BFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB05","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD1","description":"ICD-EDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB0","description":"ICD-KECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGA1","description":"ICD-BHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC1","description":"ICD-LDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC0","description":"ICD-OBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE0","description":"ICD-FIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69632","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9482","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25130","description":"Removal of wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA1","description":"ICD-JCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB0","description":"ICD-JCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD1","description":"ICD-BBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE1","description":"ICD-FBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4424","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","description":"HCPCS-Q4424","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC0","description":"ICD-NDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB0","description":"ICD-OCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF0","description":"ICD-EIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF0","description":"ICD-JACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB0","description":"ICD-KDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4773","description":"Occult blood test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD0","description":"ICD-GFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove radius bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24136","description":"Remove radius bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC0","description":"ICD-CIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC0","description":"ICD-FDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fungus isolation culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87102","description":"Fungus isolation culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF0","description":"ICD-GIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE1","description":"ICD-JHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKB0","description":"ICD-CBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581T","description":"Ablation_ Malignant Breast Tumor(S)_ Percutaneous_ Cryotherapy_ Including Imaging Guidance When Performed_ Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA0","description":"ICD-OIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC1","description":"ICD-AHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood methemoglobin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83050","description":"Blood methemoglobin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68400","description":"Incise/drain tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE1","description":"ICD-NAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot non-stndard size/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3254","description":"Orth foot non-stndard size/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA1","description":"ICD-CAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA1","description":"ICD-IHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community/work reintegration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97537","description":"Community/work reintegration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC256","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME1","description":"ICD-NJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1045","description":"Functional status measurement with score was obtained utilizing the Oxford Knee Score (OKS) patient reported outcome tool withi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD1","description":"ICD-NFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC0","description":"ICD-AGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA1","description":"ICD-CHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xylose tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84620","description":"Xylose tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0013","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv)_ includes: hiv risk assessment (initial or continued","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF0","description":"ICD-OHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC0","description":"ICD-DFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME0","description":"ICD-JFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21121","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","description":"HCPCS-Q4362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC0","description":"ICD-AHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHE1","description":"ICD-NEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA0","description":"ICD-NFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDD1","description":"ICD-CDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg >16<=48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0745","description":"Absorp drg >16<=48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1143","description":"Initiated Episode Of Rehabilitation Therapy_ Medical_ Or Chiropractic Care For Neck Impairment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE1","description":"ICD-JAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSE0","description":"ICD-OGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB0","description":"ICD-KHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE1","description":"ICD-GIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33970","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF0","description":"ICD-BIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE0","description":"ICD-BCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE1","description":"ICD-OIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWC1","description":"ICD-PDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIA1","description":"ICD-KDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1602","description":"HCPCS-C1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBF0","description":"ICD-OFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1301","description":"HCPCS-B1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esw wound healing addl wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300T","description":"Esw wound healing addl wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92602","description":"Diagnostic analysis of cochlear implant_ patient younger than 7 years of age; subsequent reprogramming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF0","description":"ICD-OBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of femur 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73551","description":"X-ray exam of femur 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE1","description":"ICD-HIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc sinus ct 28d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9349","description":"Doc sinus ct 28d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51845","description":"Repair bladder neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93971","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42400","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD1","description":"ICD-CHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No order for ceph no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9198","description":"No order for ceph no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroguide for vein device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77001","description":"Fluoroguide for vein device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB1","description":"ICD-PCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTF0","description":"ICD-EDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRC1","description":"ICD-DDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF1","description":"ICD-FGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ synthetic_ resorbable_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1849","description":"Skin substitute_ synthetic_ resorbable_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22226","description":"Revise extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA50","description":"Low Rehab_ ADL Index 0-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD1","description":"ICD-KCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient encounter during the performance period with hospice and palliative care specialty code 17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1365","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2102","description":"Adjunctive continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB0","description":"ICD-OHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61536","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe styled positioning dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3160","description":"Shoe styled positioning dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Etoposide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9181","description":"Etoposide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-asst vag hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58550","description":"Laparo-asst vag hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22515","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF1","description":"ICD-BBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78434","description":"Absolute Quantitation Of Myocardial Blood Flow (Aqmbf)_ Positron Emission Tomography (Pet)_ Rest And Pharmacologic Stress (List Separately In Addition To Code For Primary Proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA1","description":"ICD-OJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC0","description":"ICD-DBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8D","description":"Very High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26561","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME0","description":"ICD-CGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2D","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDE0","description":"ICD-BDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE1","description":"ICD-PBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","description":"HCPCS-J1737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB0","description":"ICD-AEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB0","description":"ICD-CFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB0","description":"ICD-GGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA0","description":"ICD-EIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Porc/ceram inlay >= 3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6601","description":"Porc/ceram inlay >= 3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pneum swg frct exo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5722","description":"Knee-shin pneum swg frct exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC0","description":"ICD-MGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5250","description":"Hearing aid_ prog_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA0","description":"ICD-KIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF1","description":"ICD-CHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Misc/exper non-prescript dru","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9150","description":"Misc/exper non-prescript dru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove uterus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59100","description":"Remove uterus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB1","description":"ICD-CHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB0","description":"ICD-OHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE154","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor cell deplete of harvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38211","description":"Tumor cell deplete of harvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0760T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ initial single antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID0","description":"ICD-IFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC0","description":"ICD-ADCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC1","description":"ICD-BCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97811","description":"Acupunct w/o stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD0","description":"ICD-EEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33720","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA0","description":"ICD-MCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temporal artery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37609","description":"Temporal artery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision/removal of kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27424","description":"Revision/removal of kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF0","description":"ICD-OJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O&p supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L9900","description":"O&p supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0974T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","description":"CPT-0974T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB1","description":"ICD-OFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9845","description":"Patient received anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUA0","description":"ICD-JFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA0","description":"ICD-PBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel new rubber standar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3460","description":"Shoe heel new rubber standar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVB0","description":"ICD-JAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1mg (Yondelis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9480","description":"Injection_ trabectedin_ 0.1mg (Yondelis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC0","description":"ICD-BCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver lobe split","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47145","description":"Prep donor liver lobe split","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC35","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/ tc 1 marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88184","description":"Flowcytometry/ tc 1 marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis east eqne anbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86652","description":"Encephaltis east eqne anbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD1","description":"ICD-KACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF1","description":"ICD-BHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA0","description":"ICD-CGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcyte_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4182","description":"Transcyte_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9844","description":"Patient did not receive anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA0","description":"ICD-KFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 2-3 vsts p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90952","description":"Esrd serv 2-3 vsts p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX24","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64584","description":"Removal Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTD1","description":"ICD-NFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE1","description":"ICD-GIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19366","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC0","description":"ICD-BGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA0","description":"ICD-PGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35303","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL51","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQE1","description":"ICD-OEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAME1","description":"ICD-JAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF0","description":"ICD-PISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"P2y inhib not presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9440","description":"P2y inhib not presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB0","description":"ICD-OESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA26","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA0","description":"ICD-NDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD0","description":"ICD-OEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF1","description":"ICD-CGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC213","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAB0","description":"ICD-CGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8646","description":"Asthma mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0319U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using pretransplant peripheral blood_ algorithm reported as a risk score for early acute reje","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81558","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","description":"CPT-81558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78265","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD0","description":"ICD-GBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid dispensing fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5110","description":"Hearing aid dispensing fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE1","description":"ICD-OCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext 7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12034","description":"Intmd rpr s/tr/ext 7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Promoting wellness mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0005","description":"Promoting wellness mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/rmv pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64595","description":"Revise/rmv pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC0","description":"ICD-IBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96370","description":"Sc ther infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB0","description":"ICD-BBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOE0","description":"ICD-CFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levoleucovorin_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9043","description":"Injection_ levoleucovorin_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4A","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA0","description":"ICD-IDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD0","description":"ICD-EBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA11","description":"ICD-3LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA0","description":"ICD-CEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont pain per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9326","description":"Hit cont pain per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabergoline_ oral 0.25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8515","description":"Cabergoline_ oral 0.25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46615","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95983","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered pres-redu air mattrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0277","description":"Powered pres-redu air mattrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2114","description":"Afo tib fx semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8470","description":"Pros sock single ply bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC1","description":"ICD-CCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB11","description":"ICD-1CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29822","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10120","description":"Remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE1","description":"ICD-NJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degradj d-dimer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85380","description":"Fibrin degradj d-dimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL17","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","description":"CPT-00820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD0","description":"ICD-NDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pouch absorbent material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4422","description":"Ost pouch absorbent material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/2.25-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2112","description":"Spherocylindr 7.25d/2.25-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB1","description":"ICD-JABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE1","description":"ICD-KCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt drug device for iop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0356T","description":"Insrt drug device for iop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay prostate phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84066","description":"Assay prostate phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic us exam esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43237","description":"Endoscopic us exam esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB0","description":"ICD-IIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1301","description":"HCPCS-A1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA0","description":"ICD-CBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental sedative filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2940","description":"Dental sedative filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3260","description":"Tobramycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB11","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0598U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","description":"CPT-0598U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC1","description":"ICD-KAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE1","description":"ICD-FCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topical ox deliver sys_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0446","description":"Topical ox deliver sys_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45520","description":"Treatment of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB31","description":"ICD-2CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40804","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit for hemodialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99512","description":"Home visit for hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ atezolizumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9022","description":"Injection_ atezolizumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB1","description":"ICD-KGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC0","description":"ICD-OFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC1","description":"ICD-GIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sec art thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37186","description":"Sec art thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9765","description":"Documentation that the patient declined therapy change or alternative therapies were unavailable_ has documented contraindications_ or has not been treated with an oral system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB1","description":"ICD-GEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso axilla sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1010","description":"Ctlso axilla sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroguide for spine inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77003","description":"Fluoroguide for spine inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOA1","description":"ICD-PCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lumbar hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49540","description":"Repair lumbar hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48550","description":"Donor pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE0","description":"ICD-AGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB0","description":"ICD-JIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC1","description":"ICD-CEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUF1","description":"ICD-OCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of homocystine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83090","description":"Assay of homocystine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77092","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Interpretation And Report On Fracture-Risk Only By Other Qualified Health Care Professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF1","description":"ICD-OHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIA1","description":"ICD-NGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reposition gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43761","description":"Reposition gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9775","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s)_ and atherectomy_ includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC0","description":"ICD-FFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9466","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sio flex pelvisacral custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0622","description":"Sio flex pelvisacral custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB0","description":"ICD-KCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF1","description":"ICD-MEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB0","description":"ICD-FDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF1","description":"ICD-HHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECE0","description":"ICD-EECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA0","description":"ICD-OHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB0","description":"ICD-NEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1204","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA0","description":"ICD-ABHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB0","description":"ICD-ADLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB146","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA0","description":"ICD-ECCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD1","description":"ICD-KFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA1","description":"ICD-EEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/svc oxygen equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0740","description":"Repair/svc oxygen equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system gas portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0430","description":"Oxygen system gas portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC1","description":"ICD-CCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50395","description":"Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE1","description":"ICD-KAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion total face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15780","description":"Dermabrasion total face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF1","description":"ICD-KGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFB1","description":"ICD-CAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ck (cpk)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82550","description":"Assay of ck (cpk)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL55","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE1","description":"ICD-JEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6694","description":"Elbow socket ins use w/lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0507U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","description":"CPT-0507U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE1","description":"ICD-AEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC0","description":"ICD-NDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2024","description":"Telecare equipment installation and removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr cbl combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0493","description":"Emr pwr cbl combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bleeding time test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85002","description":"Bleeding time test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8991","description":"Other pt/ot goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC17","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED1","description":"ICD-KCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE0","description":"ICD-GBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21050","description":"Removal of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE0","description":"ICD-CFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB144","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis-periapical radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0389","description":"intraoral tomosynthesis-periapical radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC0","description":"ICD-KHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE0","description":"ICD-KGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA0","description":"ICD-GHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEC1","description":"ICD-JBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kneecap bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27340","description":"Removal of kneecap bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0267T","description":"Implt/rpl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50580","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB0","description":"ICD-GBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 2.6-5.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12052","description":"Intmd rpr face/mm 2.6-5.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB0","description":"ICD-GBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7553","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC0","description":"ICD-BDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70250","description":"X-ray exam of skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOD1","description":"ICD-HCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF0","description":"ICD-NLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sex chromatin identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88130","description":"Sex chromatin identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryoablate prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55873","description":"Cryoablate prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99344","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC0","description":"ICD-KFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA30","description":"Default_ /30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC0","description":"ICD-GGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","description":"HCPCS-G0569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA1","description":"ICD-AFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube stainless","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7522","description":"Trach/laryn tube stainless","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA1","description":"ICD-KHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB1","description":"ICD-KDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE1","description":"ICD-FDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF1","description":"ICD-GEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevat legrst low extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0046","description":"Elevat legrst low extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC31","description":"ICD-4HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA0","description":"ICD-GDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF0","description":"ICD-JBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer ultrasonic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0575","description":"Nebulizer ultrasonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA0","description":"ICD-GGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0695U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695U","description":"CPT-0695U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF1","description":"ICD-OAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colorec ca scr_ sto bas dna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0464","description":"Colorec ca scr_ sto bas dna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23A","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACME0","description":"ICD-ACME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBA1","description":"ICD-EDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD0","description":"ICD-NJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD0","description":"ICD-CGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA1","description":"ICD-LBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2d tee w or w/o fol w/con_in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8925","description":"2d tee w or w/o fol w/con_in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGC1","description":"ICD-FIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA0","description":"ICD-PHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1385","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","description":"HCPCS-M1385","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pin ulnar styloid fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25651","description":"Pin ulnar styloid fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41140","description":"Removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA0","description":"ICD-KGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70460","description":"Ct head/brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9433","description":"Death_ permanent nursing home resident or receiving hospice or palliative care any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown full noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6792","description":"Crown full noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF1","description":"ICD-BDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB106","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eflapegrastim-xnst_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1449","description":"Injection_ eflapegrastim-xnst_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No knee joint with artic ali","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5220","description":"No knee joint with artic ali","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symphony_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2009","description":"Symphony_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0407","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0407","description":"CDT-D0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE0","description":"ICD-OCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt tlk psych & rx opd addic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4306F","description":"Pt tlk psych & rx opd addic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 3RD DOSE PFIZER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB0","description":"ICD-OAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0971T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","description":"CPT-0971T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49014","description":"Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing_ Including Repacking_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable gas oxygen system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0738","description":"Portable gas oxygen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med risk prostate cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3272F","description":"Med risk prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD0","description":"ICD-PFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC0","description":"ICD-JGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVC0","description":"ICD-CHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTA0","description":"ICD-ODTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC1","description":"ICD-EGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA1","description":"ICD-DDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2510","description":"Penicillin g procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDA0","description":"ICD-OIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99494","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46748","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAF0","description":"ICD-OEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney dialysate delivry sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1510","description":"Kidney dialysate delivry sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML25","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us urine capacity measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51798","description":"Us urine capacity measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB1","description":"ICD-AILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF1","description":"ICD-KCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF1","description":"ICD-JGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA1","description":"ICD-GABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC117","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exchange drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49423","description":"Exchange drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB0","description":"ICD-BHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC1","description":"ICD-FIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck ext unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9112","description":"Onc dx head/neck ext unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB0","description":"ICD-JBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF0","description":"ICD-DBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor fletcher fact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85292","description":"Clot factor fletcher fact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKC1","description":"ICD-JHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA0","description":"ICD-OCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE0","description":"ICD-KIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA31","description":"ICD-4HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC0","description":"ICD-NEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA0","description":"ICD-MEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev auto grasp feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6881","description":"Term dev auto grasp feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYC0","description":"ICD-GFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC33","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2468","description":"Injection_ palonosetron HCl (Avyxa)_ not therapeutically equivalent to J2469_ 25 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC1","description":"ICD-OFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reuse diaper/brief any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4539","description":"Reuse diaper/brief any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0143U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF1","description":"ICD-CETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test beta-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3846","description":"Gene test beta-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWB1","description":"ICD-DDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE1","description":"ICD-KEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multidisciplinary care plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580F","description":"Multidisciplinary care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA0","description":"ICD-GDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx complex interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90785","description":"Psytx complex interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5131","description":"Injection_ adalimumab-aacf (idacio)_ biosimilar_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA35","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALC0","description":"ICD-NALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9637","description":"At least two orders for the same high-risk medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC0","description":"ICD-NCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder/vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51900","description":"Repair bladder/vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB0","description":"ICD-FALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF1","description":"ICD-GAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15200","description":"Skin full graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB0","description":"ICD-GAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Snrpn/ube3a gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81331","description":"Snrpn/ube3a gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8D","description":"Very High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sperm duct(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55250","description":"Removal of sperm duct(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCA1","description":"ICD-NDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9963","description":"Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF0","description":"ICD-CCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3760","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ item that has been trimmed_ bent_ molded_ assembled_ or otherwise customized to fit a specific p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC BRST CA DNA PIK3CA 11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0177U","description":"ONC BRST CA DNA PIK3CA 11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB0","description":"ICD-CALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE136","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD1","description":"ICD-GHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD0","description":"ICD-BDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1501","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1501","description":"CDT-D1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No photodoc cecal ldmk exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9614","description":"No photodoc cecal ldmk exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB0","description":"ICD-MKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC56","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA1","description":"ICD-GANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close mult vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33675","description":"Close mult vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25565","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate clinical met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9133","description":"Onc dx prostate clinical met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB1","description":"ICD-OFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal extent unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9095","description":"Onc dx rectal extent unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of free testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84402","description":"Assay of free testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ire abltj 1+tumors open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0601T","description":"Ire abltj 1+tumors open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB1","description":"ICD-BCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE0","description":"ICD-GGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25115","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical semi-rigid adjustab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0140","description":"Cervical semi-rigid adjustab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No off assis eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9382","description":"No off assis eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sng solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2010","description":"Kafo sng solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood pku","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84030","description":"Assay of blood pku","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF0","description":"ICD-CBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF1","description":"ICD-NGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB0","description":"ICD-JEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC0","description":"ICD-JCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB1","description":"ICD-AHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL22","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPA0","description":"ICD-FBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYC1","description":"ICD-DGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB0","description":"ICD-FBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5170","description":"HCPCS-Q5170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complex lymphedema therapy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8950","description":"Complex lymphedema therapy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ leg re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1190","description":"Wheelchair amputee w/ leg re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0840T","description":"Digitization of glass microscope slides for consultation_ comprehensive_ with review of records and specimens_ with report on referred material (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","description":"HCPCS-J1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF1","description":"ICD-GFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE0","description":"ICD-KIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD0","description":"ICD-GALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00537","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","description":"CPT-00537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF1","description":"ICD-OBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us quant a only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76511","description":"Ophth us quant a only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB136","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA46","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC1","description":"ICD-NKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA0","description":"ICD-PKOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8931","description":"Mra_ w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA1","description":"ICD-MJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asp presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9435","description":"Asp presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3A","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9173","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD1","description":"ICD-OHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD1","description":"ICD-OEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L hrt cath trnsptl puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93462","description":"L hrt cath trnsptl puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF1","description":"ICD-CEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA50","description":"Medium Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB1","description":"ICD-GDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE1","description":"ICD-PEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC1","description":"ICD-GHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX60","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE1","description":"ICD-MDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipoprotein(a)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83695","description":"Assay of lipoprotein(a)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB1","description":"ICD-KANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD0","description":"ICD-CIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1920","description":"Injection_ labetalol hydrochloride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE1","description":"ICD-JBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD0","description":"ICD-MLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB0","description":"ICD-FFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd cautery tumor polyp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43250","description":"Egd cautery tumor polyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISF0","description":"ICD-HISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt talk psychsoc&rx oh dpnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4320F","description":"Pt talk psychsoc&rx oh dpnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9904","description":"Documentation of medical reason(s) for not screening for tobacco use (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33822","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA1","description":"ICD-MIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99442","description":"Phone e/m phys/qhp 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE256","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB0","description":"ICD-KIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD1","description":"ICD-OEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1090T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1090T","description":"CPT-1090T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone length studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77073","description":"X-rays bone length studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix repair bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57556","description":"Remove cervix repair bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB126","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-elec oscillatory pep dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0484","description":"Non-elec oscillatory pep dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES214","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74248","description":"Radiologic Small Intestine Follow-Through Study_ Including Multiple Serial Images (List Separately In Addition To Code For Primary Procedure For Upper Gi Radiologic Examinatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE1","description":"ICD-AECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53210","description":"Removal of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE1","description":"ICD-GAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAE1","description":"ICD-IEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA1","description":"ICD-BFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC1","description":"ICD-HCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLC0","description":"ICD-NBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA0","description":"ICD-NBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27487","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBE1","description":"ICD-KBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay other fluid chlorides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82438","description":"Assay other fluid chlorides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow aspirate &biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0364","description":"Bone marrow aspirate &biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA0","description":"ICD-OLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clamp neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61703","description":"Clamp neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair leg fascia defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27656","description":"Repair leg fascia defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sputum specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89220","description":"Sputum specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50940","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB1","description":"ICD-MFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC0","description":"ICD-NHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJC0","description":"ICD-KGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33781","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94625","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; Without Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEE1","description":"ICD-JDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27327","description":"Exc thigh/knee les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00932","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","description":"CPT-00932","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ibd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8758","description":"Ibd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB40","description":"Very High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6257","description":"Transparent film <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle/rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21705","description":"Revision of neck muscle/rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj tendon sheath/ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20550","description":"Inj tendon sheath/ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18A","description":"Special Care High _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA1","description":"ICD-OLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE0","description":"ICD-ODFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays adrenals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75733","description":"Artery x-rays adrenals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXD1","description":"ICD-NLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDD1","description":"ICD-CFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31233","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX50","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD0","description":"ICD-MLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2182","description":"Injection_ mepolizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB1","description":"ICD-JBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB0","description":"ICD-HDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In ear binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5130","description":"In ear binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline pwr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1005","description":"Pwr seat recline pwr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6097","description":"Abutment Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF1","description":"ICD-CDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF1","description":"ICD-AFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB0","description":"ICD-ADIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC1","description":"ICD-KCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hair trnspl >15 punch grafts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15776","description":"Hair trnspl >15 punch grafts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 4+ prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34848","description":"Visc & infraren abd 4+ prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44010","description":"Incision of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE0","description":"ICD-OAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC0","description":"ICD-DBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB1","description":"ICD-BFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenosine inj 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0153","description":"Adenosine inj 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC21","description":"ICD-2AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27062","description":"Remove femur lesion/bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna direct probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87149","description":"Dna/rna direct probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66983","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anidulafungin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0348","description":"Anidulafungin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB1","description":"ICD-BAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reusable underpad chair size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4540","description":"Reusable underpad chair size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC21","description":"ICD-2HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB1","description":"ICD-OFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 75 or older on their initiation of dialysis date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1264","description":"Patients age 75 or older on their initiation of dialysis date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36569","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB0","description":"ICD-GEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF0","description":"ICD-NBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD0","description":"ICD-GADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD1","description":"ICD-JCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmv antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86644","description":"Cmv antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA0","description":"ICD-NKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33724","description":"Repair venous anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA0","description":"ICD-MKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng provided symp mngmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4350F","description":"Cnslng provided symp mngmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dacarbazine 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9130","description":"Dacarbazine 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy liver add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47001","description":"Needle biopsy liver add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93241","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Includes Recording_ Scanning Analysis With Report_ Revi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIE0","description":"ICD-JAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87426","description":"IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64840","description":"Repair of leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE1","description":"ICD-CDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD0","description":"ICD-LIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWB0","description":"ICD-PGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE0","description":"ICD-KADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1103T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1103T","description":"CPT-1103T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84202","description":"Assay rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antb addl slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88341","description":"Immunohisto antb addl slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82105","description":"Alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14451","description":"Anesth corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mononuclear cell antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86356","description":"Mononuclear cell antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA1","description":"ICD-KGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF1","description":"ICD-KGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2128","description":"Documentation Of Medical Reason(S) For Not On A Daily Aspirin Or Other Antiplatelet (E.G. History Of Gastrointestinal Bleed_ Intra-Cranial Bleed_ Blood Disorders_ Idiopathic T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0528","description":"Management of established patient with dementia_ moderate to high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0403","description":"CDT-D0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24361","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: occipital headache in children","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2195","description":"Patients with clinical indications for imaging of the head: occipital headache in children","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA1","description":"ICD-GISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1312","description":"Patient not screened for tobacco use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB1","description":"ICD-MLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB0","description":"ICD-FAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE1","description":"ICD-CABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9764","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ includes angiopla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0805","description":"CDT-D0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31225","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD0","description":"ICD-NEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1178","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g._ prior anaphylaxis due to the pneumococcal vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEC1","description":"ICD-ECEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB1","description":"ICD-FCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF0","description":"ICD-AGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fecal microbiota_ live - jslm_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1440","description":"Fecal microbiota_ live - jslm_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA11","description":"Default_ /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add joint upper ext orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3956","description":"Add joint upper ext orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59150","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWA1","description":"ICD-LDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF0","description":"ICD-CHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61606","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0940T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","description":"CPT-0940T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67917","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycophenolic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7518","description":"Mycophenolic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC0","description":"ICD-MDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33619","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing complete lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81372","description":"Hla i typing complete lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0086U","description":"Infectious disease (bacterial and fungal)_ organism identification_ blood culture_ using rRNA FISH_ 6 or more organism targets_ reported as positive or negative with phenotypi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63286","description":"Bx/exc idrl imed lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ferumoxytol_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0139","description":"Ferumoxytol_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDD1","description":"ICD-JGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAC1","description":"ICD-MJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE204","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB221","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF1","description":"ICD-OIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prim art m-thrmbc 1st vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37184","description":"Prim art m-thrmbc 1st vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Path consult intraop addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88332","description":"Path consult intraop addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUC0","description":"ICD-GHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1460","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","description":"HCPCS-M1460","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC1","description":"ICD-DBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB206","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC1","description":"ICD-AEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27500","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE0","description":"ICD-NHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0800","description":"Pov group 1 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nusinersen_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2326","description":"Injection_ nusinersen_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC0","description":"ICD-NGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCE0","description":"ICD-GBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC1","description":"ICD-OJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA0","description":"ICD-GBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE0","description":"ICD-OCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE1","description":"ICD-GAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart-vein defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33732","description":"Repair heart-vein defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC0","description":"ICD-FFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC0","description":"ICD-CAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHF0","description":"ICD-BAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB0","description":"ICD-OCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF0","description":"ICD-KDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92371","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epifix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4186","description":"Epifix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt alkaline 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0603","description":"Repl batt alkaline 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC1","description":"ICD-EGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMD0","description":"ICD-FCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25360","description":"Revision of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89352","description":"Thawing cryopresrved embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Er and ip hosp <2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9521","description":"Er and ip hosp <2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary service/procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94799","description":"Pulmonary service/procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD1","description":"ICD-OLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","description":"CPT-92634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF1","description":"ICD-BHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27635","description":"Remove lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC0","description":"ICD-BAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1701","description":"CDT-D1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia init blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49501","description":"Rpr ing hernia init blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","description":"HCPCS-E1034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB11","description":"ICD-1IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF0","description":"ICD-MATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD0","description":"ICD-DEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appli half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0669","description":"Seg pneumatic appli half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75731","description":"Artery x-rays adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLB1","description":"ICD-ODLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE245","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Novafix dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4254","description":"Novafix dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA0","description":"ICD-CDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA1","description":"ICD-BEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise external hemorrhoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46083","description":"Incise external hemorrhoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB1","description":"ICD-CDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth 60 min/> as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4255F","description":"Anesth 60 min/> as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE1","description":"ICD-JITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBC1","description":"ICD-EDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB220","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA1","description":"ICD-AFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB0","description":"ICD-JIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC0","description":"ICD-CIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC0","description":"ICD-BCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPF0","description":"ICD-NBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52325","description":"Cystoscopy stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE1","description":"ICD-OAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenytoin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80185","description":"Assay of phenytoin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYF1","description":"ICD-CAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC0","description":"ICD-ODLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk pn xm on init visit date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2040F","description":"Bk pn xm on init visit date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA1","description":"ICD-ECAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE0","description":"ICD-OLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29851","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA0","description":"ICD-PASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skull lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61500","description":"Removal of skull lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4283","description":"Auto tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attendant control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2331","description":"Attendant control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0223","description":"Injection_ givosiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC0","description":"ICD-GHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1525","description":"Remove bilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB0","description":"ICD-NGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16070","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16070","description":"CPT-16070","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVD0","description":"ICD-GBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB0","description":"ICD-AABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA46","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23B","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF0","description":"ICD-HDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted px extraocular musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67399","description":"Unlisted px extraocular musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous tibial nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0736","description":"Transcutaneous tibial nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27507","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3D","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD0","description":"ICD-KGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB0","description":"ICD-KAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB1","description":"ICD-OCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD0","description":"ICD-GFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML1ST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111A","description":"ADM SARSCOV2 25MCG/0.25ML1ST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver whole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47143","description":"Prep donor liver whole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ artesunate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0391","description":"Injection_ artesunate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF1","description":"ICD-PLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0671","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0671","description":"HCPCS-G0671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD1","description":"ICD-ABDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0130U","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55707","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","description":"CPT-55707","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA1","description":"ICD-KGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC120","description":"Special Care High _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB1","description":"ICD-OLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmnioCyte Plus_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4242","description":"AmnioCyte Plus_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA1","description":"ICD-JCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11106","description":"Incisional biopsy of skin (eg_ wedge) (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLF1","description":"ICD-CCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA1","description":"ICD-OGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69420","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"B-12 binding capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82608","description":"B-12 binding capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8G","description":"High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE106","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPD0","description":"ICD-JHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF1","description":"ICD-PIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA0","description":"ICD-MKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND0","description":"ICD-NDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9247","description":"Injection_ melphalan flufenamide_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27440","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHA1","description":"ICD-NEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrmng 4 surg normothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4250F","description":"Wrmng 4 surg normothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD0","description":"ICD-MBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSD0","description":"ICD-DGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA1","description":"ICD-CCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA0","description":"ICD-OKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8577","description":"Reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC0","description":"ICD-KHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF0","description":"ICD-PEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12002","description":"Rpr s/n/ax/gen/trnk2.6-7.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9932","description":"Clean & inspect rem dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Droperidol/fentanyl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1810","description":"Droperidol/fentanyl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC1","description":"ICD-NGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC1","description":"ICD-NHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB0","description":"ICD-KBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor vii proconvertin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85230","description":"Clot factor vii proconvertin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA1","description":"ICD-HFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVE0","description":"ICD-OCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYD1","description":"ICD-KHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC0","description":"ICD-BBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD0","description":"ICD-HEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB1","description":"ICD-JHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1072","description":"Radiation Therapy For Anal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trifoc prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0508","description":"Trifoc prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office visit during hours","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9430","description":"Office visit during hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA1","description":"ICD-CICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1729","description":"Injection_ hydroxyprogesterone caproate_ not otherwise specified_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0212U","description":"RARE DS GEN DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX20","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF0","description":"ICD-OFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62143","description":"Replace skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25690","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA31","description":"Default_ /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHA0","description":"ICD-FBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artiss fibrin sealant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9250","description":"Artiss fibrin sealant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE1","description":"ICD-IITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF1","description":"ICD-JEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93298","description":"Ilr device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD1","description":"ICD-MJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIE1","description":"ICD-EDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF1","description":"ICD-GAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice respite care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2044","description":"Hospice respite care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat width 24-27 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2202","description":"Seat width 24-27 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLD1","description":"ICD-GBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA1","description":"ICD-KIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC0","description":"ICD-AFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniocentesis diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59000","description":"Amniocentesis diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE0","description":"ICD-IBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA120","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE0","description":"ICD-KAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC1","description":"ICD-MAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD0","description":"ICD-GFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB0","description":"ICD-CHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE0","description":"ICD-GCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA0","description":"ICD-BAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Face tent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4619","description":"Face tent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess dyspnea present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1019F","description":"Assess dyspnea present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC1","description":"ICD-JFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67880","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA1","description":"ICD-GAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","description":"HCPCS-M1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE0","description":"ICD-CHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC0","description":"ICD-CBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD0","description":"ICD-BDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB07","description":"Medium Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJB1","description":"ICD-GFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26590","description":"Repair finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj benztropine mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0515","description":"Inj benztropine mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventilating tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69424","description":"Remove ventilating tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0515","description":"Development of cognitive skills to improve attention_ memory_ problem solving (includes compensatory training)_ direct (one-on-one) patient contact_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enuresis alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8270","description":"Enuresis alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE0","description":"ICD-PKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychoed svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2027","description":"Psychoed svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB0","description":"ICD-OBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht pharm per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9810","description":"Ht pharm per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0204","description":"HCPCS-C0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of folic acid rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82747","description":"Assay of folic acid rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1461","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","description":"HCPCS-M1461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC0","description":"ICD-KGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc post surg anatomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9613","description":"Doc post surg anatomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPC1","description":"ICD-FGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyto/molecular report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88291","description":"Cyto/molecular report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61607","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD0","description":"ICD-JGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBD1","description":"ICD-GHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81449","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ 5-50 genes (eg_ ALK_ BRAF_ CDKN2A_ EGFR_ ERBB2_ KIT_ KRAS_ MET_ NRAS_ PDGFRA_ PDGFRB_ PGR_ PIK3CA_ PTEN_ RET)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE1","description":"ICD-GIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0017","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE1","description":"ICD-BDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA1","description":"ICD-DFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef calorie dense>/=1.5kcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4152","description":"Ef calorie dense>/=1.5kcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84583","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF1","description":"ICD-NBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB1","description":"ICD-JFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61619","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC0","description":"ICD-EIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB60","description":"High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht musc image planar mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78454","description":"Ht musc image planar mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA1","description":"ICD-PKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF1","description":"ICD-CAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB1","description":"ICD-OGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified preventive proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1999","description":"Unspecified preventive proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF0","description":"ICD-CAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symptoms improved/consist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1450F","description":"Symptoms improved/consist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1601","description":"HCPCS-A1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE1","description":"ICD-KDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA0","description":"ICD-GETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28122","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB1","description":"ICD-EFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF0","description":"ICD-KAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88373","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC31","description":"ICD-2IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76080","description":"X-ray exam of fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99424","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC231","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0401","description":"CDT-D0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED0","description":"ICD-CHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE1","description":"ICD-KEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB06","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD1","description":"ICD-AITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD0","description":"ICD-MDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF1","description":"ICD-OCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1464","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","description":"HCPCS-M1464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC1","description":"ICD-FIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","description":"HCPCS-J1308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEB1","description":"ICD-MFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC1","description":"ICD-GAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILA1","description":"ICD-GILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50551","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC151","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93644","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gadobutrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9585","description":"Gadobutrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4238","description":"Supply allowance for adjunctive continuous glucose monitor (CGM)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF0","description":"ICD-GHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB0","description":"ICD-JDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28113","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC21","description":"ICD-1IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC0","description":"ICD-KEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33464","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB113","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB1","description":"ICD-FHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE1","description":"ICD-KEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA40","description":"Very High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp common ipsi carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35601","description":"Art byp common ipsi carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD1","description":"ICD-OHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cultured chondrocytes implnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7330","description":"Cultured chondrocytes implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1222","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE206","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61305","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB1","description":"ICD-JHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF1","description":"ICD-FIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD0","description":"ICD-GIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dil retina exam interp rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2022F","description":"Dil retina exam interp rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35091","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE0","description":"ICD-ACDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXF0","description":"ICD-NLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5282","description":"Removable unilateral partial denture - one piece cast metal_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cuffs adj lock w/ active con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3740","description":"Cuffs adj lock w/ active con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32310","description":"Removal of chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB0","description":"ICD-MCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9225","description":"Norsn no foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL30","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9310","description":"Unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop applicat rigid dsg on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6388","description":"Postop applicat rigid dsg on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33267","description":"Exclusion Of Left Atrial Appendage_ Open_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30462","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 15-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88262","description":"Chromosome analysis 15-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA1","description":"ICD-CENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86774","description":"Tetanus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28112","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 2nd+ bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36254","description":"Ins cath ren art 2nd+ bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB0","description":"ICD-PKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81349","description":"Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants_ Low-Pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED0","description":"ICD-JCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-axilary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35516","description":"Art byp grft subclav-axilary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA0","description":"ICD-IEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB231","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL46","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","description":"CPT-98011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41105","description":"Biopsy of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC0","description":"ICD-EIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing fr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2600","description":"Hip clevis/thrust bearing fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0279U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand factor (VWF) and collagen III binding by enzyme-linked immunosorbent assays (ELISA)_ plasma_ report of collagen III b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD1","description":"ICD-DASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96119","description":"Neuropsychological testing (eg_ Halstead-Reitan Neuropsychological Battery_ Wechsler Memory Scales and Wisconsin Card Sorting Test)_ with qualified health care professional in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOC0","description":"ICD-CAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB1","description":"ICD-HAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA0","description":"ICD-EGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject l ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93565","description":"Inject l ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB53","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg > 48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6239","description":"Hydrocolld drg > 48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF1","description":"ICD-KFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90619","description":"Meningococcal conjugate vaccine_ serogroups A_ C_ W_ Y_ quadrivalent_ tetanus toxoid carrier (MenACWY-TT)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA0","description":"ICD-BHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exemestane_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0156","description":"Exemestane_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD0","description":"ICD-GAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin >500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96922","description":"Laser tx skin >500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA0","description":"ICD-PGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC206","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE1","description":"ICD-KFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF0","description":"ICD-LAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psych diagnostic evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90791","description":"Psych diagnostic evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE1","description":"ICD-JDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47380","description":"Open ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft t/a/l child add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15274","description":"Skn sub grft t/a/l child add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 3-4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73522","description":"X-ray exam hips bi 3-4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD1","description":"ICD-EILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC1","description":"ICD-EFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD1","description":"ICD-NKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33422","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA1","description":"ICD-CIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of arm nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64861","description":"Repair of arm nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9300","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9300","description":"HCPCS-C9300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC0","description":"ICD-GDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35458","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open reduc compd alveolus fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7770","description":"Open reduc compd alveolus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect radius/ulnar tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25170","description":"Resect radius/ulnar tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNF1","description":"ICD-OFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD1","description":"ICD-CDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB56","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple sleep latency test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95805","description":"Multiple sleep latency test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt pt opt alterna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9059","description":"Onc prac mgmt pt opt alterna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE0","description":"ICD-GIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","description":"HCPCS-J1164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF0","description":"ICD-LCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2643","description":"Brachytx_ non-stranded_c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95726","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB1","description":"ICD-NLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscop po debrid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2342","description":"Nasal endoscop po debrid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB1","description":"ICD-NKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF1","description":"ICD-OFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA1","description":"ICD-DCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31370","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB1","description":"ICD-GCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33509","description":"Harvest Of Upper Extremity Artery_ 1 Segment_ For Coronary Artery Bypass Procedure_ Endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 or no ct sinus w/in 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9354","description":"1 or no ct sinus w/in 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE1","description":"ICD-JDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB1","description":"ICD-AFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFD0","description":"ICD-BGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0767","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0767","description":"HCPCS-E0767","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF0","description":"ICD-GBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC1","description":"ICD-IEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE1","description":"ICD-IGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159T","description":"Computer-aided detection_ including computer algorithm analysis of MRI image data for lesion detection/characterization_ pharmacokinetic analysis_ with further physician revie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA1","description":"ICD-JDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54112","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0245","description":"Intravenous infusion_ bamlanivimab and etesevimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC32","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA0","description":"ICD-ECBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE0","description":"ICD-CCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA1","description":"ICD-CGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD160","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD1","description":"ICD-FHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83069","description":"Assay of urine hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD1","description":"ICD-CDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB0","description":"ICD-ODCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA1","description":"ICD-KHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0869","description":"Pwc gp 4 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6310","description":"Shoulder passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228U","description":"Oncology (prostate)_ multianalyte molecular profile by photometric detection of macromolecules adsorbed on nanosponge array slides with machine learning_ utilizing first morni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of cloacal anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46746","description":"Repair of cloacal anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD1","description":"ICD-FFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62287","description":"Percutaneous diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA1","description":"ICD-CATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64408","description":"N block inj vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28415","description":"Treat heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0918","description":"No satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC1","description":"ICD-OKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group psychotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90853","description":"Group psychotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc tb scrng-rslts interpd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3510F","description":"Doc tb scrng-rslts interpd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0024","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA0","description":"ICD-JHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE0","description":"ICD-GHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42660","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCED0","description":"ICD-KCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD0","description":"ICD-OHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1076T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1076T","description":"CPT-1076T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD1","description":"ICD-FFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE0","description":"ICD-MJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost s/d acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7405","description":"Add ue prost s/d acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND0","description":"ICD-JHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVA1","description":"ICD-FFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin sys stance flexion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5845","description":"Knee-shin sys stance flexion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB0","description":"ICD-OLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME1","description":"ICD-EIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALF1","description":"ICD-IALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Capsaicin 8% patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7336","description":"Capsaicin 8% patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC0","description":"ICD-KESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care_ in the home_ p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9126","description":"Hospice care_ in the home_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJC0","description":"ICD-KAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB34","description":"Medium Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL41","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB0","description":"ICD-EGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270U","description":"Hematology (congenital coagulation disorders)_ genomic sequence analysis of 20 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Coagulation Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36557","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Larynscop w/tumr exc + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31541","description":"Larynscop w/tumr exc + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7657","description":"Isoproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA0","description":"ICD-GFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6224","description":"Gauze > 48 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3D","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt tk tams hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9503","description":"Pt tk tams hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB0","description":"ICD-GIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ipratropium bromide non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7644","description":"Ipratropium bromide non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC0","description":"ICD-OFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE246","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNC0","description":"ICD-CDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30020","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE1","description":"ICD-GCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD0","description":"ICD-JAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gr24 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2362","description":"Gr24 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITB1","description":"ICD-EITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYF1","description":"ICD-CCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF0","description":"ICD-ECIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF0","description":"ICD-BFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46948","description":"Hemorrhoidectomy_ Internal_ By Transanal Hemorrhoidal Dearterialization_ 2 Or More Hemorrhoid Columns/Groups_ Including Ultrasound Guidance_ With Mucopexy_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD0","description":"ICD-GEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collect & prep saliva sample","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0417","description":"Collect & prep saliva sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw <4views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70100","description":"X-ray exam of jaw <4views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC1","description":"ICD-EEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE1","description":"ICD-CHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE1","description":"ICD-MGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC1","description":"ICD-MECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC1","description":"ICD-PCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47420","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA0","description":"ICD-AEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36620","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64629","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; Each Additional Vertebral Body_ Lumbar Or Sacral (List Separately In Addition To Code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA0","description":"ICD-JEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAF1","description":"ICD-MEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27829","description":"Treat lower leg joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43830","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB154","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/orogastric w/tube plmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43752","description":"Nasal/orogastric w/tube plmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21615","description":"Removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB1","description":"ICD-NDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE0","description":"ICD-BHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE250","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforced solid stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2260","description":"Reinforced solid stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61575","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB0","description":"ICD-NLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB0","description":"ICD-NKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE1","description":"ICD-CHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED0","description":"ICD-AIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA1","description":"ICD-OFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISA1","description":"ICD-DISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0903T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","description":"CPT-0903T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Belt_ strap_ sleeve_ garment_ or covering_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4467","description":"Belt_ strap_ sleeve_ garment_ or covering_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF0","description":"ICD-CERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0691U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691U","description":"CPT-0691U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL05","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart image (pet) multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78492","description":"Heart image (pet) multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC1","description":"ICD-CAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54000","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23170","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFF1","description":"ICD-KCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8717","description":"Spkt/v less than 1. 2 (single-pool clearance of urea [kt] / volume [v])_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ringers lactate infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7120","description":"Ringers lactate infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLE1","description":"ICD-CGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB0","description":"ICD-NFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE1","description":"ICD-JETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF1","description":"ICD-FIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE1","description":"ICD-FABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE1","description":"ICD-KGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1279","description":"Elevated or hypertensive blood pressure reading documented_ indicated follow-up not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB1","description":"ICD-GFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE1","description":"ICD-LGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC1","description":"ICD-GIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release finger contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26525","description":"Release finger contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC1","description":"ICD-KAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQC1","description":"ICD-KCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61524","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA0","description":"ICD-EIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (lyumjev)_ per 5 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1814","description":"Insulin (lyumjev)_ per 5 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDB1","description":"ICD-OHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE0","description":"ICD-OGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87561","description":"M.avium-intra dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long-acting inhaled bronchodilator prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9695","description":"Long-acting inhaled bronchodilator prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF0","description":"ICD-HESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB0","description":"ICD-MKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB0","description":"ICD-HFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE1","description":"ICD-KBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGC1","description":"ICD-CHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD134","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hernia repair w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49568","description":"Hernia repair w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF0","description":"ICD-KEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ fixed_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1893","description":"Intro/sheath_ fixed_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE1","description":"ICD-ECLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pamidronate disodium /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2430","description":"Pamidronate disodium /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0528U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","description":"CPT-0528U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polysom <6 yrs 4/> paramtrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95782","description":"Polysom <6 yrs 4/> paramtrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC1","description":"ICD-CIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63075","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE1","description":"ICD-BEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with nonreactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1231","description":"Patient receives hcv antibody test with nonreactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC1","description":"ICD-FGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC0","description":"ICD-KBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of nasal adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30560","description":"Release of nasal adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA1","description":"ICD-PAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE1","description":"ICD-FBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0596","description":"Patient admitted to a SPU or and ASC for a procedure which could not be certified as medically necessary for that place of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHA1","description":"ICD-OEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB1","description":"ICD-OKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cricotracheal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31592","description":"Cricotracheal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA0","description":"ICD-KBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9979","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB1","description":"ICD-CHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC0","description":"ICD-OBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct upper jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21206","description":"Reconstruct upper jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE0","description":"ICD-GHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE1","description":"ICD-JFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD1","description":"ICD-NGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD114","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBB1","description":"ICD-KGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA1","description":"ICD-NAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC1","description":"ICD-NFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","description":"HCPCS-M1411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMF1","description":"ICD-BHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69300","description":"Revise external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete sl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4270","description":"Complete sl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy of joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29999","description":"Arthroscopy of joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA0","description":"ICD-KADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (Perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9037","description":"Injection_ risperidone (Perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF1","description":"ICD-MFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elliotts b solution per ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9175","description":"Elliotts b solution per ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF0","description":"ICD-NABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA1","description":"ICD-JDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF1","description":"ICD-GFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abx pres w/in 10 dys of symp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9505","description":"Abx pres w/in 10 dys of symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1003","description":"Clinical Decision Support Mechanism Medicalis_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE0","description":"ICD-NADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA1","description":"ICD-FGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2209","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF1","description":"ICD-BIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2213","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting_ including assessment_ referral to ongoing care_ and arranging access to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXD1","description":"ICD-NKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF0","description":"ICD-IDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24545","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC1","description":"ICD-HGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18I","description":"Special Care High _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18I","description":"Clinically Complex _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34421","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF1","description":"ICD-KIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA1","description":"ICD-LFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tooth splitting","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3920","description":"Tooth splitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA1","description":"ICD-FAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB0","description":"ICD-CBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA1","description":"ICD-MECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cisplatin 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9060","description":"Cisplatin 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB1","description":"ICD-JBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVB1","description":"ICD-JFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOA0","description":"ICD-LIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF1","description":"ICD-GFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC0","description":"ICD-JEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA1","description":"ICD-EBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934]_ rs6560711 [WDR37]_ rs3735222 [SCIN/LOC10798676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apnea monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0618","description":"Apnea monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytomegalovirus imm iv /vial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0850","description":"Cytomegalovirus imm iv /vial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58940","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF0","description":"ICD-JCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX44","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24370","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA0","description":"ICD-JHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84488","description":"Test feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia push tecnique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96420","description":"Chemo ia push tecnique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0B","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1356","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture complete mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5865","description":"Overdenture complete mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF0","description":"ICD-AGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLB0","description":"ICD-GCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0829T","description":"Digitization of glass microscope slides for cytopathology_ concentration technique_ smears_ and interpretation (eg_ Saccomanno technique) (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA1","description":"ICD-GHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFF1","description":"ICD-JFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatorrhaphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48545","description":"Pancreatorrhaphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF1","description":"ICD-JBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phoenix wound matrix_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2015","description":"Phoenix wound matrix_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB0","description":"ICD-NIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEA0","description":"ICD-NLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEE0","description":"ICD-CDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB22","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE1","description":"ICD-OBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE1","description":"ICD-IBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB1","description":"ICD-JADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25100","description":"Biopsy of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1801","description":"CDT-D1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98977","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE1","description":"ICD-AEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy nerve face muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64612","description":"Destroy nerve face muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF1","description":"ICD-KCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD1","description":"ICD-FBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA0","description":"ICD-OLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tirofiban hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3246","description":"Tirofiban hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92553","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA1","description":"ICD-HBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB1","description":"ICD-JCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert prost urethral stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53855","description":"Insert prost urethral stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21082","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF1","description":"ICD-CHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB1","description":"ICD-CGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB1","description":"ICD-GECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","description":"HCPCS-M1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD1","description":"ICD-BIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB0","description":"ICD-CHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC0","description":"ICD-NLFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE0","description":"ICD-EGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC0","description":"ICD-NCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASA1","description":"ICD-KASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID0","description":"ICD-OFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA1","description":"ICD-ODOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC0","description":"ICD-CIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHB0","description":"ICD-GGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: positional headaches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2191","description":"Patients with clinical indications for imaging of the head: positional headaches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28510","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC1","description":"ICD-OJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCD0","description":"ICD-NLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC0","description":"ICD-KEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33780","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration - resorbable barrier_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6106","description":"guided tissue regeneration - resorbable barrier_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB1","description":"ICD-PGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Map tachycardia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93609","description":"Map tachycardia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay dipropylacetic acd tot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80164","description":"Assay dipropylacetic acd tot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28005","description":"Treat foot bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD1","description":"ICD-BCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj vnt elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411T","description":"Insj/rplc car modulj vnt elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB155","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1330","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1330","description":"HCPCS-L1330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii type 1 ag equiv lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81377","description":"Hla ii type 1 ag equiv lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC0","description":"ICD-GHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49605","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFD1","description":"ICD-JDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015U","description":"Drug metabolism (adverse drug reactions)_ DNA_ 22 drug metabolism and transporter genes_ real-time PCR_ blood or buccal swab_ genotype and metabolizer status for therapeutic d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7210","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE1","description":"ICD-OIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC0","description":"ICD-KGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0341U","description":"Fetal aneuploidy DNA sequencing comparative analysis_ fetal DNA from products of conception_ reported as normal (euploidy)_ monosomy_ trisomy_ or partial deletion/duplication_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED0","description":"ICD-FIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9010","description":"Mccd_ risk adj_ level 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35355","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38100","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tract equip cervical tract","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0860","description":"Tract equip cervical tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient transferred to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9826","description":"Patient transferred to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec alys vagus nrv pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317T","description":"Elec alys vagus nrv pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA02","description":"Very High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD1","description":"ICD-CIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD0","description":"ICD-KBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC0","description":"ICD-NGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB0","description":"ICD-PDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA1","description":"ICD-MBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE0","description":"ICD-FDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC260","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359T","description":"Behavior identification assessment_ by the physician or other qualified health care professional_ face-to-face with patient and caregiver(s)_ includes administration of standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA1","description":"ICD-NFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc stent & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37231","description":"Tib/per revasc stent & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC1","description":"ICD-LIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Belimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0490","description":"Belimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48140","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL52","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB1","description":"ICD-AFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB0","description":"ICD-NAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0593T","description":"Health And Well-Being Coaching Face-To-Face; Group (2 Or More Individuals)_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUF0","description":"ICD-FAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD1","description":"ICD-AELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME1","description":"ICD-NAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65710","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD112","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC0","description":"ICD-JEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE0","description":"ICD-NDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee joint drop lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2405","description":"Knee joint drop lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXF1","description":"ICD-CEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13A","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC0","description":"ICD-NJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","description":"HCPCS-M1382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4023","description":"Cast sup sht arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB0","description":"ICD-DCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF1","description":"ICD-CANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLD0","description":"ICD-OGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensve oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0150","description":"Comprehensve oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood chloride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82435","description":"Assay of blood chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC1","description":"ICD-BBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscope w/vc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31570","description":"Laryngoscope w/vc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin ischemia modified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82045","description":"Albumin ischemia modified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30130","description":"Excise inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd trapeze bar attach to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0911","description":"Hd trapeze bar attach to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01742","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","description":"CPT-01742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9596","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Illuccix)_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE0","description":"ICD-MDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27506","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant temple bone w/stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69714","description":"Implant temple bone w/stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0032","description":"Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis Of Schizophrenia_ Schizoaffective Disorder_ Or Bipolar Disorder On Or Between January 1 Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1239","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/abn lvef b-bloc no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8452","description":"Pt w/abn lvef b-bloc no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28240","description":"Release of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA0","description":"ICD-KAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care coord at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9477","description":"Care coord at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB0","description":"ICD-LFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","description":"CPT-00868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUD1","description":"ICD-NAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68130","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore abdominal vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35840","description":"Explore abdominal vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF0","description":"ICD-KHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC1","description":"ICD-BCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB0","description":"ICD-CCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v thin layer redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88143","description":"Cytopath c/v thin layer redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA0","description":"ICD-OJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC0","description":"ICD-GFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA0","description":"ICD-MAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD0","description":"ICD-AFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have an order for or are receiving hospice or palliative care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1186","description":"Patients who have an order for or are receiving hospice or palliative care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB21","description":"ICD-1JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE0","description":"ICD-KBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open coronary endarterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33572","description":"Open coronary endarterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC0","description":"ICD-IELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60521","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHF1","description":"ICD-BFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vibrate quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107T","description":"Vibrate quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80344","description":"Antipsychotics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0493","description":"Skilled services of a registered nurse (RN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requires skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB13","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388T","description":"Transcatheter removal of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA0","description":"ICD-JHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alginate dressing > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6198","description":"Alginate dressing > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA1","description":"ICD-JADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE0","description":"ICD-CALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB114","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0061U","description":"Transcutaneous measurement of five biomarkers (tissue oxygenation [StO2]_ oxyhemoglobin [ctHbO2]_ deoxyhemoglobin [ctHbR]_ papillary and reticular dermal hemoglobin concentrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD1","description":"ICD-BDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA0","description":"ICD-KCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1099T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1099T","description":"CPT-1099T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion mr imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19085","description":"Bx breast 1st lesion mr imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363U","description":"Oncology (urothelial)_ mRNA_ gene-expression profiling by real-time quantitative PCR of 5 genes (MDK_ HOXA13_ CDC2 [CDK1]_ IGFBP5_ and CXCR2)_ utilizing urine_ algorithm incor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tint photochromatic lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2744","description":"Tint photochromatic lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD0","description":"ICD-DFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Er/ip hosp =/>2 in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9522","description":"Er/ip hosp =/>2 in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0861T","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA1","description":"ICD-CILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE1","description":"ICD-JHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA1","description":"ICD-BDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst incl t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58552","description":"Laparo-vag hyst incl t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0637","description":"Lso sc r ant/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB1","description":"ICD-NIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS GEN DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213U","description":"RARE DS GEN DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE0","description":"ICD-MHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE1","description":"ICD-CINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA1","description":"ICD-KCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41113","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF0","description":"ICD-IHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF1","description":"ICD-OBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB1","description":"ICD-BDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSE1","description":"ICD-GBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9165","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0526U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","description":"CPT-0526U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB0","description":"ICD-ODOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA0","description":"ICD-GGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA260","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA0","description":"ICD-JAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65860","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF1","description":"ICD-BINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD1","description":"ICD-KCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB0","description":"ICD-HGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC1","description":"ICD-OGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE0","description":"ICD-MLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB244","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB21","description":"ICD-3IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE0","description":"ICD-OLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384T","description":"External heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81425","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF0","description":"ICD-AEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC1","description":"ICD-NJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc comm risk calc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9316","description":"Doc comm risk calc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9841","description":"RAS (KRAS and NRAS) gene mutation testing not performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF1","description":"ICD-OLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38720","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No beta-lactam abx ther_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9560","description":"No beta-lactam abx ther_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC1","description":"ICD-GHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arch supp att to shoe metata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3080","description":"Arch supp att to shoe metata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21295","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC1","description":"ICD-AFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryoablate renal mass open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50250","description":"Cryoablate renal mass open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE1","description":"ICD-OKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMF1","description":"ICD-NLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD1","description":"ICD-OADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB0","description":"ICD-CHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF0","description":"ICD-JGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured spleen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38115","description":"Repair of ruptured spleen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker monitr digital/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0615","description":"Pacemaker monitr digital/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC1","description":"ICD-NJXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6721","description":"Crown resin w/base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD1","description":"ICD-OIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXD0","description":"ICD-OEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD0","description":"ICD-GFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24155","description":"Removal of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recement supp crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6092","description":"Recement supp crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0301","description":"HCPCS-C0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27001","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1A","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB0","description":"ICD-NEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA0","description":"ICD-JDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0024U","description":"Glycosylated acute phase proteins (GlycA)_ nuclear magnetic resonance spectroscopy_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD0","description":"ICD-ODXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE0","description":"ICD-IDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC31","description":"ICD-1AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD0","description":"ICD-CEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES234","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD1","description":"ICD-GDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC1","description":"ICD-CDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1552","description":"Re-Cement Or Re-Bond Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF1","description":"ICD-OAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB1","description":"ICD-NJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA1","description":"ICD-MJLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rho(d) immune globulin h_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2792","description":"Rho(d) immune globulin h_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB0","description":"ICD-CDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF0","description":"ICD-PLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFA0","description":"ICD-CGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alert device_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9280","description":"Alert device_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Milwaukee type superstructur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1230","description":"Milwaukee type superstructur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1003","description":"TB screening performed and results interpreted within 12 months prior to initiation of first-time biologic disease modifying an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF1","description":"ICD-OIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBC1","description":"ICD-AFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQE0","description":"ICD-DHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC0","description":"ICD-KCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA0","description":"ICD-OKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0004","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81230","description":"CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg_ drug metabolism)_ gene analysis_ common variant(s) (eg_ *2_ *22)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"F emb trns canc case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4018","description":"F emb trns canc case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDA1","description":"ICD-BGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0770T","description":"Virtual reality technology to assist therapy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95712","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD1","description":"ICD-GISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF0","description":"ICD-IHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC0","description":"ICD-KFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB30","description":"Medium Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine patch legend","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4990","description":"Nicotine patch legend","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF1","description":"ICD-AHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Brexanolone_ 1Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9055","description":"Injection_ Brexanolone_ 1Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Varicella zoster ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87290","description":"Varicella zoster ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD1","description":"ICD-EDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452U","description":"Oncology (bladder)_ methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP)_ urine_ reported as likelihood of blad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA1","description":"ICD-OFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin pump initiation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9145","description":"Insulin pump initiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulse gen sys tx endolymp fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2120","description":"Pulse gen sys tx endolymp fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECD1","description":"ICD-NECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC0","description":"ICD-BDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6211","description":"Bridge base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; parenchyma (eg_ organ)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76981","description":"Ultrasound_ elastography; parenchyma (eg_ organ)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0C","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE0","description":"ICD-CDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA1","description":"ICD-NDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML43","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB155","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB0","description":"ICD-OEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD1","description":"ICD-BHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF1","description":"ICD-KESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC0","description":"ICD-EBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ 20 or more elec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1731","description":"Cath_ ep_ 20 or more elec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Empiric antibiotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4045F","description":"Empiric antibiotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9773","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevate footrest articulate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0053","description":"Elevate footrest articulate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC21","description":"ICD-4KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHF0","description":"ICD-OBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD244","description":"Clinically Complex _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB0","description":"ICD-NAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC1","description":"ICD-DIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA1","description":"ICD-JIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLF1","description":"ICD-IBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL32","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50549","description":"Laparoscope proc renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE1","description":"ICD-KDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE1","description":"ICD-JBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHF1","description":"ICD-GBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High inten beh couns std 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0445","description":"High inten beh couns std 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protein c concentrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2724","description":"Protein c concentrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1135","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9629","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF1","description":"ICD-MDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1098T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1098T","description":"CPT-1098T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99211","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2046","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2046","description":"HCPCS-A2046","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB1","description":"ICD-CFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD1","description":"ICD-PLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0491","description":"Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA1","description":"ICD-AFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF0","description":"ICD-OIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB1","description":"ICD-OLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQD1","description":"ICD-DFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXD1","description":"ICD-OLXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE0","description":"ICD-AABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD1","description":"ICD-FGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE0","description":"ICD-FIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA56","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB0","description":"ICD-PJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opps service_sched team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0175","description":"Opps service_sched team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQF1","description":"ICD-HFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB1","description":"ICD-CGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC31","description":"ICD-3BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","description":"HCPCS-J9326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD1","description":"ICD-GFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC0","description":"ICD-NIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21196","description":"Reconst lwr jaw w/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOA0","description":"ICD-OIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA1","description":"ICD-HERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed write/oral pts w/ hf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4003F","description":"Pt ed write/oral pts w/ hf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD1","description":"ICD-MDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of proinsulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84206","description":"Assay of proinsulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND0","description":"ICD-NEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA0","description":"ICD-EDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject for spine disk x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62290","description":"Inject for spine disk x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC0","description":"ICD-JHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA11","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2040","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND1","description":"ICD-BGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","description":"CPT-00812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67560","description":"Revise eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0633U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0633U","description":"CPT-0633U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF1","description":"ICD-MKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gravity assisted traction de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0941","description":"Gravity assisted traction de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9899","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAC1","description":"ICD-MFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE0","description":"ICD-KBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0665","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","description":"HCPCS-G0665","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF1","description":"ICD-IGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE0","description":"ICD-OLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIB1","description":"ICD-FDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4297","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","description":"HCPCS-A4297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQA0","description":"ICD-DCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0637T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC1","description":"ICD-CDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKC0","description":"ICD-BGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red simp malar/zygom fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7660","description":"Clsd red simp malar/zygom fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD160","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37266","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","description":"CPT-37266","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE0","description":"ICD-FEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD140","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC55","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE0","description":"ICD-JFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF1","description":"ICD-OLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brca1 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81215","description":"Brca1 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA1","description":"ICD-GCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC1","description":"ICD-KFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision/drain abscess extra","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7521","description":"Incision/drain abscess extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLE1","description":"ICD-JDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLD1","description":"ICD-EGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMC1","description":"ICD-FFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA0","description":"ICD-LHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0536T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; download review_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE0","description":"ICD-EFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD1","description":"ICD-KHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9607","description":"Documented medical reasons for not performing intraoperative cystoscopy (e.g._ urethral pathology precluding cystoscopy_ any patient who has a congenital or acquired absence o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBD0","description":"ICD-NDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reaching/grabbing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9281","description":"Reaching/grabbing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA05","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAD1","description":"ICD-NEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy face plate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4361","description":"Ostomy face plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol renal-amirosy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5000","description":"Parenteral sol renal-amirosy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder abduction joint pai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6640","description":"Shoulder abduction joint pai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF1","description":"ICD-JDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9924","description":"Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations_ orders or referrals for positive screen (e.g._ patient in pal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF1","description":"ICD-EIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC0","description":"ICD-OJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 xtra hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0829","description":"Pwc gp 2 xtra hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE1","description":"ICD-PEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metl 4/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2544","description":"Dental onlay metl 4/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB1","description":"ICD-KHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64550","description":"Application of surface (transcutaneous) neurostimulator (eg_ TENS unit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum deep <5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27619","description":"Exc leg/ankle tum deep <5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC0","description":"ICD-NGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dolasetron mesylate oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0180","description":"Dolasetron mesylate oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA0","description":"ICD-CGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJC1","description":"ICD-JBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","description":"CPT-00620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pentostatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9268","description":"Pentostatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA0","description":"ICD-BDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9765","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy_ and transluminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC1","description":"ICD-NCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD1","description":"ICD-OIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC1","description":"ICD-ODDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rep perf anoper/vestib fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46716","description":"Rep perf anoper/vestib fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB1","description":"ICD-JITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31288","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE1","description":"ICD-GARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD0","description":"ICD-JEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE1","description":"ICD-JHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF1","description":"ICD-KCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardioassist internal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92970","description":"Cardioassist internal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXE1","description":"ICD-BAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA1","description":"ICD-BIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB0","description":"ICD-BIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF0","description":"ICD-FHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD0","description":"ICD-JDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAE0","description":"ICD-BDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB101","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC0","description":"ICD-OGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE1","description":"ICD-GIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD1","description":"ICD-OLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9485","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA0","description":"ICD-FBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No sig dep symp by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3352F","description":"No sig dep symp by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methsuximide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6054","description":"Methsuximide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE0","description":"ICD-GESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUA0","description":"ICD-NFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE1","description":"ICD-OFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m fanolesomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9566","description":"Tc99m fanolesomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo urethral suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51990","description":"Laparo urethral suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES134","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF0","description":"ICD-FAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deoxycortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82634","description":"Deoxycortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoro polarize fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83663","description":"Fluoro polarize fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223T","description":"Acoustic cardiography_ including automated analysis of combined acoustic and electrical intervals; single_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC0","description":"ICD-DISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC0","description":"ICD-OJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28735","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGA0","description":"ICD-OEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Voice current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9171","description":"Voice current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-60661","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","description":"CPT-60661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC1","description":"ICD-GDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD0","description":"ICD-NHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1163","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC0","description":"ICD-DHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA1","description":"ICD-KBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0853T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each multiplex probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC1","description":"ICD-CITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE1","description":"ICD-KFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26715","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE0","description":"ICD-FELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA0","description":"ICD-JCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26200","description":"Remove hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD1","description":"ICD-KDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replc sockt above elbow disa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6884","description":"Replc sockt above elbow disa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home episodic case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0272","description":"Home episodic case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEE1","description":"ICD-JCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB1","description":"ICD-JAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD1","description":"ICD-HDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIA0","description":"ICD-GAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPC0","description":"ICD-FEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD113","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC213","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27054","description":"Removal of hip joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418U","description":"Oncology (breast)_ augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features_ reported as a recurrence score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81172","description":"AFF2 (AF4/FMR2 family_ member 2 [FMR2]) (eg_ fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg_ expanded size and methylation status)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD1","description":"ICD-HAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Death did not occur during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9815","description":"Death did not occur during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF1","description":"ICD-OGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD0","description":"ICD-DCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC0","description":"ICD-ODSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDD1","description":"ICD-IDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86813","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acyclovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0133","description":"Acyclovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF0","description":"ICD-OHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC0","description":"ICD-OLPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfacon-1 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9212","description":"Interferon alfacon-1 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA43","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Island pedicle flap graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15740","description":"Island pedicle flap graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB1","description":"ICD-OILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC0","description":"ICD-KBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOA0","description":"ICD-LEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD0","description":"ICD-MJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE1","description":"ICD-EEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE1","description":"ICD-JAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA1","description":"ICD-JEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD0","description":"ICD-KFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD151","description":"Clinically Complex _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD1","description":"ICD-JGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA1","description":"ICD-DCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0030U","description":"Drug metabolism (warfarin drug response)_ targeted sequence analysis (ie_ CYP2C9_ CYP4F2_ VKORC1_ rs12777823)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMC1","description":"ICD-KHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDA1","description":"ICD-KGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of amylase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82150","description":"Assay of amylase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27097","description":"Revision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC0","description":"ICD-JCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC1","description":"ICD-ECDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam for fungi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87220","description":"Tissue exam for fungi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scope plantar fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29893","description":"Scope plantar fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB1","description":"ICD-GDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAF0","description":"ICD-AHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIF1","description":"ICD-FHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB1","description":"ICD-MJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI STOOL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87338","description":"IAAD IA HPYLORI STOOL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33221","description":"Insert pulse gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF0","description":"ICD-IHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33017","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; 6 Years And Older Without Congenita","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE0","description":"ICD-AACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC1","description":"ICD-IBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE1","description":"ICD-CEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB1","description":"ICD-EETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD1","description":"ICD-BDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF0","description":"ICD-DBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen(s) test for platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9100","description":"Pathogen(s) test for platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF0","description":"ICD-KHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KC11","description":"ICD-4KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF0","description":"ICD-OLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD1","description":"ICD-MGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE1","description":"ICD-MLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATF0","description":"ICD-CATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE1","description":"ICD-BBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg perthes orth toronto typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1700","description":"Leg perthes orth toronto typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of embryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58976","description":"Transfer of embryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB0","description":"ICD-GHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPE1","description":"ICD-NBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA06","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nikaidoh proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33782","description":"Nikaidoh proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFE1","description":"ICD-NIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF0","description":"ICD-OJVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Card output measure subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93562","description":"Card output measure subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME0","description":"ICD-KBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA0","description":"ICD-OCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor lung double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32856","description":"Prepare donor lung double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB1","description":"ICD-GAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD1","description":"ICD-MGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deferoxamine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0895","description":"Deferoxamine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr unheal etoh w/counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9621","description":"Scr unheal etoh w/counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUA1","description":"ICD-BDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE0","description":"ICD-CHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE1","description":"ICD-JECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVD0","description":"ICD-OLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE0","description":"ICD-JIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB0","description":"ICD-KITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9258","description":"Doc stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50290","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9746","description":"Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE0","description":"ICD-CBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us limited fetus(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76815","description":"Ob us limited fetus(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD1","description":"ICD-NFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD0","description":"ICD-FDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC1","description":"ICD-FDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB1","description":"ICD-CEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC1","description":"ICD-LAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90958","description":"Esrd srv 2-3 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC1","description":"ICD-ODOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA151","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE1","description":"ICD-ACBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRA0","description":"ICD-PKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAE1","description":"ICD-NAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED0","description":"ICD-AHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC1","description":"ICD-DESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor xiii anti-hem factor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7180","description":"Factor xiii anti-hem factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMF1","description":"ICD-NJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31030","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28050","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA1","description":"ICD-FCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/2.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2212","description":"Lens sphcyl bifo 7.25-12/2.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glass/plastic slab off prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2710","description":"Glass/plastic slab off prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4214","description":"Cellesta cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF0","description":"ICD-KGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA0","description":"ICD-OKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGB1","description":"ICD-JEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrotestosterone (DHT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82642","description":"Dihydrotestosterone (DHT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc stom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43659","description":"Laparoscope proc stom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient pregnancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1061","description":"Patient pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE0","description":"ICD-NLDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB0","description":"ICD-KDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25444","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meropenem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2185","description":"Meropenem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC1","description":"ICD-FIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43497","description":"Lower Esophageal Myotomy_ Transoral (Ie_ Peroral Endoscopic Myotomy [Poem])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB0","description":"ICD-BGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7642","description":"Glycopyrrolate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD1","description":"ICD-BAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bactericidal level serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87197","description":"Bactericidal level serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo spine n generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63685","description":"Insrt/redo spine n generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54405","description":"Insert multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00800","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","description":"CPT-00800","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMB1","description":"ICD-CFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusive device in vein art","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0269","description":"Occlusive device in vein art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","description":"HCPCS-M1437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF1","description":"ICD-NALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"D & c after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59160","description":"D & c after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26235","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE0","description":"ICD-NGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon metas noevid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9088","description":"Onc dx colon metas noevid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evidence-based therapy was prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1227","description":"Evidence-based therapy was prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90616","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90616","description":"CPT-90616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA1","description":"ICD-KIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tap block uni by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64487","description":"Tap block uni by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4025","description":"Physical Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWA0","description":"ICD-PKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0560U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","description":"CPT-0560U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE1","description":"ICD-JGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB1","description":"ICD-BINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2000F","description":"Blood pressure measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was referred to another provider or specialist during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9968","description":"Patient was referred to another provider or specialist during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE0","description":"ICD-KFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Progenamatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4222","description":"Progenamatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide sol_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9530","description":"I131 iodide sol_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCC1","description":"ICD-BCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of aide_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0156","description":"Hhcp-svs of aide_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD145","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse upper gi structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47721","description":"Fuse upper gi structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBF1","description":"ICD-IHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC1","description":"ICD-GAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90451","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77786","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 2-12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laps impltj nstim vagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312T","description":"Laps impltj nstim vagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delivery/set up/dispensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9901","description":"Delivery/set up/dispensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27227","description":"Treat hip fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE0","description":"ICD-GHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB0","description":"ICD-PAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trichomonas vagin dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87660","description":"Trichomonas vagin dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sedative hypnotics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80368","description":"Sedative hypnotics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toxoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86777","description":"Toxoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL22","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES120","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD116","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD0","description":"ICD-OAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1298","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81529","description":"Oncology (Cutaneous Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE1","description":"ICD-KDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB1","description":"ICD-GGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mpsv4 vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90733","description":"Mpsv4 vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mgmt gene methylation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81287","description":"Mgmt gene methylation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1056","description":"Prescribed anticoagulant medication during the performance period_ history of GI bleeding_ history of intracranial bleeding_ bl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDED1","description":"ICD-CDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alemtuzumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9010","description":"Alemtuzumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDE1","description":"ICD-NLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA0","description":"ICD-MKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93244","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF1","description":"ICD-PDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD1","description":"ICD-MEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC1","description":"ICD-FIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_yttrium-90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2616","description":"Brachytx_ non-str_yttrium-90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73060","description":"X-ray exam of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of an implantable_ patient-activated cardiac event recorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33284","description":"Removal of an implantable_ patient-activated cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB1","description":"ICD-ACCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenervation of abductor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2340","description":"Chemodenervation of abductor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF0","description":"ICD-NKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE1","description":"ICD-BDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF1","description":"ICD-OLEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24620","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Security Deposit)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7334","description":"Community Transition Svcs (Security Deposit)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME1","description":"ICD-OAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGD0","description":"ICD-OEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1002","description":"Custom item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA0","description":"ICD-NETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA1","description":"ICD-OGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0594","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0D","description":"Very High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF1","description":"ICD-AAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Daclizumab_ parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7513","description":"Daclizumab_ parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD1","description":"ICD-KAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD1","description":"ICD-KBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8870","description":"Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81174","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF0","description":"ICD-CIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0745T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus)_ derived from anatomical image da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport bus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0110","description":"Nonemergency transport bus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC0","description":"ICD-PLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC0","description":"ICD-NEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC0","description":"ICD-KIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD1","description":"ICD-CFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC1","description":"ICD-CGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE0","description":"ICD-LHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA1","description":"ICD-GHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF0","description":"ICD-CIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVA1","description":"ICD-OJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE1","description":"ICD-CFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE0","description":"ICD-OBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA53","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC1","description":"ICD-FIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29058","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD1","description":"ICD-GHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTC1","description":"ICD-BBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD1","description":"ICD-GEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No scr utr malig/us/samp rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9620","description":"No scr utr malig/us/samp rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAD0","description":"ICD-EDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5A","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doppler flow testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93990","description":"Doppler flow testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF0","description":"ICD-EEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE1","description":"ICD-DARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","description":"CPT-00524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD1","description":"ICD-NLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA0","description":"ICD-LEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD0","description":"ICD-GCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA0","description":"ICD-BBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj protamine sulfate/10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2720","description":"Inj protamine sulfate/10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPB1","description":"ICD-NLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF1","description":"ICD-NIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ra tracer id of sentinl node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38792","description":"Ra tracer id of sentinl node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-52443","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","description":"CPT-52443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography head w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70545","description":"Mr angiography head w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA0","description":"ICD-CBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28436","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Buttock fasciotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27027","description":"Buttock fasciotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF1","description":"ICD-EITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWC0","description":"ICD-LIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE0","description":"ICD-FDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA1","description":"ICD-CANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67801","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90622","description":"Vaccinia (smallpox) virus vaccine_ live_ lyophilized_ 0.3 mL dosage_ for percutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd remove foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43247","description":"Egd remove foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC1","description":"ICD-KDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - comprehensive series of radiographic images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0372","description":"intraoral tomosynthesis - comprehensive series of radiographic images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC0","description":"ICD-FIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init bk ptb plaster direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5500","description":"Init bk ptb plaster direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF1","description":"ICD-GGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9688","description":"Patients using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD1","description":"ICD-GDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF0","description":"ICD-JEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD0","description":"ICD-JCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood collection tube/vacuum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4770","description":"Blood collection tube/vacuum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB1","description":"ICD-GBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC212","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX12","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA1","description":"ICD-OEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paramed intrcept nonvol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0208","description":"Paramed intrcept nonvol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photosensitivity tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95056","description":"Photosensitivity tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF0","description":"ICD-MGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB1","description":"ICD-FCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64837","description":"Repair nerve add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC0","description":"ICD-KGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE0","description":"ICD-CGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5953","description":"Adult speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA0","description":"ICD-MGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC1","description":"ICD-NJGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9229","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF1","description":"ICD-OBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94015","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Itraconazole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1835","description":"Itraconazole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF0","description":"ICD-GIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXF0","description":"ICD-FDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing antigen system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86911","description":"Blood typing antigen system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA40","description":"Low Rehab_ ADL Index 0-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0682","description":"Non-pneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB1","description":"ICD-KFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC1","description":"ICD-NGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE1","description":"ICD-PDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Hot Entrée","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1759","description":"Home Delivered Meals-Hot Entrée","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD0","description":"ICD-NHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHB1","description":"ICD-NAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60252","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2104","description":"Spherocylindr 4.00d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26372","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJF1","description":"ICD-GDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB0","description":"ICD-BFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQA0","description":"ICD-DBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 probe&reverse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87535","description":"Hiv-1 probe&reverse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC0","description":"ICD-JACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20702","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intramedullary (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED1","description":"ICD-AFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0301","description":"HCPCS-A0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD240","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80190","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF1","description":"ICD-CGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44188","description":"Lap colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE0","description":"ICD-GICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9732","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC0","description":"ICD-IGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD1","description":"ICD-GCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vendaje ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4279","description":"Vendaje ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1720","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1720","description":"CDT-D1720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX13","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHD0","description":"ICD-OEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB1","description":"ICD-LESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE1","description":"ICD-GGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73630","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTE1","description":"ICD-NGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28525","description":"Treat toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF1","description":"ICD-JCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ceruloplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82390","description":"Assay of ceruloplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD213","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC MRNA 5 genes ur alg rish urothelial cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012M","description":"ONC MRNA 5 genes ur alg rish urothelial cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62282","description":"Treat spinal canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier with flange","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4373","description":"Skin barrier with flange","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLD1","description":"ICD-OFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef special metabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4157","description":"Ef special metabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70010","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA1","description":"ICD-GIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1806","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1806","description":"CDT-D1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED0","description":"ICD-BCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3A","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPB1","description":"ICD-CCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10012","description":"Fine needle aspiration biopsy_ including MR guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv reactj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86078","description":"Phys blood bank serv reactj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVA0","description":"ICD-CFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA0","description":"ICD-LFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD1","description":"ICD-KCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01340","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","description":"CPT-01340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC1","description":"ICD-KHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEA0","description":"ICD-NFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD0","description":"ICD-DGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Otolaryngology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4022","description":"Otolaryngology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDC1","description":"ICD-KEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7760","description":"Clsd red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Consultation with family","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90887","description":"Consultation with family","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methacholine chloride_ neb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7674","description":"Methacholine chloride_ neb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9024","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE1","description":"ICD-GBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct thorax w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71270","description":"Ct thorax w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC34","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC0","description":"ICD-OAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC0","description":"ICD-PASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5C","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranio/maxillofacial surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21299","description":"Cranio/maxillofacial surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w/ supinat/pronator c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3202","description":"Oxford w/ supinat/pronator c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB0","description":"ICD-NLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA0","description":"ICD-OGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB1","description":"ICD-LCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB1","description":"ICD-JHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5877","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5877","description":"CDT-D5877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC1","description":"ICD-GAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal ak ultra-light m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5790","description":"Exoskeletal ak ultra-light m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE0","description":"ICD-OFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8I","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA1","description":"ICD-ADEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Volume deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38214","description":"Volume deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ster wd ifx 30 d postop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8571","description":"Ster wd ifx 30 d postop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF1","description":"ICD-EEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE0","description":"ICD-KCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose and 0.45% saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5010","description":"5% dextrose and 0.45% saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB0","description":"ICD-EEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC0","description":"ICD-CAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF0","description":"ICD-NBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX36","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","description":"HCPCS-J2804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA0","description":"ICD-GFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE0","description":"ICD-NBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD0","description":"ICD-JCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME0","description":"ICD-FDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70134","description":"X-ray exam of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBE1","description":"ICD-OGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2599","description":"Injection_ vasopressin (american regent) not therapeutically equivalent to j2598_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyrotropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3240","description":"Thyrotropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rectal catheter for use with the manual pump-operated enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4453","description":"Rectal catheter for use with the manual pump-operated enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3214","description":"Benesch boot pair junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC0","description":"ICD-CEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93457","description":"R hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65900","description":"Remove eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD0","description":"ICD-KGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF1","description":"ICD-NGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE1","description":"ICD-FHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA0","description":"ICD-OBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGD0","description":"ICD-CDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD0","description":"ICD-PCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted for performance of elective carotid intervention","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9689","description":"Patient admitted for performance of elective carotid intervention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2137","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (Vas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE0","description":"ICD-KHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC25","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88007","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95925","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF1","description":"ICD-LDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt/caregiver counsel safety","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6090F","description":"Pt/caregiver counsel safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect diaphragm simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39560","description":"Resect diaphragm simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE145","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32225","description":"Partial release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ isatuximab-irfc_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9227","description":"Injection_ isatuximab-irfc_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frozen plasma_ pooled_ sd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9023","description":"Frozen plasma_ pooled_ sd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA21","description":"ICD-2BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0769T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE0","description":"ICD-OEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC0","description":"ICD-BDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9308","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9308","description":"HCPCS-C9308","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA0","description":"ICD-FBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0204","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69554","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pyridoxine hcl 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3415","description":"Pyridoxine hcl 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23929","description":"Shoulder surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB0","description":"ICD-CIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOD0","description":"ICD-CAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEA1","description":"ICD-EDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF0","description":"ICD-OAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF1","description":"ICD-CAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC1","description":"ICD-IGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TDD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5272","description":"TDD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB1","description":"ICD-MGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA0","description":"ICD-EGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRE1","description":"ICD-KDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60500","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral pump diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9342","description":"Hit enteral pump diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE1","description":"ICD-JCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1397","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","description":"HCPCS-M1397","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery to vein shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36835","description":"Artery to vein shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE1","description":"ICD-CDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81167","description":"BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA1","description":"ICD-KDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA1","description":"ICD-NJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF0","description":"ICD-MAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 3 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP03","description":"Auto.test pane pricing code_ 3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29807","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB0","description":"ICD-EICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA21","description":"ICD-1FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC0","description":"ICD-GEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug/bio noc part b drug cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4082","description":"Drug/bio noc part b drug cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54051","description":"Anesth chest surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4772","description":"Blood glucose test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1089","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF1","description":"ICD-KFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE0","description":"ICD-CHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy splenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38120","description":"Laparoscopy splenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost b/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7403","description":"Add ue prost b/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD1","description":"ICD-GCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF1","description":"ICD-FHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA0","description":"ICD-OESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF0","description":"ICD-EIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA1","description":"ICD-IGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB1","description":"ICD-GEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tissue for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20926","description":"Removal of tissue for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC1","description":"ICD-JFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA1","description":"ICD-OARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC0","description":"ICD-GFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1026","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE0","description":"ICD-BIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE1","description":"ICD-EBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE1","description":"ICD-FDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF1","description":"ICD-GCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11310","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD1","description":"ICD-IFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE1","description":"ICD-MGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenytoin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80186","description":"Assay of phenytoin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8F","description":"Medium Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA0","description":"ICD-JHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB0","description":"ICD-CIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE0","description":"ICD-CFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB0","description":"ICD-JFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9305","description":"HCPCS-C9305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE145","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine implant_ 74.2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0570","description":"Buprenorphine implant_ 74.2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA0","description":"ICD-BGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic pulpotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3220","description":"Therapeutic pulpotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME0","description":"ICD-AAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier heated used w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0562","description":"Humidifier heated used w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE0","description":"ICD-NDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1596","description":"Injection_ glycopyrrolate_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE1","description":"ICD-DAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA1","description":"ICD-CBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE0","description":"ICD-IATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE0","description":"ICD-GDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11601","description":"Exc tr-ext mal+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee disc/dial lock/adj flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2425","description":"Knee disc/dial lock/adj flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85014","description":"Hematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post-operative body jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1310","description":"Post-operative body jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clofarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9027","description":"Clofarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF0","description":"ICD-CDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE0","description":"ICD-CEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1402","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1402","description":"CDT-D1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE0","description":"ICD-GHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA1","description":"ICD-LFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB0","description":"ICD-NENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD1","description":"ICD-ABCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB0","description":"ICD-LEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF0","description":"ICD-GHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB1","description":"ICD-IEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic cavernosometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54231","description":"Dynamic cavernosometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC1","description":"ICD-FFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC1","description":"ICD-KEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transthoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93303","description":"Echo transthoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA0","description":"ICD-BGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF1","description":"ICD-PHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD1","description":"ICD-GCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barrier sld ext wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4385","description":"Ost skn barrier sld ext wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF1","description":"ICD-OGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8660","description":"Fun stat score ls < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF0","description":"ICD-NAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB1","description":"ICD-CDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of hip socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27122","description":"Reconstruction of hip socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES360","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKB0","description":"ICD-OFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE1","description":"ICD-NHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLF1","description":"ICD-GHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9349","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0658T","description":"Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl >=3 surfac","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6615","description":"Onlay cst nbl mtl >=3 surfac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mold sckt ext knee shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5150","description":"Mold sckt ext knee shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA1","description":"ICD-NJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC1","description":"ICD-LEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF1","description":"ICD-KBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Day habil waiver per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2021","description":"Day habil waiver per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27827","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB21","description":"ICD-4KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC0","description":"ICD-NENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF0","description":"ICD-FDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX35","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB23","description":"Very High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE1","description":"ICD-IDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB0","description":"ICD-GBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef spec metabolic noninherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4154","description":"Ef spec metabolic noninherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N-et; encounter/trip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2003","description":"N-et; encounter/trip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD246","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILF0","description":"ICD-JILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33602","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37292","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","description":"CPT-37292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB0","description":"ICD-OCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cryoglobulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82595","description":"Assay of cryoglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0802","description":"CDT-D0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXD0","description":"ICD-OFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB0","description":"ICD-MBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0833T","description":"Digitization of glass microscope slides for cytopathology_ smears_ any other source; preparation_ screening and interpretation (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ vincristine sul lip 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9371","description":"Inj_ vincristine sul lip 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44160","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHC1","description":"ICD-OBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF0","description":"ICD-GIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64620","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC1","description":"ICD-CFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF1","description":"ICD-CEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWE0","description":"ICD-DCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF1","description":"ICD-OCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB1","description":"ICD-IAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF1","description":"ICD-BIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB1","description":"ICD-NIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostate ca screening; dre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0102","description":"Prostate ca screening; dre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETA1","description":"ICD-BETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9267","description":"Doc comp or mort w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33611","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA244","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA0","description":"ICD-ECMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEA1","description":"ICD-JAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC1","description":"ICD-OJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer to practice after initiation of chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9833","description":"Patient transfer to practice after initiation of chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB1","description":"ICD-GBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD1","description":"ICD-IHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus augmentation vertical","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7952","description":"Sinus augmentation vertical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0710T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Including Data Preparation And Transmission_ Quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplt autol hct/donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38241","description":"Transplt autol hct/donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF0","description":"ICD-IEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC0","description":"ICD-GAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; up to 7 vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0656T","description":"Vertebral body tethering_ anterior; up to 7 vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9278","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","description":"HCPCS-J9278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA31","description":"ICD-4CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0405","description":"HCPCS-B0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetate conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4708","description":"Acetate conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD0","description":"ICD-HFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty tricuspid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33463","description":"Valvuloplasty tricuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-cor_ tem w/del sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2625","description":"Stent_ non-cor_ tem w/del sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect nasopharynx skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61586","description":"Resect nasopharynx skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect face/scalp tum 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21016","description":"Resect face/scalp tum 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30903","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDA0","description":"ICD-MGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF0","description":"ICD-DFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB31","description":"ICD-1BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA1","description":"ICD-NIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF0","description":"ICD-CFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD1","description":"ICD-IHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA0","description":"ICD-DIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJB1","description":"ICD-FHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGF0","description":"ICD-JBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ (aponvie)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9145","description":"Injection_ aprepitant_ (aponvie)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPA0","description":"ICD-JFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 tositumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9545","description":"I131 tositumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 1 view frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71010","description":"Chest x-ray 1 view frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Case management_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2022","description":"Case management_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","description":"HCPCS-Q4414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF0","description":"ICD-KHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41015","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA1","description":"ICD-GFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9944","description":"Occlusal guard - hard appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPD0","description":"ICD-OEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip adj flex ext abduct cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2624","description":"Hip adj flex ext abduct cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABA1","description":"ICD-IABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65600","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult disp brief/diap abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4543","description":"Adult disp brief/diap abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0492U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","description":"CPT-0492U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interfyl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4171","description":"Interfyl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF1","description":"ICD-CBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psori tool doc/no bnchmk met","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9651","description":"Psori tool doc/no bnchmk met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace ureter by bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50840","description":"Replace ureter by bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 1 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34845","description":"Visc & infraren abd 1 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA1","description":"ICD-BIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB1","description":"ICD-GIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML34","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis and bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54390","description":"Repair penis and bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMD0","description":"ICD-FAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 20 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP20","description":"Auto test panel pricing code_ 20 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole neo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3310","description":"Shoe lift elev heel/sole neo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC1","description":"ICD-BIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC1","description":"ICD-GCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0633","description":"Lso sc r pos/lat pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB0","description":"ICD-NEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFF0","description":"ICD-FBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQC1","description":"ICD-PFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD0","description":"ICD-JAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF1","description":"ICD-GDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA1","description":"ICD-MAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28294","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA0","description":"ICD-CCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB1","description":"ICD-KAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE210","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGB0","description":"ICD-BBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC0","description":"ICD-JAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF1","description":"ICD-GENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA1","description":"ICD-KFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRA1","description":"ICD-LHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile cefuroxime injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0697","description":"Sterile cefuroxime injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ortho sidebar disconnect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2768","description":"Ortho sidebar disconnect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99324","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory eeg monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95950","description":"Ambulatory eeg monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB1","description":"ICD-BCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF1","description":"ICD-OGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDE0","description":"ICD-GIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25071","description":"Exc forearm les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF1","description":"ICD-NBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd esophagogastrc fndoplsty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43210","description":"Egd esophagogastrc fndoplsty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE1","description":"ICD-GCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD121","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC0","description":"ICD-FITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB1","description":"ICD-KEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC0","description":"ICD-CAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC1","description":"ICD-JAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aorsubcl/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35626","description":"Art byp aorsubcl/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44392","description":"Colonoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33800","description":"Aortic suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5942","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5942","description":"CDT-D5942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOC1","description":"ICD-OHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prostaglandin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84150","description":"Assay of prostaglandin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bile duct revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47701","description":"Bile duct revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB1","description":"ICD-MLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE0","description":"ICD-GFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unresectab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9107","description":"Onc dx pancreatic unresectab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med admin_ not oral/inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1503","description":"Med admin_ not oral/inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1004","description":"CDT-D1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA0","description":"ICD-NLKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCB1","description":"ICD-ODCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB154","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC0","description":"ICD-CCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD121","description":"Special Care Low _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD0","description":"ICD-KETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF1","description":"ICD-ACCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE114","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB0","description":"ICD-JGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration_ autologous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csf ventriculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78635","description":"Csf ventriculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD1","description":"ICD-NCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF1","description":"ICD-KFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01232","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","description":"CPT-01232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and reinsertion of sinus tarsi implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0511T","description":"Removal and reinsertion of sinus tarsi implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33542","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB0","description":"ICD-FFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair single ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33617","description":"Repair single ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99339","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stab phleb veins xtr 10-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37765","description":"Stab phleb veins xtr 10-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXD1","description":"ICD-OCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95978","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE0","description":"ICD-BIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID0","description":"ICD-GBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD0","description":"ICD-MLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA0","description":"ICD-GIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62192","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Personal care item nos each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5199","description":"Personal care item nos each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepc gn tstng docd b/4txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3266F","description":"Hepc gn tstng docd b/4txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF0","description":"ICD-IIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kras gene variants exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81275","description":"Kras gene variants exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md home visit outside cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0273","description":"Md home visit outside cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; first target lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76982","description":"Ultrasound_ elastography; first target lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE0","description":"ICD-HISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF0","description":"ICD-GADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD0","description":"ICD-FDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE0","description":"ICD-IHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID0","description":"ICD-IEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No reop req bld grft oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8578","description":"No reop req bld grft oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD1","description":"ICD-BFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA1","description":"ICD-IELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9766","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and atherectomy_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spermicide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4269","description":"Spermicide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93318","description":"Echo transesophageal intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md service required for pmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0372","description":"Md service required for pmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0009","description":"Other manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA1","description":"ICD-JCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4452","description":"Waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB0","description":"ICD-GIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD0","description":"ICD-LDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB1","description":"ICD-NKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA0","description":"ICD-BBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUC0","description":"ICD-EAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25660","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb musc/fascia add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11046","description":"Deb musc/fascia add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUE0","description":"ICD-OCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC0","description":"ICD-GGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb bone add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11047","description":"Deb bone add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA1","description":"ICD-JCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB1","description":"ICD-NHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE0","description":"ICD-MHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF1","description":"ICD-AHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281U","description":"Hematology (von Willebrand disease [VWD])_ von Willebrand propeptide_ enzyme-linked immunosorbent assays (ELISA)_ plasma_ diagnostic report of von Willebrand factor (VWF) prop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/strip long leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37722","description":"Ligate/strip long leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77336","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB0","description":"ICD-OAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3C","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE1","description":"ICD-NLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB0","description":"ICD-BBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID1","description":"ICD-CIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 quant&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87539","description":"Hiv-2 quant&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9878","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj subclav carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35694","description":"Art trnsposj subclav carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE1","description":"ICD-KGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95709","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mast radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19305","description":"Mast radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB1","description":"ICD-EAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0750","description":"Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27557","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA1","description":"ICD-IDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD201","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB40","description":"Medium Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22554","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF1","description":"ICD-CHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m bicisate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9557","description":"Tc99m bicisate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42720","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC1","description":"ICD-FIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat elevation sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2300","description":"Pwr seat elevation sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42420","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polycentric hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6600","description":"Polycentric hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC0","description":"ICD-LBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family stabilization 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9482","description":"Family stabilization 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA0","description":"ICD-OAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cms medical evidence form 2728 for dialysis patients: initial form completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1265","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA1","description":"ICD-MHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC0","description":"ICD-CAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC21","description":"ICD-4DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2209","description":"Lens sphcy bifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80430","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"WoundPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4326","description":"WoundPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aztreonam_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0457","description":"Injection_ aztreonam_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEA0","description":"ICD-MBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC35","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014U","description":"Hematology (hematolymphoid neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood or bone marrow_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polysom <6 yrs cpap/bilvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95783","description":"Polysom <6 yrs cpap/bilvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Circumcision neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54160","description":"Circumcision neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF0","description":"ICD-KEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69840","description":"Revise inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB1","description":"ICD-FHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alpha 1 proteinase inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0256","description":"Alpha 1 proteinase inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0150","description":"HCPCS-E0150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct skin color 6.0 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11920","description":"Correct skin color 6.0 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB0","description":"ICD-OEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHC1","description":"ICD-OFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Should sling/vest/abrestrain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4566","description":"Should sling/vest/abrestrain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB0","description":"ICD-OGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dispense fee initial 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0333","description":"Dispense fee initial 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venipuncture home/snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9529","description":"Venipuncture home/snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE106","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD1","description":"ICD-HCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB31","description":"ICD-2LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC0","description":"ICD-KFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75600","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB1","description":"ICD-IIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB0","description":"ICD-BFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE1","description":"ICD-FITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50570","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA0","description":"ICD-NGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD0","description":"ICD-NGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0120","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tacrolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80197","description":"Assay of tacrolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10A","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHA1","description":"ICD-OFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB0","description":"ICD-BBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB0","description":"ICD-DBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stenger test speech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92577","description":"Stenger test speech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF0","description":"ICD-MDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB1","description":"ICD-JDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF1","description":"ICD-CGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mold socket ank hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5010","description":"Mold socket ank hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE1","description":"ICD-ECAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD1","description":"ICD-FGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB1","description":"ICD-CIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA1","description":"ICD-CHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD0","description":"ICD-KCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical head harness/halter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0942","description":"Cervical head harness/halter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC1","description":"ICD-FGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58180","description":"Partial hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA0","description":"ICD-MBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME0","description":"ICD-CIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9172","description":"HCPCS-C9172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9980","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0678","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0678","description":"HCPCS-G0678","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD1","description":"ICD-GHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMA1","description":"ICD-IEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5992","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","description":"HCPCS-L5992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8497","description":"Cabg meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF1","description":"ICD-JGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9577","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGE0","description":"ICD-FBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC11","description":"ICD-2JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC1","description":"ICD-ODMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE1","description":"ICD-KDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1021T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","description":"CPT-1021T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42509","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vulva lesion/s compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56515","description":"Destroy vulva lesion/s compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA0","description":"ICD-KDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRD1","description":"ICD-LBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9879","description":"Two Medica re Diabetes Prevention Program (MDPP) core maintenance sessi on s (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50700","description":"Revision of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF0","description":"ICD-JGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prkns diag rviewed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1400F","description":"Prkns diag rviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0859","description":"Pwc gp3 hd sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB0","description":"ICD-AGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC1","description":"ICD-EEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF1","description":"ICD-MHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of left heart vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33988","description":"Insertion of left heart vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE0","description":"ICD-GISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC0","description":"ICD-CBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDD0","description":"ICD-GBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC160","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Coaching 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1733","description":"Employment - Job Coaching 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0903","description":"HCPCS-B0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD1","description":"ICD-OJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD1","description":"ICD-MACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placement of seton","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46020","description":"Placement of seton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj menotropins 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0122","description":"Inj menotropins 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA1","description":"ICD-IHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic sock multi ply ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8430","description":"Prosthetic sock multi ply ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHA0","description":"ICD-JBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD1","description":"ICD-KEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA1","description":"ICD-OGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9298","description":"Injection_ nivolumab and relatlimab-rmbw_ 3 mg/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB0","description":"ICD-BDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC0","description":"ICD-OCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37183","description":"Remove hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNA1","description":"ICD-BGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA1","description":"ICD-FCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6110","description":"Implnt/abut remov dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE1","description":"ICD-MFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE1","description":"ICD-HCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vis item/svc in other code","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2797","description":"Vis item/svc in other code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX50","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ganciclovir long act implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7310","description":"Ganciclovir long act implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF0","description":"ICD-EBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"D&c of cervical stump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57558","description":"D&c of cervical stump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52240","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD1","description":"ICD-OHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81376","description":"Hla ii typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE0","description":"ICD-OJYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo <2yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90953","description":"Esrd serv 1 visit p mo <2yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE0","description":"ICD-OBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2D","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF0","description":"ICD-LHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0248U","description":"Oncology (Brain)_ Spheroid Cell Culture In A 3D Microenvironment_ 12 Drug Panel_ Tumor-Response Prediction For Each Drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF1","description":"ICD-JEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0475T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording and storage_ data scanning with signal extraction_ technical analysis and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE0","description":"ICD-IEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF1","description":"ICD-KHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk knee joints single axis p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5676","description":"Bk knee joints single axis p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGND0","description":"ICD-BGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF1","description":"ICD-OJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Male sling procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53440","description":"Male sling procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride nail 1-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11720","description":"Debride nail 1-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Basic vestibular evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92540","description":"Basic vestibular evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF0","description":"ICD-IEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE1","description":"ICD-GELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVE0","description":"ICD-JEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPA1","description":"ICD-BDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam no pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96155","description":"Interv hlth/behav fam no pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD0","description":"ICD-NDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF1","description":"ICD-CCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12036","description":"Intmd rpr s/a/t/ext 20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extrem 5/> ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64645","description":"Chemodenerv 1 extrem 5/> ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE0","description":"ICD-PBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab 10 mg and hyaluronidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9311","description":"Injection_ rituximab 10 mg and hyaluronidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csit lowrisk surg pts preop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8961","description":"Csit lowrisk surg pts preop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRD0","description":"ICD-GBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0568U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","description":"CPT-0568U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME1","description":"ICD-KCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC1","description":"ICD-NDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of pylorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43800","description":"Reconstruction of pylorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE0","description":"ICD-OAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA1","description":"ICD-GDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF1","description":"ICD-IAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57522","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF1","description":"ICD-BAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOF0","description":"ICD-OHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscop w/vc inj + scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31571","description":"Laryngoscop w/vc inj + scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL36","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tubing (oxygen) per foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4616","description":"Tubing (oxygen) per foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBC1","description":"ICD-NDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0C","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6099","description":"Implant Supported Retainer For Fpd - Porcelain Fused To Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair stern/nuss w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21742","description":"Repair stern/nuss w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zanamivir_ inh pwdr_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9034","description":"Zanamivir_ inh pwdr_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLE0","description":"ICD-EBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analyze spine infus pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62367","description":"Analyze spine infus pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2127","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafix Core and GrafixPL Core_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4132","description":"Grafix Core and GrafixPL Core_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test sickle cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3850","description":"Gene test sickle cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81325","description":"Pmp22 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF1","description":"ICD-BHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27750","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3003","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional_ per calendar month. (list separately in additio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0685","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0685","description":"HCPCS-G0685","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0602","description":"HCPCS-B0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFE1","description":"ICD-CBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC0","description":"ICD-OLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD0","description":"ICD-NEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED1","description":"ICD-KAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0403","description":"HCPCS-C0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE0","description":"ICD-LIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Hpc Nos 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9985","description":"Injection Hpc Nos 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA0","description":"ICD-GFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interim labor facility globa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4005","description":"Interim labor facility globa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27443","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWB0","description":"ICD-PKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGC1","description":"ICD-NIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF1","description":"ICD-EGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD0","description":"ICD-MJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr-staph dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87641","description":"Mr-staph dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDD1","description":"ICD-OCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1321","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD0","description":"ICD-NGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF1","description":"ICD-LHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"West nile virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86789","description":"West nile virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD0","description":"ICD-NJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1129","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE0","description":"ICD-IFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1903","description":"CDT-D1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB1","description":"ICD-GIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24116","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace implantable hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053T","description":"Replace implantable hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF1","description":"ICD-CDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB0","description":"ICD-MBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC1","description":"ICD-FDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNB1","description":"ICD-NLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear matrix protein 22","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86386","description":"Nuclear matrix protein 22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD1","description":"ICD-CHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC1","description":"ICD-ODTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX52","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE1","description":"ICD-IGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9786","description":"Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction_ including interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB0","description":"ICD-BCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE0","description":"ICD-NFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61539","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQD1","description":"ICD-LGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA1","description":"ICD-JALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1331","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","description":"HCPCS-J9028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier 8x8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5122","description":"Solid skin barrier 8x8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRA0","description":"ICD-PBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crisis interven svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2011","description":"Crisis interven svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosth retina receive&gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100T","description":"Prosth retina receive&gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA0","description":"ICD-EECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0868T","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF1","description":"ICD-BADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL60","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE1","description":"ICD-ACIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410U","description":"Oncology (pancreatic)_ DNA_ whole genome sequencing with 5-hydroxymethylcytosine enrichment_ whole blood or plasma_ algorithm reported as cancer detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy ablate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45320","description":"Proctosigmoidoscopy ablate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA1","description":"ICD-AABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE1","description":"ICD-EBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC1","description":"ICD-CHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30420","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNF1","description":"ICD-FBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE1","description":"ICD-JDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1504","description":"CDT-D1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68325","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB1","description":"ICD-EBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD0","description":"ICD-FHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEE0","description":"ICD-MIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48152","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reopening of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49002","description":"Reopening of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB1","description":"ICD-OGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD1","description":"ICD-OGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging 3 phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78315","description":"Bone imaging 3 phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEE1","description":"ICD-KAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Loxapine for inhalation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2062","description":"Loxapine for inhalation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA0","description":"ICD-IBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB56","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE1","description":"ICD-OERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX56","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND1","description":"ICD-FAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD1","description":"ICD-GHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27003","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISC0","description":"ICD-KISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD0","description":"ICD-BBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB0","description":"ICD-NEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay >= 3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6605","description":"Cst bse mtl inlay >= 3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIE0","description":"ICD-JFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC1","description":"ICD-NGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBB0","description":"ICD-NDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIC0","description":"ICD-GAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60210","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD1","description":"ICD-BDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD0","description":"ICD-JCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESE1","description":"ICD-HESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sng/dbl mechanical act","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2005","description":"Kafo sng/dbl mechanical act","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPF1","description":"ICD-GDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB0","description":"ICD-KBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peng benzathine/procaine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0558","description":"Peng benzathine/procaine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84580","description":"Assay of urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blink reflex test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95933","description":"Blink reflex test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD1","description":"ICD-KCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy disc reposit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7874","description":"Tmj arthroscopy disc reposit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v auto redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88166","description":"Cytopath tbs c/v auto redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o contr_ cont ecg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8930","description":"Tte w or w/o contr_ cont ecg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHD0","description":"ICD-MGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0630","description":"Removal of sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace g/c tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49450","description":"Replace g/c tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC0","description":"ICD-BHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cst bse mtl inlay 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6604","description":"Cst bse mtl inlay 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61526","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE236","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cam relese assem ftrst/lgrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0051","description":"Cam relese assem ftrst/lgrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58350","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable compressor filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7013","description":"Disposable compressor filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMB1","description":"ICD-BGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2030","description":"Mh clubhouse svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53260","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of eyelid by suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67875","description":"Closure of eyelid by suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF0","description":"ICD-OHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25515","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF0","description":"ICD-BDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTF1","description":"ICD-MDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD1","description":"ICD-FGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCB1","description":"ICD-BCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31551","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF1","description":"ICD-GILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8A","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prior thyroid dise dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9553","description":"Prior thyroid dise dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision benign lesion compl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7412","description":"Excision benign lesion compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mucormycosis antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86732","description":"Mucormycosis antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB0","description":"ICD-OAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise kidney blood vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50100","description":"Revise kidney blood vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC0","description":"ICD-CHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","description":"HCPCS-G0571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYB0","description":"ICD-CIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 7-8 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98928","description":"Osteopath manj 7-8 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELE0","description":"ICD-GELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC1","description":"ICD-PGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0673T","description":"Ablation_ Benign Thyroid Nodule(S)_ Percutaneous_ Laser_ Including Imaging Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0027U","description":"JAK2 (Janus kinase 2) (eg_ myeloproliferative disorder) gene analysis_ targeted sequence analysis exons 12-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0104","description":"HCPCS-A0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0830","description":"Pwc gp2 std seat elevate s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8C","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0252U","description":"Fetal Aneuploidy Short Tandem-Repeat Comparative Analysis_ Fetal Dna From Products Of Conception_ Reported As Normal (Euploidy)_ Monosomy_ Trisomy_ Or Partial Deletion/Duplica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate renal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50541","description":"Laparo ablate renal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB51","description":"Medium Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB1","description":"ICD-OIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB0","description":"ICD-BBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES244","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5181","description":"Hearing aid_ contralateral routing device_ monaural_ behind the ear (BTE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF1","description":"ICD-KFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEF0","description":"ICD-MBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant femur ridge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27140","description":"Transplant femur ridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD0","description":"ICD-MDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQF0","description":"ICD-KFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE0","description":"ICD-BEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58152","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE1","description":"ICD-HCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA1","description":"ICD-DBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA1","description":"ICD-FIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA1","description":"ICD-MIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE1","description":"ICD-HHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA0","description":"ICD-MJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peridontal medicament","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5994","description":"Peridontal medicament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging/studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78016","description":"Thyroid met imaging/studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB0","description":"ICD-ABLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE1","description":"ICD-GFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC1","description":"ICD-BEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81183","description":"ATXN10 (ataxin 10) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB0","description":"ICD-FHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of scleral staphyloma; without graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66220","description":"Repair of scleral staphyloma; without graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF1","description":"ICD-CAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA0","description":"ICD-OICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC0","description":"ICD-CCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rasburicase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2783","description":"Rasburicase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thiopurine S-methyltransferase (TPMT)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84433","description":"Thiopurine S-methyltransferase (TPMT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF0","description":"ICD-ACIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC0","description":"ICD-FCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In hospice or using hospice services during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1167","description":"In hospice or using hospice services during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81296","description":"Msh2 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0563U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","description":"CPT-0563U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD1","description":"ICD-MKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spacer without mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8100","description":"Spacer without mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE0","description":"ICD-BACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0103","description":"Residential Habilitation 4-8 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermatological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96999","description":"Dermatological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hib-mency vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90644","description":"Hib-mency vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forearm crutch platform atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0153","description":"Forearm crutch platform atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA0","description":"ICD-MHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEC0","description":"ICD-CDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF0","description":"ICD-BIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA1","description":"ICD-CHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD0","description":"ICD-CDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF0","description":"ICD-GARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA31","description":"ICD-3BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB11","description":"ICD-3DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC0","description":"ICD-NFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0357T","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB0","description":"ICD-OBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of arm artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35045","description":"Repair defect of arm artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBE0","description":"ICD-GIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC1","description":"ICD-DCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILC0","description":"ICD-AILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA0","description":"ICD-KCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCB0","description":"ICD-EGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB0","description":"ICD-OIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2C","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37256","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","description":"CPT-37256","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Varicella-zoster antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86787","description":"Varicella-zoster antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB36","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVC0","description":"ICD-BDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID1","description":"ICD-OBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76496","description":"Fluoroscopic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61570","description":"Remove foreign body brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0679U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679U","description":"CPT-0679U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC1","description":"ICD-JECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF1","description":"ICD-KHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combination oral/nasal mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7027","description":"Combination oral/nasal mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD0","description":"ICD-BEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1072","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","description":"HCPCS-J1072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deluxe lens feature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2702","description":"Deluxe lens feature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ltwt portbl power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0012","description":"Ltwt portbl power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIE1","description":"ICD-EEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC0","description":"ICD-KDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50650","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB0","description":"ICD-OKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE1","description":"ICD-CFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was not obtained_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1029","description":"Imaging of the head (CT or MRI) was not obtained_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB1","description":"ICD-NAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28B","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYB0","description":"ICD-CEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICE1","description":"ICD-GICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA0","description":"ICD-DASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTE1","description":"ICD-GBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRC1","description":"ICD-CCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXB1","description":"ICD-FDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle control ortho pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4350","description":"Ankle control ortho pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB1","description":"ICD-FHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Energy storing foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5976","description":"Energy storing foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB11","description":"ICD-1FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC1","description":"ICD-GHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54322","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breath test heart reject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085T","description":"Breath test heart reject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mosunetuzumab-axgb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9350","description":"Injection_ mosunetuzumab-axgb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE0","description":"ICD-DDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0652T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; diagnostic_ including collection of specimen(s) by brushing or washing_ when performed (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF1","description":"ICD-BGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF1","description":"ICD-GCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA1","description":"ICD-CIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF1","description":"ICD-CDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMB1","description":"ICD-NFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7168","description":"Prothrombin complex concentrate (human)_ kcentra_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC1","description":"ICD-JCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD1","description":"ICD-FAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","description":"HCPCS-Q5098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD0","description":"ICD-JALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD0","description":"ICD-CEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE0","description":"ICD-NAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA1","description":"ICD-MFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl cushions for jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1701","description":"Repl cushions for jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD0","description":"ICD-BGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0551U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0551U","description":"CPT-0551U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEE1","description":"ICD-CCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 1.1-5.0cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11951","description":"Tx contour defects 1.1-5.0cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1245","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIC0","description":"ICD-GBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD1","description":"ICD-JBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF1","description":"ICD-BHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8H","description":"Very High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF0","description":"ICD-DIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECA1","description":"ICD-EECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mh svc plan dev by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0032","description":"Mh svc plan dev by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77615","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Root canal therapy 2 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3320","description":"Root canal therapy 2 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ewho rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3763","description":"Ewho rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB1","description":"ICD-HEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTE1","description":"ICD-NDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC0","description":"ICD-CAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAF1","description":"ICD-KHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA40","description":"Ultra High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low- dose computed tomography for lung cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8032","description":"Low- dose computed tomography for lung cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vessel mapping hemo access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0365","description":"Vessel mapping hemo access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB1","description":"ICD-OBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC1","description":"ICD-HAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD0","description":"ICD-IBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18G","description":"Special Care High _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE0","description":"ICD-JIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE0","description":"ICD-NLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE0","description":"ICD-HCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1024T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","description":"CPT-1024T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF1","description":"ICD-IDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1344","description":"Patients who did not have a baseline pam score and/or a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of bile duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47425","description":"Incision of bile duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC150","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4000","description":"Dermatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9049","description":"Injection_ tagraxofusp-erzs_ 10mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE121","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body jacket mold to patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1300","description":"Body jacket mold to patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topotecan oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8705","description":"Topotecan oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB0","description":"ICD-CBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1577","description":"HCPCS-J1577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB1","description":"ICD-OLNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA0","description":"ICD-IECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB0","description":"ICD-IICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB11","description":"ICD-4IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D8091","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8091","description":"CDT-D8091","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA241","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig osteo screen measu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8401","description":"Pt inelig osteo screen measu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0696U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696U","description":"CPT-0696U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88020","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polysom any age 1-3> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95808","description":"Polysom any age 1-3> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w<3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6442","description":"Conform band n/s w<3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE0","description":"ICD-OFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/o stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4082","description":"Enteral ng tubing w/o stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE1","description":"ICD-ACUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF1","description":"ICD-GAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF0","description":"ICD-NEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCND0","description":"ICD-GCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21179","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC0","description":"ICD-CCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96170","description":"Health Behavior Intervention_ Family (Without The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLB0","description":"ICD-BCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF0","description":"ICD-KIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33504","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","description":"HCPCS-Q5161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA1","description":"ICD-GAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC154","description":"Special Care High _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for >6 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1135F","description":"Epsd bk pain for >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNE1","description":"ICD-NKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9048","description":"Injection_ bortezomib (fresenius kabi)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE1","description":"ICD-FDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42160","description":"Treatment mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD0","description":"ICD-CDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shdr fair lead cable direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6590","description":"Shdr fair lead cable direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD0","description":"ICD-GILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable liquid oxygen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0433","description":"Portable liquid oxygen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt support & positioning sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0636","description":"Pt support & positioning sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE1","description":"ICD-NBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB1","description":"ICD-BBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8F","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID0","description":"ICD-NAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3342F","description":"Mammo assess bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE0","description":"ICD-BDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80331","description":"Analgesics non-opioid 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQA0","description":"ICD-KGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/ch access anti-rollback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0974","description":"W/ch access anti-rollback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC0","description":"ICD-KBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0237","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","description":"HCPCS-M0237","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE1","description":"ICD-OBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA1","description":"ICD-GEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytp urine 3-5 probes cmptr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88121","description":"Cytp urine 3-5 probes cmptr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65870","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA101","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0660","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","description":"HCPCS-G0660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB0","description":"ICD-HARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16373","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16373","description":"CPT-16373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE1","description":"ICD-ACTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74221","description":"Radiologic Examination_ Esophagus_ Including Scout Chest Radiograph(S) And Delayed Image(S)_ When Performed; Double-Contrast (Eg_ High-Density Barium And Effervescent Agent) S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0036U","description":"Exome (ie_ somatic mutations)_ paired formalin-fixed paraffin-embedded tumor tissue and normal specimen_ sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0003","description":"Infect agent det by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxytocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2590","description":"Oxytocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brst prsth bra & bilat form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8002","description":"Brst prsth bra & bilat form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB11","description":"ICD-2LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC1","description":"ICD-EHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC1","description":"ICD-GCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76828","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet ped plster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4015","description":"Cast sup gauntlet ped plster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD0","description":"ICD-BIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64655","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","description":"CPT-64655","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA1","description":"ICD-EGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRE0","description":"ICD-PLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX26","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13153","description":"Cmplx rpr e/n/e/l addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDB0","description":"ICD-FHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES146","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF0","description":"ICD-EEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC1","description":"ICD-HDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subs episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1128F","description":"Subs episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVA0","description":"ICD-CCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy revise stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31638","description":"Bronchoscopy revise stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28295","description":"Correction_ hallux valgus (bunionectomy)_ with sesamoidectomy_ when performed; with proximal metatarsal osteotomy_ any method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX05","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB0","description":"ICD-JHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97035","description":"Ultrasound therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","description":"HCPCS-A2033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB0","description":"ICD-FCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF0","description":"ICD-IABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Androstanediol glucuronide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82154","description":"Androstanediol glucuronide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF0","description":"ICD-NGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX10","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID1","description":"ICD-OIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDED0","description":"ICD-IDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift hydraulic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0630","description":"Patient lift hydraulic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE1","description":"ICD-CGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC1","description":"ICD-IBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC1","description":"ICD-JHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20D","description":"Special Care Low _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0494","description":"Skilled services of a licensed practical nurse (LPN) for the observation and assessment of the patient_s condition_ each 15 minutes (the change in the patient_s condition requ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE0","description":"ICD-FIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9152","description":"Injection_ aripiprazole_ (Abilify Asimtufii)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB1","description":"ICD-IAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6121","description":"Implant Supported Retainer For Metal Fpd - Perdominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen sng rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8685","description":"Implt nrostm pls gen sng rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42975","description":"Drug-Induced Sleep Endoscopy_ With Dynamic Evaluation Of Velum_ Pharynx_ Tongue Base_ And Larynx For Evaluation Of Sleep-Disordered Breathing_ Flexible_ Diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD0","description":"ICD-OEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Int therapeutic restoration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2941","description":"Int therapeutic restoration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF0","description":"ICD-BBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise aqueous shunt eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66185","description":"Revise aqueous shunt eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abdom aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75953","description":"Abdom aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD0","description":"ICD-CCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA1","description":"ICD-DBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEND0","description":"ICD-CEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic ring fracture uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0413","description":"Pelvic ring fracture uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0489U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","description":"CPT-0489U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB1","description":"ICD-NHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA1","description":"ICD-FGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHD1","description":"ICD-FDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC0","description":"ICD-FBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relieve inner eye pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65820","description":"Relieve inner eye pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD1","description":"ICD-JHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99254","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF0","description":"ICD-JEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF0","description":"ICD-JAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB1","description":"ICD-BITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE0","description":"ICD-NEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA1","description":"ICD-IEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2098","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB10","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gastrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82941","description":"Assay of gastrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE0","description":"ICD-JHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF0","description":"ICD-DFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF0","description":"ICD-KDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB1","description":"ICD-JDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic antiplasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85410","description":"Fibrinolytic antiplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC1","description":"ICD-EFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA1","description":"ICD-JCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35693","description":"Art trnsposj subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA0","description":"ICD-EBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC1","description":"ICD-GAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32608","description":"Thoracoscopy w/bx nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","description":"CPT-91124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84233","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB145","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1734","description":"Orthopedic/Device/Drug Matrix For Opposing Bone-To-Bone Or Soft Tissue-To Bone (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA1","description":"ICD-OBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90296","description":"Diphtheria antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5171","description":"HCPCS-Q5171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50660","description":"Removal of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE1","description":"ICD-DBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE1","description":"ICD-DGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWC0","description":"ICD-OKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt dia retin msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9671","description":"Intend rpt dia retin msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88399","description":"Surgical pathology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0944T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","description":"CPT-0944T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF1","description":"ICD-GFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2073","description":"Medication Assisted Treatment_ Naltrexone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Tes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKF1","description":"ICD-CHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin graft t/a/l +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15152","description":"Cult skin graft t/a/l +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND1","description":"ICD-JFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC0","description":"ICD-BDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD1","description":"ICD-EETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2402","description":"Injection_ chloroprocaine hydrochloride (clorotekal)_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Promethazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2550","description":"Promethazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFC0","description":"ICD-GDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXC0","description":"ICD-ODXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37284","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","description":"CPT-37284","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ceftizoxime sodium / 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0715","description":"Ceftizoxime sodium / 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF0","description":"ICD-CCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA1","description":"ICD-GFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin most rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5551","description":"Insulin most rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Second stage implant surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6011","description":"Second stage implant surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB1","description":"ICD-JFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44625","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB0","description":"ICD-NCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMF0","description":"ICD-FIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6203","description":"Composite drsg <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYE0","description":"ICD-PHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81554","description":"Pulmonary Disease (Idiopathic Pulmonary Fibrosis [Ipf])_ Mrna_ Gene Expression Analysis Of 190 Genes_ Utilizing Transbronchial Biopsies_ Diagnostic Algorithm Reported As Categ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0504","description":"Initial or subsequent psychiatric collaborative care management_ each additional 30 minutes in a calendar month of behavioral health care manager activities_ in consultation w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA1","description":"ICD-DFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0B","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eyeglasses delux frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2025","description":"Eyeglasses delux frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0690U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690U","description":"CPT-0690U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBC0","description":"ICD-AIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8G","description":"High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cauterization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57510","description":"Cauterization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA0","description":"ICD-CCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF0","description":"ICD-CHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36566","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD1","description":"ICD-NCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cell enumeration & id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86152","description":"Cell enumeration & id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCF0","description":"ICD-KBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD0","description":"ICD-PGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF1","description":"ICD-FCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF1","description":"ICD-JBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0523U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","description":"CPT-0523U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA1","description":"ICD-OFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOE1","description":"ICD-LGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA1","description":"ICD-OAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24586","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE1","description":"ICD-OCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC1","description":"ICD-OJFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE0","description":"ICD-EIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44970","description":"Laparoscopy appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0124A","description":"IMM ADMN SARSCOV2 BIVALENT 30 MCG/0.3 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE0","description":"ICD-OLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC1","description":"ICD-EIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electron elbow child switch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7186","description":"Electron elbow child switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93978","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48155","description":"Removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD0","description":"ICD-IACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No prol intub req","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8570","description":"No prol intub req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0106","description":"HCPCS-A0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE1","description":"ICD-KBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD0","description":"ICD-IFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC1","description":"ICD-NGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD0","description":"ICD-CIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp animat ret imag series","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380T","description":"Comp animat ret imag series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD1","description":"ICD-NAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time lee & white","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85345","description":"Coagulation time lee & white","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE0","description":"ICD-IDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUB1","description":"ICD-NEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28285","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB0","description":"ICD-BGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF1","description":"ICD-HFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB0","description":"ICD-PEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF0","description":"ICD-OFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE1","description":"ICD-IFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB0","description":"ICD-LDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAC0","description":"ICD-NCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB0","description":"ICD-JCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC0","description":"ICD-CFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES210","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC1","description":"ICD-CGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22D","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28238","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Work related disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99455","description":"Work related disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF0","description":"ICD-NDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent repair of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64872","description":"Subsequent repair of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0788T","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg_ electrode array and receiver)_ including contact group(s)_ amplitude_ pulse wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD1","description":"ICD-OIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJB0","description":"ICD-OCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval laryngoscopy sense tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92615","description":"Eval laryngoscopy sense tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML16","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87903","description":"Phenotype dna hiv w/culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB1","description":"ICD-JBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj dihydroergotamine mesylt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1110","description":"Inj dihydroergotamine mesylt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0667","description":"Seg pneumatic appl full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB0","description":"ICD-JIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB0","description":"ICD-MHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052A","description":"Imm admin by intramuscular injection of (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula_ second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF0","description":"ICD-BFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0A","description":"Very High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC0","description":"ICD-OKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA1","description":"ICD-GGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLF0","description":"ICD-CHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0611","description":"Injection_ calcium gluconate (wg critical care)_ per 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB0","description":"ICD-ICEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB31","description":"ICD-2BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd w barrier/filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4416","description":"Ost pch clsd w barrier/filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES156","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC212","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE224","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86309","description":"Heterophile antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFF1","description":"ICD-KAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g potassium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2540","description":"Penicillin g potassium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA0","description":"ICD-JCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF0","description":"ICD-BANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81451","description":"Targeted genomic sequence analysis panel_ hematolymphoid neoplasm or disorder_ 5-50 genes (eg_ BRAF_ CEBPA_ DNMT3A_ EZH2_ FLT3_ IDH1_ IDH2_ JAK2_ KIT_ KRAS_ MLL_ NOTCH1_ NPM1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66940","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME1","description":"ICD-OJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF0","description":"ICD-JDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0690T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained With Diagnostic Ultrasound Examination Of The Same Anatomy (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power operated vehicle noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0812","description":"Power operated vehicle noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50820","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC0","description":"ICD-BFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF0","description":"ICD-EGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBD0","description":"ICD-KFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF1","description":"ICD-JFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE0","description":"ICD-NAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD0","description":"ICD-OLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB1","description":"ICD-BCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF0","description":"ICD-AFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF0","description":"ICD-NFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC0","description":"ICD-KIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD1","description":"ICD-GDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC1","description":"ICD-FAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF1","description":"ICD-OFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB0","description":"ICD-NBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart/lung resuscitation cpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92950","description":"Heart/lung resuscitation cpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD1","description":"ICD-ECAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB0","description":"ICD-JIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo sling operation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51992","description":"Laparo sling operation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF0","description":"ICD-LIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxillary sinusotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7560","description":"Maxillary sinusotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF0","description":"ICD-OKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD1","description":"ICD-FEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7353","description":"Anacaulase-bcdb_ 8.8% gel_ 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frenulotomy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54164","description":"Frenulotomy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC1","description":"ICD-KITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA1","description":"ICD-NJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRD1","description":"ICD-OJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPB1","description":"ICD-NEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE0","description":"ICD-GGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPB1","description":"ICD-BBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47125","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensv oral eval prob focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0160","description":"Extensv oral eval prob focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7610","description":"Albuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB21","description":"ICD-4HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25450","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB1","description":"ICD-KGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68330","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHB1","description":"ICD-NKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF0","description":"ICD-NLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91303","description":"Janssen Covid-19 Vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of neck cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42815","description":"Excision of neck cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD0","description":"ICD-NHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB0","description":"ICD-PLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","description":"CPT-49190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPC0","description":"ICD-OJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB1","description":"ICD-MKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74183","description":"MRI abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81247","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; common variant(s) (eg_ A_ A-)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg awake and asleep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95819","description":"Eeg awake and asleep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA0","description":"ICD-CFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia with hypothermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99116","description":"Anesthesia with hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluorouracil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9190","description":"Fluorouracil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD1","description":"ICD-CGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2214","description":"Initial or subsequent psychiatric collaborative care management_ first 30 minutes in a month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim no prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95970","description":"Analyze neurostim no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair laminectomy defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63295","description":"Repair laminectomy defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF1","description":"ICD-KAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB0","description":"ICD-MHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0618","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","description":"HCPCS-J0618","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1554","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurgery penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54056","description":"Cryosurgery penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA1","description":"ICD-JDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID1","description":"ICD-EAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carcinoembryonic antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82378","description":"Carcinoembryonic antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy addl lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63044","description":"Laminotomy addl lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSF0","description":"ICD-CGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF1","description":"ICD-ECDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So acro/clav can web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3670","description":"So acro/clav can web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ DNA (523 genes) and RNA (55 genes) by next-generation sequencing_ interrogation for sequence variants_ gene cop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE1","description":"ICD-DCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00754","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","description":"CPT-00754","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7170","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asp not presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9436","description":"Asp not presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF0","description":"ICD-OGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC0","description":"ICD-HDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m maa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9540","description":"Tc99m maa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33777","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC0","description":"ICD-JIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPB1","description":"ICD-JIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93786","description":"Ambulatory bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse liver ducts & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47765","description":"Fuse liver ducts & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEA0","description":"ICD-FHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF1","description":"ICD-PHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC0","description":"ICD-KCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD0","description":"ICD-DAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC1","description":"ICD-JAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severity angina by actvty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1010F","description":"Severity angina by actvty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE1","description":"ICD-IFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQC1","description":"ICD-HDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJE1","description":"ICD-OFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB1","description":"ICD-GFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0404","description":"CDT-D0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA1","description":"ICD-FBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27756","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC0","description":"ICD-BIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct guide for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77013","description":"Ct guide for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dalbavancin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0875","description":"Injection_ dalbavancin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB0","description":"ICD-BDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC101","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair diaphragm laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39501","description":"Repair diaphragm laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA31","description":"ICD-3FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ofloxacin_ 400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0034","description":"Injection_ ofloxacin_ 400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reas antibiotic pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8709","description":"Med reas antibiotic pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81223","description":"Cftr gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUD0","description":"ICD-FIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures mandibl part metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5214","description":"Dentures mandibl part metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271T","description":"Rev/remvl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED0","description":"ICD-MCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth ear surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12051","description":"Anesth ear surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62651","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAA0","description":"ICD-OFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA0","description":"ICD-GFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUA1","description":"ICD-OEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC0","description":"ICD-JGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA1","description":"ICD-IATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE1","description":"ICD-CDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC0","description":"ICD-BAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31766","description":"Reconstruction of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA0","description":"ICD-OKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker folding adjust/fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0135","description":"Walker folding adjust/fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC1","description":"ICD-BGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE1","description":"ICD-FBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth iridectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14751","description":"Anesth iridectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC0","description":"ICD-EBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fluphenazine hcl_ 1.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2679","description":"Injection_ fluphenazine hcl_ 1.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCF1","description":"ICD-GCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lidocaine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2001","description":"Lidocaine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB1","description":"ICD-KCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE0","description":"ICD-KHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53454","description":"Periurethral Transperineal Adjustable Balloon Continence Device; Percutaneous Adjustment Of Balloon(S) Fluid Volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA0","description":"ICD-GDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cath intracranial art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36228","description":"Place cath intracranial art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86632","description":"Chlamydia igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB1","description":"ICD-NLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAE0","description":"ICD-JBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain w bar & filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4424","description":"Ost pch drain w bar & filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4225","description":"Supplies for external insulin infusion pump_ syringe type cartridge_ sterile_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA1","description":"ICD-IDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKA1","description":"ICD-KDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC0","description":"ICD-MACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA0","description":"ICD-NCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28630","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA1","description":"ICD-FAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB31","description":"ICD-2IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57423","description":"Repair paravag defect lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE1","description":"ICD-IHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD0","description":"ICD-FIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1470","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","description":"HCPCS-M1470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKF0","description":"ICD-GDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA1","description":"ICD-JBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD1","description":"ICD-PBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHC1","description":"ICD-AHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays for bone age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77072","description":"X-rays for bone age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22830","description":"Exploration of spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX01","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91010","description":"Esophagus motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC0","description":"ICD-JDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB1","description":"ICD-CDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD145","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE1","description":"ICD-EFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC1","description":"ICD-JAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In111 ibritumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9542","description":"In111 ibritumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54344","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reusable rectal thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4932","description":"Reusable rectal thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5113","description":"Injection_ trastuzumab-pkrb_ biosimilar_ (herzuma)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA0","description":"ICD-NFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAF0","description":"ICD-BBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21453","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB52","description":"Medium Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC1","description":"ICD-GFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17106","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA0","description":"ICD-NADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31070","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB1","description":"ICD-LEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE155","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","description":"HCPCS-M1412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orth foot non-standard size/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3255","description":"Orth foot non-standard size/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flexible keel foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5972","description":"Flexible keel foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC0","description":"ICD-FICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD0","description":"ICD-HASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC11","description":"ICD-1JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63700","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst nbl mtl 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6614","description":"Onlay cst nbl mtl 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12007","description":"Rpr s/n/ax/gen/trnk >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE213","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77057","description":"Mammogram screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4540","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD0","description":"ICD-PFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped fluid and electrolyte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4103","description":"Ef ped fluid and electrolyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA1","description":"ICD-OIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB11","description":"ICD-3KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD1","description":"ICD-HBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery-vein nonautograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36830","description":"Artery-vein nonautograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANF1","description":"ICD-BANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB1","description":"ICD-LFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","description":"HCPCS-Q4407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF0","description":"ICD-AEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD1","description":"ICD-OKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55812","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tap block unil by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64486","description":"Tap block unil by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE0","description":"ICD-MAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1938","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","description":"HCPCS-J1938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1338","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1468","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","description":"HCPCS-M1468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artacent AC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4189","description":"Artacent AC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nushield 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4160","description":"Nushield 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66160","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE1","description":"ICD-CBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87485","description":"Chylmd pneum dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditor evoke potent limit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92586","description":"Auditor evoke potent limit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA0","description":"ICD-LDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41825","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABD0","description":"ICD-CABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Natalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2323","description":"Natalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA0","description":"ICD-NLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE1","description":"ICD-JBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0497T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recorder without 24 hour attended moni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA1","description":"ICD-KBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology work-up evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9050","description":"Oncology work-up evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE1","description":"ICD-KDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND0","description":"ICD-CAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA0","description":"ICD-ODGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB0","description":"ICD-BHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQA1","description":"ICD-HAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_strble_non-peel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1766","description":"Intro/sheath_strble_non-peel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB0","description":"ICD-BDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient received any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9723","description":"Hospice services for patient received any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex nes antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86694","description":"Herpes simplex nes antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB1","description":"ICD-OCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enter infusion pump w/o alrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9000","description":"Enter infusion pump w/o alrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE1","description":"ICD-KDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC0","description":"ICD-BBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal canal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62355","description":"Remove spinal canal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE1","description":"ICD-OELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental recement bridge","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6930","description":"Dental recement bridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMB0","description":"ICD-FGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB1","description":"ICD-AECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD1","description":"ICD-NFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD0","description":"ICD-OGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE1","description":"ICD-OACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE1","description":"ICD-GHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA1","description":"ICD-JEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB1","description":"ICD-OJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD0","description":"ICD-IIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Woundplus membrane or e-graft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4277","description":"Woundplus membrane or e-graft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99155","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA0","description":"ICD-JDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobilization of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44139","description":"Mobilization of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKD1","description":"ICD-NCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA0","description":"ICD-GGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","description":"HCPCS-A9615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB0","description":"ICD-MLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA0","description":"ICD-GFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3376F","description":"Ajcc brstcncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27178","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB35","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC0","description":"ICD-DIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE260","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychiatric symp absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1183F","description":"Neuropsychiatric symp absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE1","description":"ICD-JBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD0","description":"ICD-BHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF1","description":"ICD-ODYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA0","description":"ICD-BBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA1","description":"ICD-JGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD1","description":"ICD-JFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB20","description":"Ultra High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC0","description":"ICD-MHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33016","description":"Pericardiocentesis_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTE1","description":"ICD-GHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB1","description":"ICD-KFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sutures diff surgeon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15851","description":"Remove sutures diff surgeon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9376","description":"Hit hydra 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9549","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPE1","description":"ICD-NDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB1","description":"ICD-KDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8097","description":"Asthma kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE0","description":"ICD-FFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen specific nucleic acid (DNA or RNA)_ 33 targets_ real-time semi-quantitative PCR_ bronchoalveolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9793","description":"3d predictive model generation for pre-planning of a cardiac procedure_ using data from cardiac computed tomographic angiography with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB1","description":"ICD-JFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB20B","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA156","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0479U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","description":"CPT-0479U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs lwr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29581","description":"Apply multlay comprs lwr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOB0","description":"ICD-GFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External receiver_ cgm sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9278","description":"External receiver_ cgm sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC1","description":"ICD-KAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME1","description":"ICD-FAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB0","description":"ICD-HEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o 3+ post-opnausea&vom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4557F","description":"Pt w/o 3+ post-opnausea&vom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA0","description":"ICD-IFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0487U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","description":"CPT-0487U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE1","description":"ICD-FFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB1","description":"ICD-EAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX50","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8911","description":"Mra w/o fol w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME0","description":"ICD-OBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE0","description":"ICD-OGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD0","description":"ICD-JIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB0","description":"ICD-CFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthro_ loose body + chondro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0289","description":"Arthro_ loose body + chondro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Inherited Thrombocytopenia Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0276U","description":"Hematology (inherited thrombocytopenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Inherited Thrombocytopenia Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX16","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9926","description":"Safety concerns screening positive screen is without provision of mitigation recommendations_ including but not limited to referral to other resources","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES115","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA1","description":"ICD-PBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIE0","description":"ICD-ECIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5+ cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4209","description":"5+ cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB25","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2371","description":"Injection_ phenylephrine hydrochloride_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25370","description":"Revise radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA0","description":"ICD-KHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA0","description":"ICD-KHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC1","description":"ICD-CEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD1","description":"ICD-NGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC120","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC1","description":"ICD-ODYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE1","description":"ICD-NIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB0","description":"ICD-OGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0738","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education_ include microprocessor_ all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSC1","description":"ICD-PLSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB1","description":"ICD-CAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC1","description":"ICD-HGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA0","description":"ICD-OHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC1","description":"ICD-EHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPB1","description":"ICD-JHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67850","description":"Treat eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA1","description":"ICD-GBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA0","description":"ICD-FIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"XK GNOTYP XK EXONS 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200U","description":"XK GNOTYP XK EXONS 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneum int legs/trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0670","description":"Seg pneum int legs/trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDF0","description":"ICD-BIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc rect tum transanal full","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45172","description":"Exc rect tum transanal full","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin chromotography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83021","description":"Hemoglobin chromotography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC206","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML14","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB1","description":"ICD-CDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5248","description":"Hearing aid_ binaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB1","description":"ICD-KGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA0","description":"ICD-JHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC0","description":"ICD-ACBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; urine (eg_ microalbumin)_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82043","description":"Albumin; urine (eg_ microalbumin)_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65800","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results documented and reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1277","description":"Colorectal cancer screening results documented and reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2791","description":"Crown full cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE0","description":"ICD-OEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC0","description":"ICD-NCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA0","description":"ICD-CDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPC1","description":"ICD-CIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61564","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27792","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD1","description":"ICD-OHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc membranes fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111T","description":"Rbc membranes fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thaw cryoprsvrd reprod tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89354","description":"Thaw cryoprsvrd reprod tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"American amnion ac tri-layer_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4305","description":"American amnion ac tri-layer_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27759","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD1","description":"ICD-NFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haptoglobin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83010","description":"Assay of haptoglobin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB0","description":"ICD-KFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF0","description":"ICD-OAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA1","description":"ICD-GESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Draw blood off venous device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36591","description":"Draw blood off venous device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD1","description":"ICD-IGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB0","description":"ICD-MGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL43","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUF0","description":"ICD-EDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110U","description":"Oncology (hepatic)_ mRNA expression levels of 161 genes_ utilizing fresh he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tcd vasoreactivity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93890","description":"Tcd vasoreactivity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA0","description":"ICD-OEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pild/placebo control clin tr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0276","description":"Pild/placebo control clin tr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF0","description":"ICD-OCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF1","description":"ICD-NDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39000","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67250","description":"Reinforce eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44132","description":"Enterectomy cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA1","description":"ICD-ACTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF1","description":"ICD-NAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bile acids total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82239","description":"Bile acids total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33741","description":"Transcatheter Atrial Septostomy (Tas) For Congenital Cardiac Anomalies To Create Effective Atrial Flow_ Including All Imaging Guidance By The Proceduralist_ When Performed_ An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrvl 3/>yr pts clnscp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529F","description":"Intrvl 3/>yr pts clnscp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum-vagina fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57305","description":"Repair rectum-vagina fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fuse&remov bel c2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22551","description":"Neck spine fuse&remov bel c2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51585","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fndngs mammo 2pt w/in 3 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5060F","description":"Fndngs mammo 2pt w/in 3 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD0","description":"ICD-AICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0794T","description":"Patient-specific_ assistive_ rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient_s tumor-specific cancer marker information obtained fr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC0","description":"ICD-OATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEF0","description":"ICD-KFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB1","description":"ICD-KFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB1","description":"ICD-NHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low extemity neur not perfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8405","description":"Low extemity neur not perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70481","description":"Ct orbit/ear/fossa w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electron microscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88348","description":"Electron microscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMB0","description":"ICD-KAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA0","description":"ICD-NIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99356","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6115","description":"Implnt/abut fixed dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tenoglide tendon prot_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9356","description":"Tenoglide tendon prot_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJF1","description":"ICD-CDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0C","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 3 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9367","description":"Hit tpn 3 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKD0","description":"ICD-ODKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD1","description":"ICD-KFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surfactant admin thru tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94610","description":"Surfactant admin thru tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF0","description":"ICD-PCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23500","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC1","description":"ICD-NLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQD0","description":"ICD-KGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rn telephone calls to dmp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0320","description":"Rn telephone calls to dmp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow w/deb open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24358","description":"Repair elbow w/deb open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB1","description":"ICD-KIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE0","description":"ICD-AFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC0","description":"ICD-EIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE0","description":"ICD-KGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51727","description":"Cystometrogram w/up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64596","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; initial electrode arra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt gest hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9211","description":"Home mgmt gest hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","description":"CPT-01140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percussor elect/pneum home m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0480","description":"Percussor elect/pneum home m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE1","description":"ICD-CARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES117","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB1","description":"ICD-IHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWD1","description":"ICD-PBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB0","description":"ICD-FBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pooling blood platelets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86965","description":"Pooling blood platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF0","description":"ICD-NIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA1","description":"ICD-PLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-fixed paraffin embedded tissue or fresh frozen tissue_ predictive algorithm reported as potential ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23466","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA1","description":"ICD-LEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLC0","description":"ICD-CGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0049","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX06","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht irrigation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9590","description":"Ht irrigation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB0","description":"ICD-KBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE0","description":"ICD-IHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB0","description":"ICD-CERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB0","description":"ICD-KDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE0","description":"ICD-KAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVA0","description":"ICD-JFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE0","description":"ICD-MCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD1","description":"ICD-AGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD0","description":"ICD-MBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADF0","description":"ICD-BADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHF0","description":"ICD-EBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA11","description":"ICD-3CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF1","description":"ICD-AFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57550","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIF0","description":"ICD-GFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB21","description":"ICD-4JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","description":"HCPCS-Q4421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0538U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","description":"CPT-0538U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE1","description":"ICD-DESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2101","description":"CDT-D2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag-coronal panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0638","description":"Lso sag-coronal panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE0","description":"ICD-ACAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49580","description":"Rpr umbil hern reduc < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAA1","description":"ICD-ACAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93641","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhs/hospice of lpn ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0300","description":"Hhs/hospice of lpn ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac event recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0616","description":"Cardiac event recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED1","description":"ICD-BHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2006","description":"Novosorb Synpath Dermal Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB0","description":"ICD-NHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove skull plate/flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62142","description":"Remove skull plate/flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0437U","description":"Psychiatry (anxiety disorders)_ mRNA_ gene expression profiling by RNA sequencing of 15 biomarkers_ whole blood_ algorithm reported as predictive risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB1","description":"ICD-OCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC11","description":"ICD-4BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF1","description":"ICD-OLQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE0","description":"ICD-MJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mw therapy for breast tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301T","description":"Mw therapy for breast tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg over 1 hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95813","description":"Eeg over 1 hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46612","description":"Anoscopy remove lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61530","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBC0","description":"ICD-OEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC230","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE1","description":"ICD-KAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Migration inhibitory factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86378","description":"Migration inhibitory factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECC1","description":"ICD-KECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9038","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF0","description":"ICD-LDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHA0","description":"ICD-EAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26686","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGA1","description":"ICD-JBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In111 pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9548","description":"In111 pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOC0","description":"ICD-DEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27540","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF1","description":"ICD-NFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD1","description":"ICD-KFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE0","description":"ICD-MEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390U","description":"Obstetrics (preeclampsia)_ kinase insert domain receptor (KDR)_ Endoglin (ENG)_ and retinol-binding protein 4 (RBP4)_ by immunoassay_ serum_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE1","description":"ICD-JCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frnt cstr cmpl sem-pneum tir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0072","description":"Frnt cstr cmpl sem-pneum tir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF0","description":"ICD-EGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9153","description":"Injection_ liposomal_ 1 mg daunorubicin and 2.27 mg cytarabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWF1","description":"ICD-GDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME0","description":"ICD-ABME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEA0","description":"ICD-JHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIE1","description":"ICD-CCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDE1","description":"ICD-MLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin depres scrn no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8511","description":"Clin depres scrn no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF0","description":"ICD-MGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE1","description":"ICD-NKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heat quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109T","description":"Heat quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOD1","description":"ICD-CIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD1","description":"ICD-JAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE1","description":"ICD-FHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIC0","description":"ICD-AFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0406","description":"HCPCS-A0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/giving drugs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95954","description":"Eeg monitoring/giving drugs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC1","description":"ICD-GEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE0","description":"ICD-DGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXC1","description":"ICD-KBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCA0","description":"ICD-CBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31257","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup band/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2020","description":"Kafo dbl solid stirrup band/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","description":"CPT-55710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB1","description":"ICD-OFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF1","description":"ICD-MITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA0","description":"ICD-CFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta dev setup&educaj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0604T","description":"Rem oct rta dev setup&educaj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD0","description":"ICD-IBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA251","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scoliosis dna alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004M","description":"Scoliosis dna alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0896T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; each additional hour_ including physiological and laboratory assessments (eg_ perfu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF1","description":"ICD-JHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36570","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral knee autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27416","description":"Osteochondral knee autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Baclofen intrathecal trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0476","description":"Baclofen intrathecal trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA0","description":"ICD-DIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25000","description":"Incision of tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC0","description":"ICD-CEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD0","description":"ICD-OEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRA0","description":"ICD-OJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA0","description":"ICD-KIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE0","description":"ICD-ABHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5145","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","description":"HCPCS-Q5145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB0","description":"ICD-GAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID1","description":"ICD-BFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-2b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9214","description":"Interferon alfa-2b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE0","description":"ICD-EABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ifosfamide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9208","description":"Ifosfamide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA1","description":"ICD-MDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF1","description":"ICD-KEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9352","description":"Not >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection into vocal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31513","description":"Injection into vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF0","description":"ICD-IAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0576","description":"Injection_ buprenorphine extended-release (brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5B","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE1","description":"ICD-OIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE111","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immune globulin_ powder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1566","description":"Immune globulin_ powder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC0","description":"ICD-KFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0817T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX07","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder tumor surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91251","description":"Anesth bladder tumor surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens gas permbl bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2512","description":"Cntct lens gas permbl bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b core antibody total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86704","description":"Hep b core antibody total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA51","description":"High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE1","description":"ICD-CFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE1","description":"ICD-NKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA1","description":"ICD-CAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB0","description":"ICD-IGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulp cap direct","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3110","description":"Pulp cap direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy ligate perf veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37500","description":"Endoscopy ligate perf veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIED0","description":"ICD-MIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA0","description":"ICD-JEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF1","description":"ICD-LIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6601","description":"Gradient compression bandaging supply_ high density foam pad_ any size or shape_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAB0","description":"ICD-GEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","description":"CPT-00770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE0","description":"ICD-BDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin frct swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5812","description":"Endo knee-shin frct swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Promazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2950","description":"Promazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF0","description":"ICD-GFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Straight tip urine catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4351","description":"Straight tip urine catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE0","description":"ICD-GFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65815","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg ak ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5430","description":"Postop dsg ak ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1681","description":"Hip orthosis (HO)_ bilateral hip joints and thigh cuffs_ adjustable flexion_ extension_ abduction control of hip joint_ postoperative hip abduction type_ prefabricated item th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA0","description":"ICD-OHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE260","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD1","description":"ICD-DDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLF0","description":"ICD-IGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB0","description":"ICD-AFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB0","description":"ICD-PDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29582","description":"Apply multlay comprs upr leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow child myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7191","description":"Elbow child myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED1","description":"ICD-OIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27700","description":"Revision of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA0","description":"ICD-JHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC1","description":"ICD-PKOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27091","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA1","description":"ICD-OBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC1","description":"ICD-IAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE1","description":"ICD-BDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF1","description":"ICD-CFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC1","description":"ICD-OAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA12C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis a igm antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86709","description":"Hepatitis a igm antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD1","description":"ICD-KHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6537","description":"Gc stocking full lngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc dr wh motor/gear comb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2370","description":"Pwr wc dr wh motor/gear comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB0","description":"ICD-FHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av fusion direct any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36821","description":"Av fusion direct any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC0","description":"ICD-GGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy remove segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32669","description":"Thoracoscopy remove segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJA1","description":"ICD-GGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0993T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","description":"CPT-0993T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAC1","description":"ICD-CIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITC0","description":"ICD-EITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGB1","description":"ICD-FAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC1","description":"ICD-OECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA0","description":"ICD-FBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3052F","description":"Ostectomy_ partial_ exostectomy or condylectomy_ metatarsal head_ each meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB22","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD1","description":"ICD-DAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC0","description":"ICD-NLXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC1","description":"ICD-MEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no ahi or rdi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8843","description":"Doc reas no ahi or rdi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME1","description":"ICD-CCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0457","description":"Chest shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB0","description":"ICD-PLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE1","description":"ICD-KITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mental status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2014F","description":"Mental status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0818T","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction_ including analysis_ programming_ and imaging_ when performed_ posterior tibial nerve; subcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE0","description":"ICD-EGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csf shunt reprogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62252","description":"Csf shunt reprogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE117","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA1","description":"ICD-GHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB1","description":"ICD-KBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9815","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9815","description":"HCPCS-C9815","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA1","description":"ICD-BFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA1","description":"ICD-CDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA0","description":"ICD-KAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace/revise brain shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62230","description":"Replace/revise brain shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF0","description":"ICD-ABDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF1","description":"ICD-BDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA0","description":"ICD-EGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peritoneal lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49084","description":"Peritoneal lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC0","description":"ICD-NKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC1","description":"ICD-MJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg >16 <=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6252","description":"Absorpt drg >16 <=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC1","description":"ICD-MLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23D","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scleral lens liquid bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0515","description":"Scleral lens liquid bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA1","description":"ICD-FENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt info into recall system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7010F","description":"Pt info into recall system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE1","description":"ICD-GDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx/pro/dx inj new drug addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96375","description":"Tx/pro/dx inj new drug addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC0","description":"ICD-NEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 2999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4723","description":"Dialys sol fld vol > 2999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE0","description":"ICD-NKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD1","description":"ICD-OIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA1","description":"ICD-HDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61563","description":"Excision of skull tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked re symp auto dysfxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4326F","description":"Pt asked re symp auto dysfxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE1","description":"ICD-AFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33230","description":"Insrt pulse gen w/dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC1","description":"ICD-KDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB1","description":"ICD-OABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37249","description":"Transluminal balloon angioplasty (except dialysis circuit)_ open or percutaneous_ including all imaging and radiological supervision and interpretation necessary to perform th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA1","description":"ICD-CHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC1","description":"ICD-FEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML52","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cid ext speech process repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8627","description":"Cid ext speech process repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27686","description":"Revise lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE0","description":"ICD-CFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dev interrog remote 1/2/mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93295","description":"Dev interrog remote 1/2/mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS DELTA ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87380","description":"IAAD IA HEPATITIS DELTA ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME1","description":"ICD-IEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD1","description":"ICD-EFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL13","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram one breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77055","description":"Mammogram one breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILE0","description":"ICD-GILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home hospice case 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0271","description":"Home hospice case 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25605","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD1","description":"ICD-MCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion_ posture_ gait_ and muscl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0778T","description":"Surface mechanomyography (sMMG) with concurrent application of inertial measurement unit (IMU) sensors for measurement of multi-joint range of motion_ posture_ gait_ and muscl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glycopyrrolate comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7643","description":"Glycopyrrolate comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31620","description":"Endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) (list separately in addition to code for primary procedure(s))","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0012","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD1","description":"ICD-KHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0808","description":"Pov group 2 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dalteparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1645","description":"Dalteparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFE1","description":"ICD-GGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDID0","description":"ICD-NDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transect pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33922","description":"Transect pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME0","description":"ICD-JBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLA0","description":"ICD-OJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metabolic panel ionized ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80047","description":"Metabolic panel ionized ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHA0","description":"ICD-EHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tisotumab vedotin-tftv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9273","description":"Injection_ tisotumab vedotin-tftv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC130","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc w ami s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9606","description":"Perc d-e cor revasc w ami s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF1","description":"ICD-OBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE1","description":"ICD-FFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng prgrm eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305T","description":"Icar ischm mntrng prgrm eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement pressure alarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1540","description":"Replacement pressure alarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6526","description":"Gradient compression garment_ full leg and foot_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTE1","description":"ICD-CGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flex-walk sys low ext prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5981","description":"Flex-walk sys low ext prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00561","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","description":"CPT-00561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c wdth 24-27 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2341","description":"W/c wdth 24-27 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSE1","description":"ICD-CCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE0","description":"ICD-HIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort ii anterior intrusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21150","description":"Lefort ii anterior intrusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC1","description":"ICD-IIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE1","description":"ICD-NKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA1","description":"ICD-FCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC1","description":"ICD-KEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA1","description":"ICD-NHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA0","description":"ICD-GDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8C","description":"Medium Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg >4.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11406","description":"Exc tr-ext b9+marg >4.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9782","description":"Blinded procedure for New York Heart Association (NYHA) Class II or III heart failure_ or Canadian Cardiovascular Society (CCS) Class III or IV chronic refractory angina; tran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","description":"CPT-00952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABD0","description":"ICD-IABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB0","description":"ICD-NHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cvr knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5706","description":"Custom shape cvr knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1098","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","description":"HCPCS-J1098","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF1","description":"ICD-NDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE0","description":"ICD-CDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5624","description":"Test socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Renal scope w/tumor resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50562","description":"Renal scope w/tumor resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87662","description":"Infectious agent detection by nucleic acid (DNA or RNA); Zika virus_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKE1","description":"ICD-KHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF1","description":"ICD-PBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA1","description":"ICD-GECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB0","description":"ICD-FAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sumatriptan succinate / 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3030","description":"Sumatriptan succinate / 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Piperacillin/tazobactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2543","description":"Piperacillin/tazobactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01953","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","description":"CPT-01953","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA1","description":"ICD-IITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA11","description":"ICD-1EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF0","description":"ICD-GABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67010","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at e0733","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4541","description":"Monthly supplies for use of device coded at e0733","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep addl 100 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15003","description":"Wound prep addl 100 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD0","description":"ICD-MADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBB1","description":"ICD-MLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ inf_ per/cent/midline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1751","description":"Cath_ inf_ per/cent/midline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0591T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Initial Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair double ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33612","description":"Repair double ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA0","description":"ICD-KGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD1","description":"ICD-CDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69145","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transposition ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58825","description":"Transposition ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA1","description":"ICD-ODJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC0","description":"ICD-MBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB0","description":"ICD-GATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE1","description":"ICD-BDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mis sup/ac imp vad nopay med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0509","description":"Mis sup/ac imp vad nopay med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOF1","description":"ICD-HBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC1","description":"ICD-FBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX21","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE1","description":"ICD-DHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE150","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mt bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20957","description":"Mt bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forehead flap w/vasc pedicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15731","description":"Forehead flap w/vasc pedicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calcium gluconate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0610","description":"Calcium gluconate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE0","description":"ICD-NCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRD1","description":"ICD-CHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB0","description":"ICD-DCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lithotripsy_ coronary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1761","description":"Catheter_ transluminal intravascular lithotripsy_ coronary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA0","description":"ICD-CEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt asst re end life issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4553F","description":"Pt asst re end life issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comm trans waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2038","description":"Comm trans waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ durvalumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9492","description":"Injection_ durvalumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88029","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF0","description":"ICD-KGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place needles h&n for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41019","description":"Place needles h&n for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKC0","description":"ICD-CGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniocentesis therapeutic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59001","description":"Amniocentesis therapeutic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE1","description":"ICD-JFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Melan follow-up complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015F","description":"Melan follow-up complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryocautery of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57511","description":"Cryocautery of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99347","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-81524","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","description":"CPT-81524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emer response sys instal&tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5160","description":"Emer response sys instal&tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symes met fr leath socket ar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5060","description":"Symes met fr leath socket ar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2062","description":"Qualified Nonphysician Healthcare Professional Online Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA1","description":"ICD-BIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA0","description":"ICD-ODIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF0","description":"ICD-CBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69905","description":"Remove inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent BP is less than or equal to 140/90 mm Hg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9788","description":"Most recent BP is less than or equal to 140/90 mm Hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB0","description":"ICD-KFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair brain fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62100","description":"Repair brain fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF1","description":"ICD-CBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAC0","description":"ICD-JAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81106","description":"Human Platelet Antigen 2 genotyping (HPA-2)_ GP1BA (glycoprotein Ib [platelet]_ alpha polypeptide [GPIba]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF0","description":"ICD-MFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sacituzumab govitecan-hziy_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9066","description":"Injection_ sacituzumab govitecan-hziy_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIND0","description":"ICD-OIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped gastro ed given caregvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4058F","description":"Ped gastro ed given caregvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15011","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","description":"CPT-15011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv artific diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22856","description":"Cerv artific diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87478","description":"Infectious agent detection by nucleic acid (DNA or RNA); Borrelia miyamotoi_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc rf ablate renal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50592","description":"Perc rf ablate renal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cognitive skills development","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97532","description":"Cognitive skills development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delivery comp imrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6016","description":"Delivery comp imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood split unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9011","description":"Blood split unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJE1","description":"ICD-BHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61550","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF1","description":"ICD-MDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGB1","description":"ICD-NFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIE1","description":"ICD-AGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87324","description":"IAAD IA CLOSTRIDIUM DIFFICILE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo unilat torsion cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2080","description":"Hkafo unilat torsion cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMF1","description":"ICD-GFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA22","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC0","description":"ICD-EBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1146","description":"Ongoing care not clinically indicated because the patient needed a home program only_ referral to another provider or facility_ or consultation only_ as documented in the medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF1","description":"ICD-NEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56810","description":"Repair of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED1","description":"ICD-EEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVD0","description":"ICD-FHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF1","description":"ICD-OHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1357","description":"Battery charger_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB1","description":"ICD-HIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of cheek nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64734","description":"Incision of cheek nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC1","description":"ICD-JIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB0","description":"ICD-KIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA131","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA0","description":"ICD-OGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMA1","description":"ICD-IAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUF0","description":"ICD-NAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE1","description":"ICD-MCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF1","description":"ICD-GBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB1","description":"ICD-PKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD0","description":"ICD-OCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2201","description":"Documentation of medical reason(s) for not providing brief counseling (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_ without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No implantable/insertable device used with device-intensive procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1890","description":"No implantable/insertable device used with device-intensive procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA154","description":"Clinically Complex _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44121","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC1","description":"ICD-PGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB54","description":"Low Rehab_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAE0","description":"ICD-MDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","description":"HCPCS-J3375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB1","description":"ICD-CGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE0","description":"ICD-JGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE0","description":"ICD-BANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC0","description":"ICD-GGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no burn prior to d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8909","description":"Pt doc no burn prior to d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED1","description":"ICD-GEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB0","description":"ICD-MGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF0","description":"ICD-CEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE101","description":"Special Care Low _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch forearm pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0110","description":"Crutch forearm pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD1","description":"ICD-CCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7531","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7531","description":"HCPCS-J7531","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ova and parasites smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87177","description":"Ova and parasites smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0543T","description":"Transapical mitral valve repair_ including transthoracic echocardiography_ when performed_ with placement of artificial chordae tendineae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECB0","description":"ICD-AECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9431","description":"No pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2205","description":"Lens sphcy bifocal 4.00d/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA1","description":"ICD-GIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUD0","description":"ICD-MJUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDB1","description":"ICD-MKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD1","description":"ICD-NDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00600","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","description":"CPT-00600","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEA0","description":"ICD-BDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening fentanyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80354","description":"Drug screening fentanyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA0","description":"ICD-FALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motion analysis video/3d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96000","description":"Motion analysis video/3d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icm device interrogat remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93297","description":"Icm device interrogat remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC256","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD1","description":"ICD-KAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurg ablate fa each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19105","description":"Cryosurg ablate fa each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5134","description":"Injection_ natalizumab-sztn (tyruko)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of arm & girdle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23900","description":"Amputation of arm & girdle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare fecal microbiota","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44705","description":"Prepare fecal microbiota","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9790","description":"Most recent BP is greater than 140/90 mm Hg_ or blood pressure not documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPC1","description":"ICD-CAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electro-oculography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92270","description":"Electro-oculography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ue fx orth shoul cap forearm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3981","description":"Ue fx orth shoul cap forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cromolyn sodium noncomp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7631","description":"Cromolyn sodium noncomp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Octreotide inj_ non-depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2354","description":"Octreotide inj_ non-depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE0","description":"ICD-JHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67973","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF1","description":"ICD-AGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost urine pch w b/bltin conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4430","description":"Ost urine pch w b/bltin conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF0","description":"ICD-MHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWC1","description":"ICD-CHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITA1","description":"ICD-AITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io map of sent lymph node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38900","description":"Io map of sent lymph node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trilaciclib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1448","description":"Injection_ trilaciclib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC0","description":"ICD-EELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1C","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ceftriaxone sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0696","description":"Ceftriaxone sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC1","description":"ICD-ADDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chem/antisept solution_ 8oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4674","description":"Chem/antisept solution_ 8oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFF0","description":"ICD-CIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB1","description":"ICD-GFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD0","description":"ICD-EFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC0","description":"ICD-NAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKC1","description":"ICD-BIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC31","description":"ICD-1CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUB1","description":"ICD-ABUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF0","description":"ICD-MLLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB1","description":"ICD-ODYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPD0","description":"ICD-GEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA1","description":"ICD-JGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD214","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD0","description":"ICD-OAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYE1","description":"ICD-PJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thiocyanate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84430","description":"Assay of thiocyanate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVF0","description":"ICD-NLVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD1","description":"ICD-LAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32851","description":"Lung transplant single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","description":"HCPCS-G0567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICB0","description":"ICD-GICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB0","description":"ICD-FBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC0","description":"ICD-MDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCB0","description":"ICD-EBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE0","description":"ICD-GHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc exten prosth addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34826","description":"Endovasc exten prosth addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0484U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","description":"CPT-0484U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDA0","description":"ICD-BEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC245","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC234","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA1","description":"ICD-JACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC1","description":"ICD-PISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTE1","description":"ICD-MHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4355","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","description":"HCPCS-Q4355","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIF1","description":"ICD-IIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIA1","description":"ICD-MHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFC0","description":"ICD-GAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33767","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUE1","description":"ICD-NLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/femoroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29914","description":"Hip arthro w/femoroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXF1","description":"ICD-OHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDC1","description":"ICD-MEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKD0","description":"ICD-FAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Max ultrasound image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0386","description":"Max ultrasound image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAF0","description":"ICD-CGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA0","description":"ICD-OJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Persist asthma medicine ctrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4015F","description":"Persist asthma medicine ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC1","description":"ICD-HFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME1","description":"ICD-ODME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0910T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","description":"CPT-0910T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC0","description":"ICD-OAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj ocular telescope prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0308T","description":"Insj ocular telescope prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF0","description":"ICD-EGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE221","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim spinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0748","description":"Elec osteogen stim spinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB1","description":"ICD-FHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery translocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33506","description":"Repair artery translocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instr xrcz back pain 12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4240F","description":"Instr xrcz back pain 12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA23","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1501","description":"HCPCS-A1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63661","description":"Remove spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have a diagnosis of rhabdomyolysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9780","description":"Patients who have a diagnosis of rhabdomyolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33779","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB1","description":"ICD-IHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20C","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB1","description":"ICD-GIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD104","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE0","description":"ICD-IDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8G","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj hormone diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9560","description":"Ht inj hormone diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE0","description":"ICD-GIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE0","description":"ICD-OHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treprostinil injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3285","description":"Treprostinil injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC1","description":"ICD-LIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF1","description":"ICD-GBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC1","description":"ICD-IHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB1","description":"ICD-JFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME1","description":"ICD-JHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA1","description":"ICD-OKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61312","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20605","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56159","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Truss add to std pad scrotal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8330","description":"Truss add to std pad scrotal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXD1","description":"ICD-NDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27303","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQB1","description":"ICD-CHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc chl syp documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9228","description":"Gc chl syp documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed institutional t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0270","description":"Hospital bed institutional t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372U","description":"Infectious disease (genitourinary pathogens)_ antibiotic-resistance gene detection_ multiplex amplified probe technique_ urine_ reported as an antimicrobial stewardship risk s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOF1","description":"ICD-CCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0531U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","description":"CPT-0531U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laundry serv_ext_prof_/order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5175","description":"Laundry serv_ext_prof_/order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB0","description":"ICD-CDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD1","description":"ICD-PKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICD0","description":"ICD-GICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","description":"HCPCS-Q4423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC1","description":"ICD-FAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF1","description":"ICD-JANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB1","description":"ICD-BDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF1","description":"ICD-FFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC0","description":"ICD-OCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA1","description":"ICD-MFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX46","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0283","description":"Injection_ amiodarone hydrochloride (nexterone)_ 30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31613","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental connector bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6920","description":"Dental connector bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID1","description":"ICD-KEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27632","description":"Exc leg/ankle les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","description":"CPT-70473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNC1","description":"ICD-OHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75710","description":"Artery x-rays arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA1","description":"ICD-IDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEF0","description":"ICD-GGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED1","description":"ICD-NHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uvl md cabinet sys 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0694","description":"Uvl md cabinet sys 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF0","description":"ICD-GBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD1","description":"ICD-OCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD1","description":"ICD-OAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB1","description":"ICD-KDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE0","description":"ICD-CGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWD1","description":"ICD-DBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45307","description":"Proctosigmoidoscopy fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF0","description":"ICD-CGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate biliary duct/ampulla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47542","description":"Dilate biliary duct/ampulla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj calcitriol per 0.1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0636","description":"Inj calcitriol per 0.1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD1","description":"ICD-KCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8B","description":"High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC1","description":"ICD-MKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73590","description":"X-ray exam of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQF0","description":"ICD-GDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular flange prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5934","description":"Mandibular flange prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB0","description":"ICD-FGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF0","description":"ICD-FEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDB1","description":"ICD-NFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pap oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7044","description":"Pap oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE0","description":"ICD-GAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8702","description":"Repair Of Fixed Retainer_ Includes Reattachment - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier 6x6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5121","description":"Solid skin barrier 6x6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA0","description":"ICD-GFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture anaerobe ident each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87076","description":"Culture anaerobe ident each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","description":"HCPCS-M1420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB1","description":"ICD-MFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC11B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF0","description":"ICD-AFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-62330","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","description":"CPT-62330","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE1","description":"ICD-DBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLC0","description":"ICD-NGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF1","description":"ICD-KDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ethanolamine oleate 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1430","description":"Ethanolamine oleate 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brca2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81216","description":"Brca2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC0","description":"ICD-KEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB1","description":"ICD-KEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct ulna/radioulnar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25337","description":"Reconstruct ulna/radioulnar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA0","description":"ICD-GEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0547T","description":"Bone-material quality testing by microindentation(s) of the tibia(s)_ with results reported as a score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA1","description":"ICD-NHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-51721","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","description":"CPT-51721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy remove myoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58561","description":"Hysteroscopy remove myoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 1-7 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0480","description":"Drug test def 1-7 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID1","description":"ICD-BHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0902T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","description":"CPT-0902T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD1","description":"ICD-IDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mandible graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7950","description":"Mandible graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE1","description":"ICD-KATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card angio/athrect 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92924","description":"Prq card angio/athrect 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE1","description":"ICD-OIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87580","description":"M.pneumon dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lung hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32800","description":"Repair lung hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD1","description":"ICD-LFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB0","description":"ICD-KIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal vestibular lateral wall stenosis with implant(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9749","description":"Repair of nasal vestibular lateral wall stenosis with implant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB1","description":"ICD-MBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31632","description":"Bronchoscopy/lung bx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB1","description":"ICD-CBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD250","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43312","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37799","description":"Vascular surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2615","description":"Pos back post/lat wdth <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB0","description":"ICD-OEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF1","description":"ICD-NFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8I","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA43","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Htlv-ii antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86688","description":"Htlv-ii antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB0","description":"ICD-GGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLD1","description":"ICD-ADLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC0","description":"ICD-GDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5133","description":"Injection_ tocilizumab-bavi (tofidence)_ biosimilar_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC1","description":"ICD-OHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF1","description":"ICD-FIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB0","description":"ICD-BHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF0","description":"ICD-EEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE0","description":"ICD-FBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRF0","description":"ICD-DDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAF1","description":"ICD-ODAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretreatment serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86978","description":"Rbc pretreatment serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA1","description":"ICD-ECDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ureter calculus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51065","description":"Remove ureter calculus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38550","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10051","description":"Anesth salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy internal hemorrhoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46930","description":"Destroy internal hemorrhoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA35","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venous mech thrombectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37187","description":"Venous mech thrombectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4B","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE0","description":"ICD-GECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc brchiocph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237T","description":"Trluml perip athrc brchiocph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5215","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHA1","description":"ICD-GAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA1","description":"ICD-IEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2D","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA1","description":"ICD-NDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ drainage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1729","description":"Cath_ drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11626","description":"Exc s/n/h/f/g mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lamellar bdy fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83664","description":"Lamellar bdy fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC0","description":"ICD-FHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLD1","description":"ICD-JCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE1","description":"ICD-LHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10D","description":"Special Care High _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8H","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42340","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA1","description":"ICD-BCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB134","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC1","description":"ICD-CEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAD0","description":"ICD-GFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB0","description":"ICD-BHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","description":"HCPCS-J0167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24130","description":"Removal of head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC1","description":"ICD-OJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC0","description":"ICD-NKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQA1","description":"ICD-KHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES246","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE1","description":"ICD-GFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros md in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8509","description":"Trach-esoph voice pros md in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5275","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB0","description":"ICD-LCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urofollitropin_ 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3355","description":"Urofollitropin_ 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA26","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6596","description":"Gradient compression bandaging supply_ conforming gauze_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA0","description":"ICD-EIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0622T","description":"Trabeculostomy Ab Interno By Laser; With Use Of Ophthalmic Endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD0","description":"ICD-KIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB1","description":"ICD-OCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1228","description":"Wheelchair spec sz spec ht b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculation shell via","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87254","description":"Virus inoculation shell via","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB1","description":"ICD-PEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMC0","description":"ICD-GIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5948","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5948","description":"CDT-D5948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYF0","description":"ICD-CDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD1","description":"ICD-FALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0559T","description":"Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE0","description":"ICD-OFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27307","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF1","description":"ICD-OHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0500U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","description":"CPT-0500U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPA0","description":"ICD-NBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision addl breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19126","description":"Excision addl breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0D","description":"Very High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral bolus nurs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9343","description":"Hit enteral bolus nurs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC0","description":"ICD-FCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA1","description":"ICD-BELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE0","description":"ICD-ODOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME1","description":"ICD-FHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21263","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA1","description":"ICD-NGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occluder lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2770","description":"Occluder lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93242","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27720","description":"Repair of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE0","description":"ICD-NBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic lightbox tabletp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0203","description":"Therapeutic lightbox tabletp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30150","description":"Partial removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUB0","description":"ICD-AAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Distal shoe space maintainer - fixed - unilateral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1575","description":"Distal shoe space maintainer - fixed - unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0513","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide cardiocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76930","description":"Echo guide cardiocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF0","description":"ICD-BGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD0","description":"ICD-MKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBF0","description":"ICD-KBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43340","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA0","description":"ICD-HDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for percutaneous transhepatic cholangiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47500","description":"Injection procedure for percutaneous transhepatic cholangiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5278","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drive belt power wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0098","description":"Drive belt power wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","description":"HCPCS-J0162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reguard_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4255","description":"Reguard_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD0","description":"ICD-KCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC0","description":"ICD-CIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36511","description":"Apheresis wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49189","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","description":"CPT-49189","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1010","description":"Clinical Decision Support Mechanism Stanson_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl <11 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3281F","description":"Hgb lvl <11 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA0","description":"ICD-BAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVD0","description":"ICD-JEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE0","description":"ICD-BBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC0","description":"ICD-MCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28505","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE0","description":"ICD-MCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF0","description":"ICD-NHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVB1","description":"ICD-FIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63102","description":"Remove vert body dcmprn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHB0","description":"ICD-BBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC1","description":"ICD-IECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC0","description":"ICD-NKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEE1","description":"ICD-CHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031U","description":"CYP1A2 (cytochrome P450 family 1_ subfamily A_ member 2)(eg_ drug metabolism) gene analysis_ common variants (ie_ *1F_ *1K_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one well-child visit with a PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9964","description":"Patient received at least one well-child visit with a PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD113","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95071","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8039","description":"Breast prosthesis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC1","description":"ICD-JBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem focal defic constant fri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5230","description":"Fem focal defic constant fri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36903","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF0","description":"ICD-FAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE1","description":"ICD-PCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","description":"HCPCS-A2034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC0","description":"ICD-CEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB1","description":"ICD-PCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC1","description":"ICD-MJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF1","description":"ICD-IIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99234","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0256U","description":"Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile_ tandem mass spectrometry (MS/MS)_ urine_ with algorithmic analysis and interpretive report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE135","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3304","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moveable patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0639","description":"Moveable patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB0","description":"ICD-MIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atropine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7636","description":"Atropine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE1","description":"ICD-IDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99458","description":"Remote Physiologic Monitoring Treatment Management Services_ Clinical Staff/Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring Interactive C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIF1","description":"ICD-JBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPC1","description":"ICD-BBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTE1","description":"ICD-OCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF1","description":"ICD-OBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic pneumothorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32960","description":"Therapeutic pneumothorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74475","description":"Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection_ percutaneous_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hpv types 16 & 18 only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87625","description":"Hpv types 16 & 18 only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4047F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASF1","description":"ICD-DASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF1","description":"ICD-JFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft femur head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27170","description":"Repair/graft femur head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB11","description":"ICD-1JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJC0","description":"ICD-FCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPF0","description":"ICD-OCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPF1","description":"ICD-GAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9959","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9959","description":"CDT-D9959","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2005","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2005","description":"CDT-D2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF1","description":"ICD-IIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cap bacterial assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012F","description":"Cap bacterial assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGME1","description":"ICD-CGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA0","description":"ICD-NKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC1","description":"ICD-FFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODND0","description":"ICD-ODND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii multimetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85247","description":"Clot factor viii multimetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXD0","description":"ICD-FEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE1","description":"ICD-JGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow switch control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6930","description":"Below elbow switch control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rubeola ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87283","description":"Rubeola ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBD0","description":"ICD-ECBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD0","description":"ICD-FGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic radiation trmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77432","description":"Stereotactic radiation trmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special service/proc/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99199","description":"Special service/proc/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKF0","description":"ICD-KAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB1","description":"ICD-CEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA0","description":"ICD-BADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAND1","description":"ICD-BAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg >16<=48 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6255","description":"Absorpt drg >16<=48 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8B","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0111U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA0","description":"ICD-OCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTC1","description":"ICD-KCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA1","description":"ICD-GHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC1","description":"ICD-KBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE1","description":"ICD-KGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD0","description":"ICD-GBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF0","description":"ICD-LIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD1","description":"ICD-FDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hh aide or cn aide per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1021","description":"Hh aide or cn aide per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tibial tubercle hgt w/ toe f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5020","description":"Tibial tubercle hgt w/ toe f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1092T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1092T","description":"CPT-1092T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD0","description":"ICD-JAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVB0","description":"ICD-BAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUB1","description":"ICD-NIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NuDYN DL or NuDYN DL MESH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4285","description":"NuDYN DL or NuDYN DL MESH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC1","description":"ICD-GGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD1","description":"ICD-FGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","description":"HCPCS-Q5151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ heavy weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6580","description":"Gradient compression glove_ custom_ heavy weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID0","description":"ICD-MLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1702","description":"HCPCS-A1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME1","description":"ICD-MKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMD1","description":"ICD-NEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical performance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97750","description":"Physical performance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Throat surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42999","description":"Throat surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL03","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC0","description":"ICD-CHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAD1","description":"ICD-IEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB0","description":"ICD-MBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF0","description":"ICD-DGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIB1","description":"ICD-ADIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF0","description":"ICD-GBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA1","description":"ICD-FGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1285","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYB0","description":"ICD-OBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","description":"CPT-01482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND1","description":"ICD-NHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF0","description":"ICD-IELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable endoscope sheath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4270","description":"Disposable endoscope sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6955","description":"Above elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA0","description":"ICD-DCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB1","description":"ICD-DHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA0","description":"ICD-KHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX14","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYF0","description":"ICD-CBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt tx sys bio med psori 6mth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9652","description":"Pt tx sys bio med psori 6mth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diuretic thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4221F","description":"Diuretic thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB1","description":"ICD-OKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis adsorp/reinfuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36515","description":"Apheresis adsorp/reinfuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB1","description":"ICD-BIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF0","description":"ICD-CBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC0","description":"ICD-FCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC0","description":"ICD-GDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 20 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis apoe alzheimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3852","description":"Dna analysis apoe alzheimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1301","description":"CDT-D1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBF0","description":"ICD-NLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00174","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","description":"CPT-00174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25312","description":"Transplant forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRA0","description":"ICD-DFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDC0","description":"ICD-NFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF0","description":"ICD-FABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB1","description":"ICD-BEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/renal stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52343","description":"Cysto w/renal stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant radiation dosimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4650","description":"Implant radiation dosimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43130","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB1","description":"ICD-NFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC1","description":"ICD-MFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam infant hips static","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76886","description":"Us exam infant hips static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34708","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQC0","description":"ICD-PGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC0","description":"ICD-CILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37269","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","description":"CPT-37269","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9797","description":"Vacsular emobolization or occlusion procedure with use of pressure-generation catheter (e.g._ one-way_ intermittentrly occluding)_ inclusive of all radiological supervision an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90283","description":"Human ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF1","description":"ICD-KEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB0","description":"ICD-AFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9762","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with strain im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC1","description":"ICD-BHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMF1","description":"ICD-AGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYE0","description":"ICD-KAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lsh w/t/o uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58544","description":"Lsh w/t/o uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB1","description":"ICD-EIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0C","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA0","description":"ICD-GHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYD1","description":"ICD-GFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF1","description":"ICD-AILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSA1","description":"ICD-PGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB0","description":"ICD-OGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35511","description":"Art byp grft subclav-subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUC0","description":"ICD-FDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYA0","description":"ICD-DCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procainamide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2690","description":"Procainamide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63655","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC146","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 1.1-2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11302","description":"Shave skin lesion 1.1-2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0704","description":"HCPCS-A0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC21","description":"ICD-2BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58356","description":"Endometrial cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF0","description":"ICD-OHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDB0","description":"ICD-EDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF0","description":"ICD-AHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB1","description":"ICD-GCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF1","description":"ICD-KBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE0","description":"ICD-LCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB0","description":"ICD-JDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect shoulder tumor < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23077","description":"Resect shoulder tumor < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMC1","description":"ICD-NCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB0","description":"ICD-IILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX50","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC0","description":"ICD-MFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace tissue expander","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11970","description":"Replace tissue expander","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB1","description":"ICD-FFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control band & belt u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2630","description":"Pelvic control band & belt u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluzone vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2038","description":"Fluzone vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Twelve volt battery utah/equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7364","description":"Twelve volt battery utah/equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE1","description":"ICD-GBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63011","description":"Remove spine lamina 1/2 scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE1","description":"ICD-MDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0457","description":"Tlso flex trnk sj-ss pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC1","description":"ICD-FINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1319","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4D","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand les sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26115","description":"Exc hand les sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC1","description":"ICD-OCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis training complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90989","description":"Dialysis training complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4594","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime_ mouthpiece each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID0","description":"ICD-FGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC1","description":"ICD-NIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPB1","description":"ICD-KGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFME0","description":"ICD-NFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2D","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5159","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","description":"HCPCS-Q5159","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23020","description":"Release shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0492","description":"Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB0","description":"ICD-OBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cable mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6580","description":"Wrist/elbow bowden cable mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF0","description":"ICD-GBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50970","description":"Ureter endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUC0","description":"ICD-JAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD1","description":"ICD-PJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93619","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID1","description":"ICD-KBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD0","description":"ICD-CHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXA0","description":"ICD-GHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36555","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA1","description":"ICD-IBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodener muscle larynx emg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64617","description":"Chemodener muscle larynx emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE0","description":"ICD-GGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNC0","description":"ICD-OGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWE1","description":"ICD-HEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE1","description":"ICD-FAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD0","description":"ICD-GGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJB0","description":"ICD-FFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC0","description":"ICD-PHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIB1","description":"ICD-IIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLE1","description":"ICD-GGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0118","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 5 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7298","description":"Levonorgestrel iu 52mg 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17260","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sirolimus_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7520","description":"Sirolimus_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65272","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch faceplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5053","description":"Clsd ostomy pouch faceplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA0","description":"ICD-GBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF0","description":"ICD-AEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID1","description":"ICD-MDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27884","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE0","description":"ICD-KIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC0","description":"ICD-KFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF0","description":"ICD-OIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD0","description":"ICD-PJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9303","description":"Norsn no pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERF0","description":"ICD-HERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF1","description":"ICD-KFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93979","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB1","description":"ICD-BCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA0","description":"ICD-MCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD0","description":"ICD-KHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB0","description":"ICD-HBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKA1","description":"ICD-OIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Theragenesis_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2008","description":"Theragenesis_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate w/rise psa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9080","description":"Onc dx prostate w/rise psa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE1","description":"ICD-CDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Review/report bp recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93790","description":"Review/report bp recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA0","description":"ICD-DBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB0","description":"ICD-PCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1329","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOB1","description":"ICD-ODOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB0","description":"ICD-OKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Certified nurse midwife mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0064","description":"Certified nurse midwife mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67825","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carbamazepine; -10_11-Epoxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80161","description":"Carbamazepine; -10_11-Epoxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0918T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","description":"CPT-0918T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCE0","description":"ICD-IFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC1","description":"ICD-GFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing paternity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86910","description":"Blood typing paternity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microsurg epi sperm asp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4028","description":"Microsurg epi sperm asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1116","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE0","description":"ICD-FANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB0","description":"ICD-GBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA0","description":"ICD-MELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE0","description":"ICD-OAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF1","description":"ICD-BEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF0","description":"ICD-IDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF1","description":"ICD-DEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81448","description":"Hereditary peripheral neuropathies (eg_ Charcot-Marie-Tooth_ spastic paraplegia)_ genomic sequence analysis panel_ must include sequencing of at least 5 peripheral neuropathy-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18C","description":"Special Care Low _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mcoln1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81290","description":"Mcoln1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95165","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal over 12.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2214","description":"Lens sphcyl bifocal over 12.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1447","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","description":"HCPCS-M1447","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICF1","description":"ICD-KICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIB1","description":"ICD-AAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC0","description":"ICD-MDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2002","description":"HCPCS-B2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33904","description":"Percutaneous pulmonary artery revascularization by stent placement_ each additional vessel or separate lesion_ normal or abnormal connections (List separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF0","description":"ICD-FGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRA0","description":"ICD-HGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrmed rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3551F","description":"Intrmed rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB134","description":"Special Care High _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB0","description":"ICD-BCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD1","description":"ICD-NKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLF1","description":"ICD-IFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Regadenoson injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2785","description":"Regadenoson injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recd scrn hcv infec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9383","description":"Recd scrn hcv infec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF0","description":"ICD-PKQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23100","description":"Biopsy of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB0","description":"ICD-OGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB05","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF0","description":"ICD-NHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB06","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD0","description":"ICD-OAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0202","description":"HCPCS-C0202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA1","description":"ICD-NFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE0","description":"ICD-CECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC1","description":"ICD-DBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA0","description":"ICD-GALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF0","description":"ICD-NADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF0","description":"ICD-MJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD0","description":"ICD-PERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna/rna amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87150","description":"Dna/rna amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQF1","description":"ICD-OHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB1","description":"ICD-IDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD1","description":"ICD-CHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF0","description":"ICD-CCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray nose to rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76010","description":"X-ray nose to rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDA0","description":"ICD-BFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; interpretation and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA0","description":"ICD-NATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neostigmine methylslfte inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2710","description":"Neostigmine methylslfte inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin < 250 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96920","description":"Laser tx skin < 250 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indic for head ct valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9531","description":"Indic for head ct valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB0","description":"ICD-EIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone replacement graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7953","description":"Bone replacement graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9938","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB1","description":"ICD-JHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE0","description":"ICD-PGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC0","description":"ICD-AGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF1","description":"ICD-BBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wc van mileage per mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0209","description":"Wc van mileage per mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA1","description":"ICD-GDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB0","description":"ICD-JFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE0","description":"ICD-CDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1230","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test_ or patient has a reactive hcv antibody test and has a follow up hcv viral test that dete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC0","description":"ICD-JCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB0","description":"ICD-HBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnicore pro_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4298","description":"Amnicore pro_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE0","description":"ICD-BBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB1","description":"ICD-IHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD0","description":"ICD-HEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE1","description":"ICD-GHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC0","description":"ICD-FDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2643","description":"Dental onlay porcelin 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA1","description":"ICD-NJVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8B","description":"Very High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cogenex Flowable Amnion_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4230","description":"Cogenex Flowable Amnion_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL54","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC0","description":"ICD-KAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB201","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1803","description":"HCPCS-B1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML42","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA0","description":"ICD-NCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58200","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0503","description":"HCPCS-A0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt surv results not avail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9604","description":"Pt surv results not avail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flu immuno admind rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4274F","description":"Flu immuno admind rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42960","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vesiculobullous disease carr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5991","description":"Vesiculobullous disease carr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove & treat brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61544","description":"Remove & treat brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC0","description":"ICD-KBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53025","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE205","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD0","description":"ICD-KIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA0","description":"ICD-NBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD1","description":"ICD-KIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF1","description":"ICD-KIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIB0","description":"ICD-EAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio spine w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72159","description":"Mr angio spine w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE1","description":"ICD-LFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7295","description":"Ethinyl estradiol and etonogestrel 0.015 mg_ 0.12 mg per 24hours; monthly vaginal ring_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBC1","description":"ICD-OFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82488","description":"Chromatography_ qualitative; paper_ 2-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE0","description":"ICD-JDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88305","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_cong","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8926","description":"Tee w or w/o fol w/cont_cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHE0","description":"ICD-KFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn binaur hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5120","description":"Body-worn binaur hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine & cord thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63195","description":"Incise spine & cord thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE0","description":"ICD-NJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC0","description":"ICD-CBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99334","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE1","description":"ICD-CCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5B","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF1","description":"ICD-NJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia init reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49500","description":"Rpr ing hernia init reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9513","description":"Lutetium lu 177_ dotatate_ therapeutic_ 1 millicure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Giardia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87269","description":"Giardia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20D","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVB1","description":"ICD-CFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIB0","description":"ICD-NHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE1","description":"ICD-NBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99283","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7171","description":"Injection_ ADAMTS13_ recombinant-krhn_ 10 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64628","description":"Thermal Destruction Of Intraosseous Basivertebral Nerve_ Including All Imaging Guidance; First 2 Vertebral Bodies_ Lumbar Or Sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC0","description":"ICD-NCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD0","description":"ICD-NGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal pacemaker electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33235","description":"Removal pacemaker electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap mobil splenic fl add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44213","description":"Lap mobil splenic fl add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33786","description":"Repair arterial trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTD0","description":"ICD-MGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA0","description":"ICD-CCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF0","description":"ICD-MIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy prostatic imp 1-3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9739","description":"Cystoscopy prostatic imp 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYE1","description":"ICD-CEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSD1","description":"ICD-HHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50693","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27742","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma valve w diaphra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7501","description":"Tracheostoma valve w diaphra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE0","description":"ICD-NKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUF1","description":"ICD-EGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDE1","description":"ICD-KCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip flexible cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5966","description":"Hip flexible cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC1","description":"ICD-NGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","description":"HCPCS-L6029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/up stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52342","description":"Cysto w/up stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntr interr eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306T","description":"Icar ischm mntr interr eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tprnl Plmt Biodegradable Matrl Periprostatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438T","description":"Tprnl Plmt Biodegradable Matrl Periprostatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPE0","description":"ICD-CHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPE1","description":"ICD-OGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD1","description":"ICD-ADMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND1","description":"ICD-FHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD0","description":"ICD-EEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA1","description":"ICD-OCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0496U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","description":"CPT-0496U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMF1","description":"ICD-AFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA1","description":"ICD-ADUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF0","description":"ICD-PASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA1","description":"ICD-LGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percut ablate liver rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47382","description":"Percut ablate liver rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB1","description":"ICD-PCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head/neck/ptrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30051","description":"Anesth head/neck/ptrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0460U","description":"Oncology_ whole blood or buccal_ DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCB0","description":"ICD-BFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF1","description":"ICD-GIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC0","description":"ICD-MCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD0","description":"ICD-GEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE1","description":"ICD-GBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKE0","description":"ICD-CCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC0","description":"ICD-NKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMD1","description":"ICD-NBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCB0","description":"ICD-NGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF1","description":"ICD-OCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD0","description":"ICD-DHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64802","description":"Sympathectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr special size/constrc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1220","description":"Whlchr special size/constrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25365","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA1","description":"ICD-JFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0669","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0669","description":"HCPCS-G0669","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rn home care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1030","description":"Rn home care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF0","description":"ICD-OANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA0","description":"ICD-NBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35131","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC0","description":"ICD-EFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2409","description":"Fetal surg noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVE1","description":"ICD-BIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE1","description":"ICD-DFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB10","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQF0","description":"ICD-PLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore chest vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35820","description":"Explore chest vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC1","description":"ICD-ODKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7552","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation; wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC21","description":"ICD-3HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharm dx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4641","description":"Radiopharm dx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthes w/o adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8030","description":"Breast prosthes w/o adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct midface no graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7948","description":"Reconstruct midface no graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB1","description":"ICD-PHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vbac care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59614","description":"Vbac care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADD0","description":"ICD-OADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx post pelvic fxcture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0415","description":"Open tx post pelvic fxcture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9849","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB0","description":"ICD-NCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB0","description":"ICD-HCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE1","description":"ICD-LCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD1","description":"ICD-EGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray/ct/ultrsnd et al ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3319F","description":"X-ray/ct/ultrsnd et al ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF1","description":"ICD-NHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecallantide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1290","description":"Ecallantide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92286","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF0","description":"ICD-BBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipopro bld electrophoretic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83700","description":"Lipopro bld electrophoretic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0848T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; initial single probe stain procedure (List separately in addition to code for prima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v >/= 1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3084F","description":"Kt/v >/= 1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB1","description":"ICD-NIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","description":"CPT-01220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEB1","description":"ICD-KCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE0","description":"ICD-JAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion 7-12 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22802","description":"Post fusion 7-12 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB0","description":"ICD-OHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD1","description":"ICD-KFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC1","description":"ICD-OEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder bone part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23130","description":"Remove shoulder bone part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARB1","description":"ICD-HARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA0","description":"ICD-FBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Activate matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4301","description":"Activate matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB0","description":"ICD-FCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC0","description":"ICD-KHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB0","description":"ICD-GFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE0","description":"ICD-CGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF1","description":"ICD-GEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ single_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1786","description":"Pmkr_ single_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE0","description":"ICD-MKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluocinolone acetonide implt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7311","description":"Fluocinolone acetonide implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF0","description":"ICD-KGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF1","description":"ICD-IHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC0","description":"ICD-BIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDC0","description":"ICD-EFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF1","description":"ICD-CHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE0","description":"ICD-GFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xray control catheter change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75984","description":"Xray control catheter change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD0","description":"ICD-AALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76987","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; including placement and manipulation of transducer_ image acquisi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYD0","description":"ICD-KAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27707","description":"Incision of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB0","description":"ICD-DCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWB0","description":"ICD-PCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA0","description":"ICD-FDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD1","description":"ICD-KHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD1","description":"ICD-NAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTD0","description":"ICD-EGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB0","description":"ICD-BANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPE1","description":"ICD-FGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB0","description":"ICD-LHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCE1","description":"ICD-KGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81108","description":"Human Platelet Antigen 4 genotyping (HPA-4)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF1","description":"ICD-GCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCC1","description":"ICD-NKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16078","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16078","description":"CPT-16078","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87336","description":"IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE0","description":"ICD-GHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ velmanase alfa-tycv_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0217","description":"Injection_ velmanase alfa-tycv_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA0","description":"ICD-BABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC1","description":"ICD-MFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC1","description":"ICD-LBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45562","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC1","description":"ICD-GEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1016","description":"Case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA0","description":"ICD-JBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Face bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21210","description":"Face bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC1","description":"ICD-JDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable ext urethral dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4360","description":"Disposable ext urethral dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA1","description":"ICD-OEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB1","description":"ICD-JECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA20","description":"Medium Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infus pump portab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9004","description":"Parenteral infus pump portab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKB0","description":"ICD-JHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC0","description":"ICD-FALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA1","description":"ICD-FCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB201","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9296","description":"Injection_ pemetrexed (accord) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA0","description":"ICD-OKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert w lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5673","description":"Socket insert w lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF1","description":"ICD-JFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF1","description":"ICD-GHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF0","description":"ICD-KDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB1","description":"ICD-MGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDC0","description":"ICD-CEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm washing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58323","description":"Sperm washing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF1","description":"ICD-DCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39540","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9763","description":"Patient did not have at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE1","description":"ICD-OENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried pain fxn w/ instr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1502F","description":"Pt queried pain fxn w/ instr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin hydral swg ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5814","description":"Endo knee-shin hydral swg ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYA1","description":"ICD-PBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD0","description":"ICD-NDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96933","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD1","description":"ICD-BAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC0","description":"ICD-GIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEF0","description":"ICD-JBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFD0","description":"ICD-JBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44402","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53431","description":"Reconstruct urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA1","description":"ICD-NDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE1","description":"ICD-PJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD1","description":"ICD-ECLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardioversion electric int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92961","description":"Cardioversion electric int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHF1","description":"ICD-MIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNC1","description":"ICD-NDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0980T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","description":"CPT-0980T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0574U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","description":"CPT-0574U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18I","description":"Clinically Complex _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELA1","description":"ICD-NELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29010","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC0","description":"ICD-OIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12031","description":"Intmd rpr s/a/t/ext 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE0","description":"ICD-EHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB1","description":"ICD-DASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD1","description":"ICD-CBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB0","description":"ICD-GDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 3.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4168","description":"Parenteral sol amino acid 3.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney/ureter surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86251","description":"Anesth kidney/ureter surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dev delay prev dp ch_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2037","description":"Dev delay prev dp ch_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB1","description":"ICD-GIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlh w/t/o 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58571","description":"Tlh w/t/o 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCF1","description":"ICD-OKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal mets recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9098","description":"Onc dx esophageal mets recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA0","description":"ICD-GFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride genit/per/abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11006","description":"Debride genit/per/abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1590","description":"Hemodialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC0","description":"ICD-OLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1903","description":"HCPCS-A1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF1","description":"ICD-ODUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF0","description":"ICD-BACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD1","description":"ICD-GFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB1","description":"ICD-FDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA0","description":"ICD-NJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26420","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA0","description":"ICD-MIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy dx sep proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58555","description":"Hysteroscopy dx sep proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78803","description":"Tumor imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0213T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle/tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24301","description":"Muscle/tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL34","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Px sup fee anti-can sub pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0512","description":"Px sup fee anti-can sub pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLD0","description":"ICD-IDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14B","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE1","description":"ICD-NAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD0","description":"ICD-EDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF0","description":"ICD-NFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blooc clot factor v test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85220","description":"Blooc clot factor v test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29821","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Withdrawal of arterial blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36600","description":"Withdrawal of arterial blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB1","description":"ICD-JAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA45","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWD0","description":"ICD-HFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA1","description":"ICD-FBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC0","description":"ICD-LBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE0","description":"ICD-EGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glasses binaural hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5150","description":"Glasses binaural hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD0","description":"ICD-JDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2281","description":"Injection_ moxifloxacin (fresenius kabi) not therapeutically equivalent to j2280_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA1","description":"ICD-BDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB0","description":"ICD-NEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34820","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy_ by abdominal or retroperitoneal incision_ unilateral (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinsert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65155","description":"Reinsert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0937T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","description":"CPT-0937T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF1","description":"ICD-ODNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heinz bodies induced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85445","description":"Heinz bodies induced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart flow reserve measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93571","description":"Heart flow reserve measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF1","description":"ICD-JDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69706","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil res waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2017","description":"Habil res waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE1","description":"ICD-FGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB1","description":"ICD-MEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWC0","description":"ICD-OJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD1","description":"ICD-BECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGB0","description":"ICD-NKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC1","description":"ICD-MEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC1","description":"ICD-BCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC1","description":"ICD-NDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Canal prep/fitting of dowel","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3950","description":"Canal prep/fitting of dowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHD0","description":"ICD-FFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB1","description":"ICD-OEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imp neurosti pls gn any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8679","description":"Imp neurosti pls gn any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF0","description":"ICD-KDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Certified translation or sign-language services per visit.","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9990","description":"Certified translation or sign-language services per visit.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD0","description":"ICD-OHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE1","description":"ICD-GCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB1","description":"ICD-NAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Molded socket shin sach foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5100","description":"Molded socket shin sach foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0856T","description":"Digitization of glass microscope slides for electron microscopy_ diagnostic (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7502","description":"Percutaneous breast biopsies using magnetic resonance guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE0","description":"ICD-NJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF0","description":"ICD-CAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA0","description":"ICD-JGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable rubber pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4378","description":"Drainable rubber pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCB1","description":"ICD-MLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA201","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA0","description":"ICD-NLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77767","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21554","description":"Exc neck tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE0","description":"ICD-NJLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVB0","description":"ICD-OJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance waiting 1/2 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0420","description":"Ambulance waiting 1/2 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9786","description":"Pathology report diagnosing cutaneous basal cell carcinoma or squamous cell carcinoma (to include in situ disease) was not sent from the pathologist/dermatopathologist to the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23D","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDB1","description":"ICD-KHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD1","description":"ICD-AGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF0","description":"ICD-HGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aneurysm pressure sens study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93982","description":"Aneurysm pressure sens study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKD1","description":"ICD-JDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC212","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCC1","description":"ICD-MLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF0","description":"ICD-OKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gel pressure mattress pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0185","description":"Gel pressure mattress pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC1","description":"ICD-AHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vinblastine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9360","description":"Vinblastine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45385","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB0","description":"ICD-DEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth low intestine scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81051","description":"Anesth low intestine scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Robot lin-radsurg com_ first","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0339","description":"Robot lin-radsurg com_ first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41008","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj midazolam hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2250","description":"Inj midazolam hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA0A","description":"Very High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA0","description":"ICD-KAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC31","description":"ICD-2AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOB0","description":"ICD-CDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb subq tissue add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11045","description":"Deb subq tissue add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove palate/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42120","description":"Remove palate/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE1","description":"ICD-NDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA11","description":"ICD-2EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Co/membane diffuse capacity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94729","description":"Co/membane diffuse capacity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE0","description":"ICD-AELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIA0","description":"ICD-MIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCE0","description":"ICD-JGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pinworm examinations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0113","description":"Pinworm examinations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior asis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1250","description":"Anterior asis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wellness assessment by nonph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5190","description":"Wellness assessment by nonph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tum unknown origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81540","description":"Oncology tum unknown origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture aerobic identify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87077","description":"Culture aerobic identify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0026","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","description":"HCPCS-G0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXA0","description":"ICD-NDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine incon plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509F","description":"Urine incon plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA0","description":"ICD-ACBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise lumbar artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22862","description":"Revise lumbar artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of lower spine disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72295","description":"X-ray of lower spine disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB1","description":"ICD-GEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0461","description":"Volume control ventilator_ without pressure support mode_ may include pressure control mode_ used with noninvasive interface (e.g._ mask)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA1","description":"ICD-BHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE0","description":"ICD-KCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx adolescent","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8080","description":"Compre dental tx adolescent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB0","description":"ICD-NDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF0","description":"ICD-NFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantable/insertable device for device intensive procedure_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1889","description":"Implantable/insertable device for device intensive procedure_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE1","description":"ICD-FCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pituit tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62165","description":"Remove pituit tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1833","description":"Monitor_ Cardiac_ Including Intracardiac Lead And All System Components (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD1","description":"ICD-JAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self care d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8989","description":"Self care d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded to pt silicone s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3251","description":"Shoe molded to pt silicone s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD1","description":"ICD-CAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81173","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 0.5 cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11400","description":"Exc tr-ext b9+marg 0.5 cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4215","description":"Sterile needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF0","description":"ICD-GEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","description":"CPT-01520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB33","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DA21","description":"ICD-1DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1172","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g._ prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c >/= 130 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3050F","description":"Ldl-c >/= 130 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening propoxyphene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80367","description":"Drug screening propoxyphene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD156","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Var vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90716","description":"Var vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD0","description":"ICD-JIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA0","description":"ICD-BGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141U","description":"Infectious disease (bacteria and fungi)_ gram-positive organism identification and drug resistance element detection_ DNA (20 gram-positive bacterial targets_ 4 resistance gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB112","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3751","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA0","description":"ICD-BGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC0","description":"ICD-OGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD1","description":"ICD-GATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA50","description":"Very High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE0","description":"ICD-CAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC11","description":"ICD-2LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJF0","description":"ICD-CFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn total diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9364","description":"Hit tpn total diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB0","description":"ICD-FBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF0","description":"ICD-NBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7461","description":"Rem nonodonto cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRF1","description":"ICD-OCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34713","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger)_ including ultrasound guidance_ when performed_ unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 1 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72081","description":"X-ray exam entire spi 1 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC1","description":"ICD-KGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wedge biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47100","description":"Wedge biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB0","description":"ICD-NJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA1","description":"ICD-FFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC0","description":"ICD-NETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMB0","description":"ICD-MFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery anal lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46917","description":"Laser surgery anal lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB0","description":"ICD-KAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58520","description":"Repair of ruptured uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9325","description":"Injection_ talimogene laherparepvec_ per 1 million plaque forming units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9150","description":"Medical home level iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen 2 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33263","description":"Rmvl & rplcmt dfb gen 2 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9163","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1B","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAF1","description":"ICD-FGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth head nerve surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22251","description":"Anesth head nerve surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart rhythm pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93618","description":"Heart rhythm pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD0","description":"ICD-LHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIA1","description":"ICD-CGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0160U","description":"MSH6 (mutS homolog 6) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electromyograph biofeedback","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0746","description":"Electromyograph biofeedback","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA1","description":"ICD-KHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L0720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","description":"HCPCS-L0720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA0","description":"ICD-NHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin test nos antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86486","description":"Skin test nos antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transportation costs to and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9992","description":"Transportation costs to and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB255","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm system binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5282","description":"Ald fm/dm system binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atropine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0461","description":"Atropine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES313","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE254","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace molded thigh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4040","description":"Replace molded thigh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD0","description":"ICD-EICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC0","description":"ICD-GHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd remove lesion snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43251","description":"Egd remove lesion snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC0","description":"ICD-OFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0040U","description":"BCR/ABL1 (t(9;22)) (eg_ chronic myelogenous leukemia) translocation analysis_ major breakpoint_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC1","description":"ICD-PLOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF0","description":"ICD-KAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF1","description":"ICD-HEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC1","description":"ICD-DGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJF0","description":"ICD-JAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant with bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32854","description":"Lung transplant with bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF1","description":"ICD-OJFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit day life activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99509","description":"Home visit day life activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB0","description":"ICD-MCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intl custm cong/latyp insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5681","description":"Intl custm cong/latyp insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35460","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLA0","description":"ICD-MJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93584","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; anomalous or persistent superior vena cava when it ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic procd strg endur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0237","description":"Therapeutic procd strg endur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB1","description":"ICD-ODKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXC1","description":"ICD-CAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC1","description":"ICD-OLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJC0","description":"ICD-KEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF0","description":"ICD-GBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD0","description":"ICD-FFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB42","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection eye drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67028","description":"Injection eye drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJC1","description":"ICD-CHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1053T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1053T","description":"CPT-1053T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trichomonas vaginalis amplif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87661","description":"Trichomonas vaginalis amplif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE1","description":"ICD-OHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOE1","description":"ICD-CBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXC1","description":"ICD-OFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22843","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASD0","description":"ICD-DASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA1","description":"ICD-KFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB1","description":"ICD-HBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD0","description":"ICD-NFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27690","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC1","description":"ICD-FDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22837","description":"Anterior thoracic vertebral body tethering_ including thoracoscopy_ when performed; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB0","description":"ICD-OBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD0","description":"ICD-CALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros sheath/sock w gel cushn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8417","description":"Pros sheath/sock w gel cushn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD1","description":"ICD-HFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0878T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB1","description":"ICD-GGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measles and rubella virus vaccine_ live_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90708","description":"Measles and rubella virus vaccine_ live_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove infected skull bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61501","description":"Remove infected skull bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB0","description":"ICD-JBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC0","description":"ICD-ACMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC0","description":"ICD-CDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32900","description":"Removal of rib(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD1","description":"ICD-KEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meas lung vol thru 2 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94013","description":"Meas lung vol thru 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE1","description":"ICD-BDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit fecal/enema mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99511","description":"Home visit fecal/enema mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 15-21 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0482","description":"Drug test def 15-21 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAE0","description":"ICD-FFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE1","description":"ICD-GDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD0","description":"ICD-JEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE1","description":"ICD-FGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD0","description":"ICD-BAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEED0","description":"ICD-GEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF0","description":"ICD-GGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction susp ak/knee disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5652","description":"Suction susp ak/knee disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE1","description":"ICD-CIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC11","description":"ICD-4LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB30","description":"Ultra High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED1","description":"ICD-EDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6245","description":"Bridge porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0A","description":"High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE0","description":"ICD-BIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAB0","description":"ICD-OKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo single coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1777","description":"Lead_ aicd_ endo single coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5C","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/o kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74240","description":"X-ray upper gi delay w/o kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA1","description":"ICD-FATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD1","description":"ICD-HBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA0","description":"ICD-IBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst including t/o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58262","description":"Vag hyst including t/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF1","description":"ICD-GHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF1","description":"ICD-BCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7314","description":"Injection_ fluocinolone acetonide_ intravitreal implant (Yutiq)_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF0","description":"ICD-OBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zidovudine_ oral_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0104","description":"Zidovudine_ oral_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCA1","description":"ICD-KFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB0","description":"ICD-MICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE1","description":"ICD-FFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release inner ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69960","description":"Release inner ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD1","description":"ICD-NIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWB0","description":"ICD-LIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA1","description":"ICD-CHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9407","description":"No 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFC1","description":"ICD-OGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monitor elec or comb vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0484","description":"Monitor elec or comb vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy w/o taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44126","description":"Enterectomy w/o taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tension based scoliosis orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1005","description":"Tension based scoliosis orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIB1","description":"ICD-JGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9160","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXD1","description":"ICD-FBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of tricuspid valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33460","description":"Revision of tricuspid valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC0","description":"ICD-MATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD1","description":"ICD-CAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD0","description":"ICD-DIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0735","description":"Non-invasive vagus nerve stimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF0","description":"ICD-JFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC1","description":"ICD-KADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33241","description":"Remove pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQC0","description":"ICD-DGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD1","description":"ICD-BBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87529","description":"Hsv dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33803","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD1","description":"ICD-MELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF0","description":"ICD-ECBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVD0","description":"ICD-BFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF1","description":"ICD-LHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore chest free adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32124","description":"Explore chest free adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1026","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Using A Catheter Continuously For Three Months Or Longer Under The Care Of The Same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF1","description":"ICD-KANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0D","description":"Medium Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N-et; commerc carrier pass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2004","description":"N-et; commerc carrier pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neomatrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2021","description":"Neomatrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD1","description":"ICD-MITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF1","description":"ICD-OLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66500","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE0","description":"ICD-LEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc endocrine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60659","description":"Laparo proc endocrine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1558","description":"Removal Of Fixed Bilateral Space Maintainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC1","description":"ICD-JDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA1","description":"ICD-EETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Site no lung or lung cx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9424","description":"Site no lung or lung cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE0","description":"ICD-EDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTC1","description":"ICD-MCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQD0","description":"ICD-PBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52285","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8H","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4405","description":"Nonpectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHA1","description":"ICD-JCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext breastprosthesis garment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8015","description":"Ext breastprosthesis garment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA1","description":"ICD-KFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL11","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE1","description":"ICD-OJXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96203","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD0","description":"ICD-EFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ isavuconazonium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1833","description":"Injection_ isavuconazonium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE1","description":"ICD-GCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air ambulan nonemerg rotary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9961","description":"Air ambulan nonemerg rotary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB1","description":"ICD-LASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 1 sting insect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95130","description":"Immntx 1 sting insect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","description":"HCPCS-A6548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC0","description":"ICD-FCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4389","description":"Drainable pch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF1","description":"ICD-JHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF1","description":"ICD-JBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic vein harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33508","description":"Endoscopic vein harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE0","description":"ICD-KIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC0","description":"ICD-FAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC1","description":"ICD-BBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC0","description":"ICD-CAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLA0","description":"ICD-ABLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIA0","description":"ICD-KIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0632U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0632U","description":"CPT-0632U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYB0","description":"ICD-PCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECC0","description":"ICD-BECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31535","description":"Laryngoscopy w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray strenoclavic jt 3/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71130","description":"X-ray strenoclavic jt 3/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE1","description":"ICD-JGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75825","description":"Vein x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE1","description":"ICD-CDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF1","description":"ICD-CGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE0","description":"ICD-GETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE1","description":"ICD-OFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE1","description":"ICD-IICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF1","description":"ICD-GHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ 1.54-1.65 p/1.60-1.79g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2782","description":"Lens_ 1.54-1.65 p/1.60-1.79g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1202","description":"HCPCS-A1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1305","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0364","description":"Cone beam ct capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release forearm/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26449","description":"Release forearm/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC1","description":"ICD-OBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC1","description":"ICD-KELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF0","description":"ICD-JELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB1","description":"ICD-LIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRB1","description":"ICD-CIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB0","description":"ICD-OBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC113","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA34","description":"Very High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC43","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1002","description":"HCPCS-A1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD0","description":"ICD-NAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF0","description":"ICD-OHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1299","description":"Influenza immunization administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation nasal sinus artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30915","description":"Ligation nasal sinus artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYD1","description":"ICD-KDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ >= 1.66 p/>=1.80 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2783","description":"Lens_ >= 1.66 p/>=1.80 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35583","description":"Vein byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63709","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin sig dep sym by dep tool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3354F","description":"Clin sig dep sym by dep tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0191","description":"Assessment of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFC0","description":"ICD-JFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB1","description":"ICD-NKJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQA0","description":"ICD-OBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE1","description":"ICD-KGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA1","description":"ICD-CHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate pleura w/o imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32554","description":"Aspirate pleura w/o imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXB0","description":"ICD-CIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF1","description":"ICD-HEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay clozapine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80159","description":"Drug assay clozapine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0709T","description":"Intradermal Cancer Immunotherapy; Each Additional Injection (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBID0","description":"ICD-KBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHC0","description":"ICD-IAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF1","description":"ICD-LEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB0","description":"ICD-KHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90623","description":"Meningococcal pentavalent vaccine_ conjugated Men A_ C_ W_ Y- tetanus toxoid carrier_ and Men B-FHbp_ for intracmuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA0","description":"ICD-OFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC0","description":"ICD-KCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB1","description":"ICD-FEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5152","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","description":"HCPCS-Q5152","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298U","description":"Oncology (Pan Tumor)_ Whole Transcriptome Sequencing Of Paired Malignant And Normal Rna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC0","description":"ICD-HFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Graftjacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4107","description":"Graftjacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0909T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","description":"CPT-0909T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXA1","description":"ICD-NCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91315","description":"SARSCOV2 VACCINE BIVALENT 10 MCG/0.2 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB0","description":"ICD-CDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF1","description":"ICD-KCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical services after hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99050","description":"Medical services after hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB1","description":"ICD-NLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB0","description":"ICD-EIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6614","description":"HCPCS-A6614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84300","description":"Assay of urine sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27059","description":"Resect hip/pelv tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX26","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB1","description":"ICD-OHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA23","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD260","description":"Special Care Low _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHF0","description":"ICD-KIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject epidural patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62273","description":"Inject epidural patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB1","description":"ICD-KCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA0","description":"ICD-KILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71045","description":"Radiologic examination_ chest; single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOE1","description":"ICD-LEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCC1","description":"ICD-JCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA0","description":"ICD-KHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB0","description":"ICD-MATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA1","description":"ICD-KITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE111","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE1","description":"ICD-CCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB1","description":"ICD-NIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBD1","description":"ICD-JIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD1","description":"ICD-CADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methadone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1230","description":"Methadone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF0","description":"ICD-KERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB0","description":"ICD-KCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15610","description":"Delay flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD246","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF1","description":"ICD-JGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contracept iud","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4989","description":"Contracept iud","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xyntha inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7185","description":"Xyntha inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81438","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE1","description":"ICD-BETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE0","description":"ICD-CIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAD0","description":"ICD-BIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES304","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scintimammography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8080","description":"Scintimammography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB0","description":"ICD-JAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01360","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","description":"CPT-01360","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27181","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA1","description":"ICD-JBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC1","description":"ICD-MDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF0","description":"ICD-KEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC0","description":"ICD-NHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXF1","description":"ICD-FFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD0","description":"ICD-CGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8914","description":"Mra w/o fol w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF0","description":"ICD-GCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9976","description":"Injection ferric pyrophosphate citrate solution 0.1 mg iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist inter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46275","description":"Remove anal fist inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE0","description":"ICD-KCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB0","description":"ICD-FEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGC1","description":"ICD-NHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA0","description":"ICD-CGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRD1","description":"ICD-PBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54308","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF1","description":"ICD-CGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKED1","description":"ICD-NKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB0","description":"ICD-OAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGB1","description":"ICD-OCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tooth transplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7272","description":"Tooth transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB1","description":"ICD-PAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECA0","description":"ICD-JECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEA1","description":"ICD-OCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA1","description":"ICD-OECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9948","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95975","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude_ pulse duration_ configuration of wave form_ battery status_ electrode selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9177","description":"Injection_ enfortumab vedotin-ejfv_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1060T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1060T","description":"CPT-1060T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF0","description":"ICD-MBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE0","description":"ICD-EITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electro connect btw 2 sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2311","description":"Electro connect btw 2 sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0636U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0636U","description":"CPT-0636U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33692","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1111","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0504","description":"HCPCS-B0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB0","description":"ICD-KIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decalcification procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0475","description":"Decalcification procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of hip joint/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27036","description":"Excision of hip joint/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB0","description":"ICD-CGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA0","description":"ICD-EFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE1","description":"ICD-BBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0204","description":"HCPCS-A0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF1","description":"ICD-FBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD0","description":"ICD-CERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 20 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1020","description":"Methylprednisolone 20 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82489","description":"Chromatography_ qualitative; thin layer_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3D","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0701","description":"Injection_ cefepime hydrochloride (baxter)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tendon excision palm/finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26145","description":"Tendon excision palm/finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA0","description":"ICD-ICEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27215","description":"Treat pelvic fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integra flowable wound matri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4114","description":"Integra flowable wound matri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49610","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF1","description":"ICD-OCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1113","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA1","description":"ICD-NDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB1","description":"ICD-NHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9594","description":"Gallium ga-68 psma-11_ diagnostic_ (ucla)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC1","description":"ICD-BFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna hepatitis b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87912","description":"Genotype dna hepatitis b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18D","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Baclofen 10 mg injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0475","description":"Baclofen 10 mg injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD1","description":"ICD-CHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6455","description":"Self-adher band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem odontogen cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7450","description":"Rem odontogen cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5C","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB250","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB36","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB1","description":"ICD-PIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE0","description":"ICD-GCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45020","description":"Drainage of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVA0","description":"ICD-NAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHC0","description":"ICD-KHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81202","description":"Apc gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9817","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9817","description":"HCPCS-C9817","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUF1","description":"ICD-IEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD1","description":"ICD-CHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2D","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAB1","description":"ICD-MHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1030","description":"Patients with clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92945","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","description":"CPT-92945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shock absorber for man w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1015","description":"Shock absorber for man w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37227","description":"Fem/popl revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA0","description":"ICD-CALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD1","description":"ICD-ABUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA1","description":"ICD-MJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; vascular procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0133U","description":"Anesthesia for intracranial procedures; vascular procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA1","description":"ICD-JHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA1","description":"ICD-OJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIB0","description":"ICD-MIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78802","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA1","description":"ICD-OEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex dx brush","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43197","description":"Esophagoscopy flex dx brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC21","description":"ICD-3IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj phrenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64410","description":"N block inj phrenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF1","description":"ICD-KCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29126","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC0","description":"ICD-JCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal hemoglobin chemical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83030","description":"Fetal hemoglobin chemical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWA0","description":"ICD-KAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB0","description":"ICD-FCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB0","description":"ICD-PDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTB1","description":"ICD-JHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC0","description":"ICD-JFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF1","description":"ICD-CDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE0","description":"ICD-KHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF1","description":"ICD-ADTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr source elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0490","description":"Emr pwr source elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35241","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2202","description":"Patient did not receive brief counseling if identified as an unhealthy alcohol user_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA0","description":"ICD-KHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA1","description":"ICD-FIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc serum pretx id dilution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86976","description":"Rbc serum pretx id dilution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC1","description":"ICD-IBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1297","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of hand bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26230","description":"Partial removal of hand bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70486","description":"Ct maxillofacial w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28G","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND1","description":"ICD-FBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA0","description":"ICD-DCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE0","description":"ICD-GCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB1","description":"ICD-JAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA0","description":"ICD-CDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA21","description":"ICD-1IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC1","description":"ICD-PJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80435","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJF0","description":"ICD-JHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD1","description":"ICD-GDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF0","description":"ICD-CIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA1","description":"ICD-EAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA1","description":"ICD-IIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meloxicam_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9059","description":"Injection_ meloxicam_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9392","description":"Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC1","description":"ICD-GHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_ uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8903","description":"MRI w/cont_ breast_ uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD0","description":"ICD-KDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSB0","description":"ICD-OCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB0","description":"ICD-FDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumat walking boot pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4360","description":"Pneumat walking boot pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABME1","description":"ICD-ABME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD0","description":"ICD-CDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID0","description":"ICD-ECID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLF1","description":"ICD-OLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF0","description":"ICD-KAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0964T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","description":"CPT-0964T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9613","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9613","description":"HCPCS-A9613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7563","description":"HCPCS-C7563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69620","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8721","description":"HCPCS-L8721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA1","description":"ICD-OFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reas pt_ pn_ not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8722","description":"Med reas pt_ pn_ not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233T","description":"Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX53","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sho heel count plast reinfor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3430","description":"Sho heel count plast reinfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-eval post-op visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0171","description":"Re-eval post-op visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD0","description":"ICD-CIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA21","description":"ICD-4BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB1","description":"ICD-NHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF1","description":"ICD-KBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAC0","description":"ICD-KDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF0","description":"ICD-BFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD1","description":"ICD-BCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD1","description":"ICD-GBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1413","description":"Injection_ delandistrogene moxeparvovec-rokl_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin fluid swg & stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5728","description":"Knee-shin fluid swg & stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC1","description":"ICD-ACHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c probe&rvrs trnsc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87521","description":"Hepatitis c probe&rvrs trnsc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGE1","description":"ICD-JBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual semi-reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1225","description":"Manual semi-reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment x10sv retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67228","description":"Treatment x10sv retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC1","description":"ICD-DCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE1","description":"ICD-CGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF0","description":"ICD-JEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC0","description":"ICD-JEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4349","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","description":"HCPCS-Q4349","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE1","description":"ICD-CAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA0","description":"ICD-CHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD0","description":"ICD-OFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52700","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSD0","description":"ICD-LFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB1","description":"ICD-BGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81278","description":"Igh@/Bcl2 (T(14;18)) (Eg_ Follicular Lymphoma) Translocation Analysis_ Major Breakpoint Region (Mbr) And Minor Cluster Region (Mcr) Breakpoints_ Qualitative Or Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00164","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","description":"CPT-00164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99607","description":"Mtms by pharm addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF1","description":"ICD-JFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0606U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","description":"CPT-0606U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77761","description":"Apply intrcav radiat simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB1","description":"ICD-EEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon tolerance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82946","description":"Glucagon tolerance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE0","description":"ICD-OLRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE256","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lg vol nebulizer disposable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7007","description":"Lg vol nebulizer disposable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF0","description":"ICD-LERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSB0","description":"ICD-GBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB1","description":"ICD-GAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVC0","description":"ICD-FIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC1","description":"ICD-MIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393U","description":"Neurology (eg_ Parkinson disease_ dementia with Lewy bodies)_ cerebrospinal fluid (CSF)_ detection of misfolded a-synuclein protein by seed amplification assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKB0","description":"ICD-NGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40490","description":"Biopsy of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA1","description":"ICD-EFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA21","description":"ICD-4DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME1","description":"ICD-NBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA0","description":"ICD-DAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF0","description":"ICD-OLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5A","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for heart biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76932","description":"Echo guide for heart biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIE1","description":"ICD-CEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHA0","description":"ICD-NDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE1","description":"ICD-FGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA07","description":"Default_ /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE1","description":"ICD-CBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25645","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE1","description":"ICD-FHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received active chemotherapy any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1156","description":"Patient received active chemotherapy any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHB0","description":"ICD-GAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE0","description":"ICD-GGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2118","description":"Patients 81 Years Of Age And Older With A Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids mult qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82128","description":"Amino acids mult qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glycated protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82985","description":"Assay of glycated protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATF1","description":"ICD-MATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA204","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC1","description":"ICD-OJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA0","description":"ICD-BFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0663","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","description":"HCPCS-G0663","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0363T","description":"Exposure behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by physician or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not disch to home day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8825","description":"Pt not disch to home day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC1","description":"ICD-JCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFD1","description":"ICD-CEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC0","description":"ICD-JBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human epididymis protein 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86305","description":"Human epididymis protein 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33411","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB240","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart damage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33545","description":"Repair of heart damage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza dna amp prob addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87503","description":"Influenza dna amp prob addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE0","description":"ICD-OKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","description":"HCPCS-A8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eps Gast Cardia Plic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9724","description":"Eps Gast Cardia Plic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA1","description":"ICD-CESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87451","description":"IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA1","description":"ICD-BFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAF1","description":"ICD-NFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB1","description":"ICD-NLIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2002","description":"HCPCS-A2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0689","description":"Injection_ cefazolin sodium (baxter)_ not therapeutically equivalent to j0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22A","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84126","description":"Assay of feces porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"corticotomy - four or more teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7297","description":"corticotomy - four or more teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41821","description":"Excision of gum flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medrsn >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9353","description":"Medrsn >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Man w/ch acc seat w>=20in<24in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2201","description":"Man w/ch acc seat w>=20in<24in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE1","description":"ICD-GGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam of vagina w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57420","description":"Exam of vagina w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4170","description":"Cygnus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUD0","description":"ICD-EEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA24","description":"Very High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ suprapubic/cystoscopic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2627","description":"Cath_ suprapubic/cystoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF0","description":"ICD-NDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND1","description":"ICD-NBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult foster care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5140","description":"Adult foster care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETB0","description":"ICD-AETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit resp therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99503","description":"Home visit resp therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAF0","description":"ICD-EIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC0","description":"ICD-GIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36514","description":"Apheresis plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE0","description":"ICD-FDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF1","description":"ICD-FGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE1","description":"ICD-KAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA0","description":"ICD-HIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair brake extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0961","description":"Wheelchair brake extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE0","description":"ICD-EHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB1","description":"ICD-GDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC1","description":"ICD-IGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence supply","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4335","description":"Incontinence supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for myelogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62284","description":"Injection for myelogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECD1","description":"ICD-KECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1096T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1096T","description":"CPT-1096T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27193","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF0","description":"ICD-CFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD1","description":"ICD-CDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No ret for surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9307","description":"No ret for surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC1","description":"ICD-JAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33863","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1048","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart revascularize (tmr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33140","description":"Heart revascularize (tmr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB0","description":"ICD-GHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF0","description":"ICD-GEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHF0","description":"ICD-AAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE0","description":"ICD-BGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87513","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","description":"CPT-87513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occult blood feces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82270","description":"Occult blood feces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA0","description":"ICD-BBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE0","description":"ICD-PFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB1","description":"ICD-FHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC0","description":"ICD-EFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF0","description":"ICD-CBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB1","description":"ICD-KHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDD0","description":"ICD-CGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF1","description":"ICD-JADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF0","description":"ICD-JHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415U","description":"Cardiovascular disease (acute coronary syndrome [ACS])_ IL-16_ FAS_ FASLigand_ HGF_ CTACK_ EOTAXIN_ and MCP-3 by immunoassay combined with age_ sex_ family history_ and person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45303","description":"Proctosigmoidoscopy dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB0","description":"ICD-BATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA0","description":"ICD-OGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC0","description":"ICD-BALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn no stat tx/presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9667","description":"Doc med rsn no stat tx/presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53000","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF1","description":"ICD-OBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abobotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0586","description":"Abobotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sorbent cartridges per 10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1636","description":"Sorbent cartridges per 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD0","description":"ICD-JAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC0","description":"ICD-GCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surg lower abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84051","description":"Anesth surg lower abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydromorphone 250 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0092","description":"Hydromorphone 250 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6400","description":"Below elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibiot not rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4124F","description":"Antibiot not rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tubing with heating element","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4604","description":"Tubing with heating element","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp remove duct calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43264","description":"Ercp remove duct calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC0","description":"ICD-BAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC1","description":"ICD-MBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC0","description":"ICD-OESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGE0","description":"ICD-GCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE0","description":"ICD-FHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73552","description":"X-ray exam of femur 2/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9034","description":"Injection_ dexamethasone 9%_ intraocular_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD1","description":"ICD-BHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXB0","description":"ICD-FCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vacc no prsv 6-35 m im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90685","description":"Iiv4 vacc no prsv 6-35 m im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA06","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA1","description":"ICD-BBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfusion service fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36460","description":"Transfusion service fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25125","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin suppl 100 caps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0194","description":"Vitamin suppl 100 caps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102T","description":"Extracorp shockwv tx anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBB0","description":"ICD-OEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46924","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOB1","description":"ICD-LGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8650","description":"Fun stat score knee not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVF1","description":"ICD-NEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA121","description":"Clinically Complex _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of multivisc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2054","description":"Transplantation of multivisc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACE0","description":"ICD-OACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40820","description":"Treatment of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPE0","description":"ICD-FDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paramedicintercep nonhospals","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0207","description":"Paramedicintercep nonhospals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9045","description":"Injection_ moxetumomab pasudotox-tdfx_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optic nerve head eval done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2027F","description":"Optic nerve head eval done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKA0","description":"ICD-JBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYF1","description":"ICD-KIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB0","description":"ICD-NBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPB1","description":"ICD-GEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD1","description":"ICD-JABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy fundoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43280","description":"Laparoscopy fundoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXB0","description":"ICD-GFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1276","description":"Bmi documented outside normal parameters_ no follow-up plan documented_ no reason given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac drug stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93024","description":"Cardiac drug stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anticonv thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4230F","description":"Anticonv thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0671U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671U","description":"CPT-0671U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC1","description":"ICD-GGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC0","description":"ICD-BEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPB0","description":"ICD-NIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOF1","description":"ICD-PAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31588","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD1","description":"ICD-FGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA1","description":"ICD-BINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Second level cer diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22858","description":"Second level cer diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DermaBind FM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4313","description":"DermaBind FM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC1","description":"ICD-OISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cholera vaccine for injectable use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90725","description":"Cholera vaccine for injectable use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye socket wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65290","description":"Repair of eye socket wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA0","description":"ICD-OKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8F","description":"High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC1","description":"ICD-FIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma not detect screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3776F","description":"Adenoma not detect screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE1","description":"ICD-OJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4045","description":"Cast sup sht leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA01","description":"High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood clot lysis time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85175","description":"Blood clot lysis time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0676","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0676","description":"HCPCS-G0676","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF1","description":"ICD-GEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE0","description":"ICD-JDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcmnd flw-up 10 yrs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528F","description":"Rcmnd flw-up 10 yrs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB1","description":"ICD-CHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE1","description":"ICD-ACEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOE1","description":"ICD-OGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement bulb th lightbox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4634","description":"Replacement bulb th lightbox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF0","description":"ICD-BDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5258","description":"Hearing aid_ digit_ bin_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation foot complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20838","description":"Replantation foot complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF1","description":"ICD-AALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC0","description":"ICD-JBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF1","description":"ICD-OATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Single energy x-ray study","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0130","description":"Single energy x-ray study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD0","description":"ICD-KAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diet counsel at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9474","description":"Diet counsel at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296U","description":"Oncology (Oral And/Or Oropharyngeal Cancer)_ Gene Expression Profiling By Rna Sequencing At Least 20 Molecular Features (Eg_ Human And/Or Microbial Mrna)_ Saliva_ Algorithm Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch on barr w/flng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5073","description":"Urinary pouch on barr w/flng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex for nonspeech device rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92605","description":"Ex for nonspeech device rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70557","description":"MRI brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9121","description":"Injection_ argatroban","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB1","description":"ICD-GGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB0","description":"ICD-BBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch and cane holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2207","description":"Crutch and cane holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96373","description":"Ther/proph/diag inj ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duplicate/copy patient_s records","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9961","description":"Duplicate/copy patient_s records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD0","description":"ICD-NJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHF1","description":"ICD-MDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroplasty w/o v-band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43843","description":"Gastroplasty w/o v-band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiology port images(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77417","description":"Radiology port images(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQA0","description":"ICD-HFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF1","description":"ICD-NEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx septal fx w/wo stabj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21336","description":"Open tx septal fx w/wo stabj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEF0","description":"ICD-OLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home Adaptations (<$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0140","description":"Home Adaptations (<$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAF0","description":"ICD-OAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE0","description":"ICD-PCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina wall partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57106","description":"Remove vagina wall partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB0","description":"ICD-IDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMD1","description":"ICD-ACMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mifepristone_ oral_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0190","description":"Mifepristone_ oral_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply interstit radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77778","description":"Apply interstit radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKC0","description":"ICD-CFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNB1","description":"ICD-GGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9509","description":"Iodine i-123 sod iodide mil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC1","description":"ICD-FGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE1","description":"ICD-JBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJA0","description":"ICD-JBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8I","description":"Very High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD1","description":"ICD-FFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF1","description":"ICD-JGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alprostadil for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0270","description":"Alprostadil for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion ball bearing j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2060","description":"Hkafo torsion ball bearing j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15836","description":"Excise excessive skin arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC0","description":"ICD-JDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD1","description":"ICD-OIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRC0","description":"ICD-DIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arm tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24305","description":"Arm tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6180","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6180","description":"CDT-D6180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive ear/neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69155","description":"Extensive ear/neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93981","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAA0","description":"ICD-EGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF0","description":"ICD-IBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD1","description":"ICD-AHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13C","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF0","description":"ICD-FDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC0","description":"ICD-GHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC0","description":"ICD-OKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0517","description":"Removal of non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17273","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJF0","description":"ICD-CHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext ureth clmp or compr dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4356","description":"Ext ureth clmp or compr dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk thigh lacer non-molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5680","description":"Bk thigh lacer non-molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD0","description":"ICD-ABHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF1","description":"ICD-CCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED0","description":"ICD-GFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement facemask interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7031","description":"Replacement facemask interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC0","description":"ICD-FHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0657U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0657U","description":"CPT-0657U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTE0","description":"ICD-BFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70200","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF0","description":"ICD-CDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penile vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93980","description":"Penile vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA1","description":"ICD-JHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB21","description":"ICD-2BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE1","description":"ICD-FIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA0","description":"ICD-CIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis for chromosomal abnormalities_ copy number variants_ duplications/deletions_ inversions_ unb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDF1","description":"ICD-GBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syringe w/wo needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4657","description":"Syringe w/wo needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq lumbosacral injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22511","description":"Perq lumbosacral injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF0","description":"ICD-OGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDD0","description":"ICD-GCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD0","description":"ICD-LAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE1","description":"ICD-GDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCND0","description":"ICD-KCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID0","description":"ICD-NFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not trans to hosp at d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8915","description":"Pt not trans to hosp at d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRC1","description":"ICD-CFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB1","description":"ICD-OCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD0","description":"ICD-BBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB0","description":"ICD-CIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAA1","description":"ICD-KIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preop asses 4 cataract surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3325F","description":"Preop asses 4 cataract surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61055","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHF1","description":"ICD-KEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot drop splint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4398","description":"Foot drop splint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14020","description":"Tis trnfr s/a/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26700","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01760","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","description":"CPT-01760","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE235","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBA1","description":"ICD-KDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ leadless pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD1","description":"ICD-CBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIA0","description":"ICD-KCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC31","description":"ICD-3GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE0","description":"ICD-AETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE116","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB0","description":"ICD-BGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1202","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1202","description":"CDT-D1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA0","description":"ICD-CDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51700","description":"Irrigation of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE0","description":"ICD-KFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99474","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Separate Self-Measurements Of Two Readings One Minute Apart_ Twice Daily Over A 30-Day Period (Min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC0","description":"ICD-MKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD1","description":"ICD-IIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6232","description":"Hydrogel dsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pentamidine comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7676","description":"Pentamidine comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVF0","description":"ICD-CGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial brush biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31717","description":"Bronchial brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCC1","description":"ICD-NJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test cran nerve bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95868","description":"Muscle test cran nerve bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC0","description":"ICD-MJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27080","description":"Removal of tail bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA1","description":"ICD-OIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA1","description":"ICD-CBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDB0","description":"ICD-IBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDND1","description":"ICD-JDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDB0","description":"ICD-GIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD1","description":"ICD-EECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4270F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE0","description":"ICD-PASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQD0","description":"ICD-DBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA1","description":"ICD-OCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2373","description":"Injection_ phenylephrine HCl (Immphentiv)_ 20 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFC0","description":"ICD-GGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA0","description":"ICD-KCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOE0","description":"ICD-GBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF1","description":"ICD-MDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo frict swg & st","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5712","description":"Knee-shin exo frict swg & st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID0","description":"ICD-NCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB0","description":"ICD-AFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYA0","description":"ICD-LFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF1","description":"ICD-GAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB1","description":"ICD-NIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gamma globulin 1 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1460","description":"Gamma globulin 1 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB0","description":"ICD-OKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE1","description":"ICD-LBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0114U","description":"Anesthesia for reconstructive procedures of eyelid (eg_ blepharoplasty_ pto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWC0","description":"ICD-OFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1007","description":"Clinical Decision Support Mechanism Aim Specialty Health_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95958","description":"Eeg monitoring/function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF1","description":"ICD-KCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycoplasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87109","description":"Mycoplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of finger/thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26951","description":"Amputation of finger/thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB1","description":"ICD-CAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVA0","description":"ICD-OHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesions over 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11057","description":"Trim skin lesions over 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB0","description":"ICD-CFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC0","description":"ICD-HDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg <=16 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6242","description":"Hydrogel drg <=16 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy single lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63042","description":"Laminotomy single lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACE1","description":"ICD-BACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30435","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC0","description":"ICD-CHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay quant nos nonab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83520","description":"Immunoassay quant nos nonab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE0","description":"ICD-GBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009M","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUF0","description":"ICD-GDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0081","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90481","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","description":"CPT-90481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In vivo lab service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88749","description":"In vivo lab service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA21","description":"High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDC0","description":"ICD-OFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove inner ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69970","description":"Remove inner ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA1","description":"ICD-CCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB125","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58672","description":"Laparoscopy fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory surgical boot eac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3260","description":"Ambulatory surgical boot eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD0","description":"ICD-KATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin node stgng docdb/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3323F","description":"Clin node stgng docdb/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE1","description":"ICD-NLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD0","description":"ICD-GITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE0","description":"ICD-MHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27641","description":"Partial removal of fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procuren or other growth fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9055","description":"Procuren or other growth fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24A","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA1","description":"ICD-KFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54660","description":"Revision of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optimal care for kidney health mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0002","description":"Optimal care for kidney health mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome study additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88289","description":"Chromosome study additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC1","description":"ICD-ICLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA0","description":"ICD-JIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAA0","description":"ICD-FGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"KLF1 TARGETED SEQUENCING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0195U","description":"KLF1 TARGETED SEQUENCING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc back les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21931","description":"Exc back les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoelectrophoresis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86327","description":"Immunoelectrophoresis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBE0","description":"ICD-ACBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","description":"HCPCS-A9154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD0","description":"ICD-OGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA0","description":"ICD-NLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB0","description":"ICD-CCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2604","description":"Skin protect wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC31","description":"ICD-1HC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC0","description":"ICD-FBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA1","description":"ICD-GEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNB1","description":"ICD-ODNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE1","description":"ICD-NLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75803","description":"Lymph vessel x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRB1","description":"ICD-DBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symptom mgmnt plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0555F","description":"Symptom mgmnt plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate wrist w/anesthes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25259","description":"Manipulate wrist w/anesthes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSA0","description":"ICD-CHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUB0","description":"ICD-FDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy bowel pouch/biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44386","description":"Endoscopy bowel pouch/biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC22","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF0","description":"ICD-GHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Private duty/independent nsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1000","description":"Private duty/independent nsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIA0","description":"ICD-KHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIA0","description":"ICD-KEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB226","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion (mpr)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59866","description":"Abortion (mpr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0576T","description":"Interrogation Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Analysis_ Review And Report By A Physician Or Othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand/chin ctrl std joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2374","description":"Hand/chin ctrl std joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA0","description":"ICD-KBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65765","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total cortisol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82533","description":"Total cortisol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQC1","description":"ICD-DHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiometry complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92556","description":"Speech audiometry complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA0","description":"ICD-NGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5103","description":"HCPCS-A5103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0B","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC0","description":"ICD-IHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLA1","description":"ICD-NBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD0","description":"ICD-IFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD0","description":"ICD-CDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB0","description":"ICD-NJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBC1","description":"ICD-FBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF0","description":"ICD-CHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8X","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD0","description":"ICD-FEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx chron care w/o pt vsit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99487","description":"Cmplx chron care w/o pt vsit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF1","description":"ICD-FALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHC1","description":"ICD-IFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB1","description":"ICD-NHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBF1","description":"ICD-IDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA0","description":"ICD-GFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cosyntropin cortrosyn inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0834","description":"Cosyntropin cortrosyn inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA0","description":"ICD-OCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA1","description":"ICD-JBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7566","description":"HCPCS-C7566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCD0","description":"ICD-OJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOA1","description":"ICD-PEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB0","description":"ICD-NFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGD1","description":"ICD-GEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA1","description":"ICD-KIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ transpl pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2152","description":"Solid organ transpl pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC112","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAE1","description":"ICD-AFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEE0","description":"ICD-CEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB241","description":"Special Care Low _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina tissue compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57111","description":"Remove vagina tissue compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HPYLORI","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87339","description":"IAAD IA HPYLORI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB0","description":"ICD-KFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56800","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laminate labial veneer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2960","description":"Laminate labial veneer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73030","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB1","description":"ICD-KEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB1","description":"ICD-BEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee disart expand wall sock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5653","description":"Knee disart expand wall sock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBE0","description":"ICD-CEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC1","description":"ICD-OARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE245","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0655U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0655U","description":"CPT-0655U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA1","description":"ICD-NIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF1","description":"ICD-NJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE0","description":"ICD-BFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25316","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA1","description":"ICD-JGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA0","description":"ICD-LCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subepithelial tissue graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4273","description":"Subepithelial tissue graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC1","description":"ICD-JBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC0","description":"ICD-FEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB0","description":"ICD-ODVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC0","description":"ICD-MCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC1","description":"ICD-NGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t1-3_n1-2_no pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9084","description":"Onc dx colon t1-3_n1-2_no pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57465","description":"Computer-Aided Mapping Of Cervix Uteri During Colposcopy_ Including Optical Dynamic Spectral Imaging And Algorithmic Quantification Of The Acetowhitening Effect (List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB0","description":"ICD-NBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE1","description":"ICD-BGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHF1","description":"ICD-EFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25931","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55110","description":"Explore scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KB21","description":"ICD-3KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99153","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA0","description":"ICD-KEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad sleeve med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8422","description":"Custom grad sleeve med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1064T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1064T","description":"CPT-1064T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF1","description":"ICD-CIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC0","description":"ICD-MHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Expandable controller_ repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2376","description":"Expandable controller_ repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2211","description":"Lens sphcy bifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC1","description":"ICD-CGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC0","description":"ICD-NFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHB1","description":"ICD-KAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon gamma 1-b inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9216","description":"Interferon gamma 1-b inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of chest tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32551","description":"Insertion of chest tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF1","description":"ICD-MBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA0","description":"ICD-OGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing serologic rh(d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86901","description":"Blood typing serologic rh(d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB1","description":"ICD-CIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF1","description":"ICD-PDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6241","description":"Bridge porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE0","description":"ICD-OLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC1","description":"ICD-PBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86831","description":"Hla class ii phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27606","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/o hemodyn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75887","description":"Vein x-ray liver w/o hemodyn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMB0","description":"ICD-KIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA21","description":"ICD-3JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYA0","description":"ICD-HAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfe gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81256","description":"Hfe gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF0","description":"ICD-HHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEC1","description":"ICD-BGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of homovanillic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83150","description":"Assay of homovanillic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA1","description":"ICD-MGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj xtrspinl 1/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98943","description":"Chiropract manj xtrspinl 1/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB0","description":"ICD-MBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE0","description":"ICD-OEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethral lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57230","description":"Repair of urethral lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29200","description":"Strapping of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2781","description":"Injection_ pegcetacoplan_ intravitreal_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect thigh/knee tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27364","description":"Resect thigh/knee tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N-et; stretcher van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2005","description":"N-et; stretcher van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0668T","description":"Backbench standard preparation of cadaver or living donor uterine allograft prior to transplantation_ including dissection and removal of surrounding soft tissues and preparat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLA1","description":"ICD-IHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99600","description":"Home visit nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit tocolysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9349","description":"Hit tocolysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD1","description":"ICD-KBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair detachable arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1060","description":"Wheelchair detachable arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESE1","description":"ICD-PESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF1","description":"ICD-NCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE0","description":"ICD-JATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA0","description":"ICD-MCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWA0","description":"ICD-HEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE1","description":"ICD-BHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC1","description":"ICD-BIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ epirubicin hcl_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9178","description":"Inj_ epirubicin hcl_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intent pot remv time placemt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9539","description":"Intent pot remv time placemt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADB0","description":"ICD-FADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tob non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9459","description":"Tob non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE1","description":"ICD-IGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIE0","description":"ICD-BFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NFCT AGT HIV GNRJ SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219U","description":"NFCT AGT HIV GNRJ SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD1","description":"ICD-CFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA1","description":"ICD-CGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB0","description":"ICD-ECDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77423","description":"High energy neutron radiation treatment delivery_ 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge_ and/or compensator(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Statin not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9443","description":"Statin not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA0","description":"ICD-OIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB1","description":"ICD-CAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoluminal bx biliary tree","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47543","description":"Endoluminal bx biliary tree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAF1","description":"ICD-JHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve addl insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31651","description":"Bronchial valve addl insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD1","description":"ICD-MJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE0","description":"ICD-BCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","description":"CPT-01840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF0","description":"ICD-CGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6049","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6049","description":"CDT-D6049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA1","description":"ICD-GIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA1","description":"ICD-LBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVF1","description":"ICD-FAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echosclerotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2202","description":"Echosclerotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm device interrogate remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93294","description":"Pm device interrogate remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF1","description":"ICD-OIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluid flow or fluid GF_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4206","description":"Fluid flow or fluid GF_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synvisc or synvisc-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7325","description":"Synvisc or synvisc-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD0","description":"ICD-OCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC0","description":"ICD-OALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA56","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8E","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF0","description":"ICD-HAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33665","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria toxoid_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90719","description":"Diphtheria toxoid_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF0","description":"ICD-GBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA11","description":"ICD-3AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWC0","description":"ICD-OCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED1","description":"ICD-NEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF1","description":"ICD-CHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neostim membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4266","description":"Neostim membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD156","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB0","description":"ICD-CIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43121","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE144","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15935","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1140","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF1","description":"ICD-NAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF0","description":"ICD-MIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-63032","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","description":"CPT-63032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0541","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","description":"HCPCS-G0541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB1","description":"ICD-AGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF1","description":"ICD-OCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hook to hand cable adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6670","description":"Hook to hand cable adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31293","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE1","description":"ICD-JAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB1","description":"ICD-HGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA0","description":"ICD-GIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB1","description":"ICD-IEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9936","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9936","description":"CDT-D9936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ trans atherec_rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1724","description":"Cath_ trans atherec_rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51820","description":"Revision of urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHE0","description":"ICD-JGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC0","description":"ICD-GAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB41","description":"High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51500","description":"Removal of bladder cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA1","description":"ICD-JHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXF1","description":"ICD-CCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA0","description":"ICD-MEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA0","description":"ICD-GDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33778","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37297","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","description":"CPT-37297","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVF1","description":"ICD-CIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE0","description":"ICD-KGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8E","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2020","description":"Services for high intensity clinical services associated with the initial engagement and outreach of beneficiaries assigned to the sip component of the pcf model (do not bill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC0","description":"ICD-OIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0183","description":"Powered pressure reducing underlay/pad_ alternating_ with pump_ inc heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE1","description":"ICD-FGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224U","description":"Antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ includes titer(s)_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9146","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED1","description":"ICD-ADED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1078","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE0","description":"ICD-BHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral administration ki","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4224","description":"Parenteral administration ki","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC1","description":"ICD-OCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC1","description":"ICD-CCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYE0","description":"ICD-LFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD0","description":"ICD-CITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD0","description":"ICD-KCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB0","description":"ICD-BGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87486","description":"Chylmd pneum dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTA0","description":"ICD-EBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF1","description":"ICD-KFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEB1","description":"ICD-KEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detach adjust armrst upper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0018","description":"Detach adjust armrst upper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC0","description":"ICD-BGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA1","description":"ICD-EEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us < 14 wks single fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76801","description":"Ob us < 14 wks single fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD0","description":"ICD-FCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575T","description":"Programming Device Evaluation (In Person) Of Implantable Cardioverter-Defibrillator System With Substernal Electrode_ With Iterative Adjustment Of The Implantable Device To Te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1278","description":"Elevated or hypertensive blood pressure reading documented_ and the indicated follow-up is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Agriflu vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2034","description":"Agriflu vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1A","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA1","description":"ICD-ABUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Outside state ambulance serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0021","description":"Outside state ambulance serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42971","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv push sngl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96409","description":"Chemo iv push sngl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA1","description":"ICD-DIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45315","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1150","description":"Left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD0","description":"ICD-BFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Puncture drainage of lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10160","description":"Puncture drainage of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE0","description":"ICD-MILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD160","description":"Reduced Physical Function _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE0","description":"ICD-BDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB1","description":"ICD-IDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE0","description":"ICD-KASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","description":"HCPCS-L1006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC0","description":"ICD-KHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1901","description":"CDT-D1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9759","description":"Transcatheter intraoperative blood vessel microinfusion(s) (e.g._ intraluminal_ vascular wall and/or perivascular) ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB0","description":"ICD-GBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB0","description":"ICD-JFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIA0","description":"ICD-CAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEE1","description":"ICD-IHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta not given no reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9188","description":"Beta not given no reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC211","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJA0","description":"ICD-ODJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86756","description":"Respiratory virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2002","description":"CDT-D2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE1","description":"ICD-OKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLE1","description":"ICD-KCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF1","description":"ICD-JGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology colon mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81525","description":"Oncology colon mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61156","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF1","description":"ICD-KGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACA0","description":"ICD-JACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - care coordination","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9992","description":"Dental case management - care coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA0","description":"ICD-GFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC0","description":"ICD-OFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIF1","description":"ICD-NFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81545","description":"Oncology thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKND0","description":"ICD-NKND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC0","description":"ICD-EAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWD1","description":"ICD-LHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAA1","description":"ICD-NIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA1","description":"ICD-PJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE1","description":"ICD-FGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUD1","description":"ICD-NEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy ring each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4404","description":"Ostomy ring each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF0","description":"ICD-IECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF0","description":"ICD-CBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC0","description":"ICD-EHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKA0","description":"ICD-KHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Mechanical Prosthetic Heart Valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0043","description":"Patients With Mechanical Prosthetic Heart Valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD1","description":"ICD-KIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9853","description":"Patient admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25810","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE1","description":"ICD-OFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA1","description":"ICD-KHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Jak2 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81270","description":"Jak2 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not recvng antiv hep c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4151F","description":"Pt not recvng antiv hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF0","description":"ICD-LCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE0","description":"ICD-HHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90483","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","description":"CPT-90483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0638U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0638U","description":"CPT-0638U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD0","description":"ICD-ECUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD1","description":"ICD-OBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA1","description":"ICD-NAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot s total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85305","description":"Clot inhibit prot s total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF0","description":"ICD-FIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD1","description":"ICD-EBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc lymphatic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38589","description":"Laparoscope proc lymphatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC1","description":"ICD-HCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90645","description":"Hemophilus influenza b vaccine (hib)_ hboc conjugate (4 dose schedule)_for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE0","description":"ICD-OEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1401","description":"HCPCS-B1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE1","description":"ICD-KIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast hi noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2780","description":"Crown 3/4 cast hi noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96116","description":"Neurobehavioral status exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF1","description":"ICD-BGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE0","description":"ICD-IHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD0","description":"ICD-NLFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90584","description":"Dengue vaccine_ quadrivalent_ live_ 2 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9593","description":"Gallium ga-68 psma-11_ diagnostic_ (ucsf)_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHC1","description":"ICD-CIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Max sterile barriers flwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6030F","description":"Max sterile barriers flwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB1","description":"ICD-ADTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE1","description":"ICD-CIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD1","description":"ICD-PCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGC1","description":"ICD-CCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic therapy stroke","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37195","description":"Thrombolytic therapy stroke","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD241","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB0","description":"ICD-KIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIA0","description":"ICD-EDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB150","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD1","description":"ICD-GAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28A","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD0","description":"ICD-DARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE1","description":"ICD-CHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quantalcohols","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80320","description":"Drug screen quantalcohols","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23470","description":"Reconstruct shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp unt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7629","description":"Bitolterol mesylate comp unt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE1","description":"ICD-CCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appl multlay comprs arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29584","description":"Appl multlay comprs arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0570T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Each Additional Prosthesis During Same Session (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0487","description":"Electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy hamstring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27325","description":"Neurectomy hamstring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC1","description":"ICD-EETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2 contents gas cubic ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8120","description":"O2 contents gas cubic ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF1","description":"ICD-NEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93926","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIC0","description":"ICD-CIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC0","description":"ICD-CGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum/swg pha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5830","description":"Endo knee-shin pneum/swg pha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBE0","description":"ICD-KEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of quinidine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80194","description":"Assay of quinidine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHC0","description":"ICD-MAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE1","description":"ICD-KIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construct bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51980","description":"Construct bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5144","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","description":"HCPCS-Q5144","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDD0","description":"ICD-IHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOC0","description":"ICD-LAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC1","description":"ICD-GCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8G","description":"Medium Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dispos cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0500","description":"Dispos cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD0","description":"ICD-ODCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVE0","description":"ICD-CGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE1","description":"ICD-FAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37273","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","description":"CPT-37273","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair wrist joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25447","description":"Repair wrist joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF0","description":"ICD-HCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML56","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99475","description":"Ped crit care age 2-5 init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA0","description":"ICD-EAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQC1","description":"ICD-HAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD1","description":"ICD-BFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB0","description":"ICD-EIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part hand myo exclu term dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6026","description":"Part hand myo exclu term dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA1","description":"ICD-MBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBE0","description":"ICD-IEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF1","description":"ICD-ICEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA1","description":"ICD-PLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oct brst/node i&r per spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352T","description":"Oct brst/node i&r per spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"E-Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4318","description":"E-Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA1","description":"ICD-FFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATE1","description":"ICD-MATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF1","description":"ICD-OHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg scrn dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3351F","description":"Neg scrn dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA1","description":"ICD-JEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC0","description":"ICD-LDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND0","description":"ICD-BDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA1","description":"ICD-CCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2400","description":"Chloroprocaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC11","description":"ICD-1CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB1","description":"ICD-DHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0602","description":"HCPCS-A0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0426","description":"Inpt/ed teleconsult50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0843T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ initial site (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTF0","description":"ICD-FCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1107","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69552","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHB0","description":"ICD-IBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Theraskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4121","description":"Theraskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE0","description":"ICD-CIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSB1","description":"ICD-CHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA1","description":"ICD-ODXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7627","description":"Budesonide comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF0","description":"ICD-NHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE0","description":"ICD-GBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB1","description":"ICD-KGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carmustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9050","description":"Carmustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip canad sing axi cons fric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5250","description":"Hip canad sing axi cons fric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57130","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA1","description":"ICD-OBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID0","description":"ICD-NBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJC0","description":"ICD-KCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pt care icu/vent in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4169F","description":"No pt care icu/vent in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0683T","description":"Programming Device Evaluation (In-Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52356","description":"Cysto/uretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB1","description":"ICD-IGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA0","description":"ICD-FGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation vad in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93750","description":"Interrogation vad in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC134","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD0","description":"ICD-CEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pm generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33233","description":"Removal of pm generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB1","description":"ICD-CECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37287","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","description":"CPT-37287","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED1","description":"ICD-GCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB0","description":"ICD-AHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWD1","description":"ICD-OKWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE0","description":"ICD-FBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEF0","description":"ICD-GEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB0","description":"ICD-IGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE0","description":"ICD-OADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF1","description":"ICD-FFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE1","description":"ICD-LCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC110","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25526","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal hysteresis deter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92145","description":"Corneal hysteresis deter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC0","description":"ICD-AGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retrograde filling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3430","description":"Retrograde filling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID0","description":"ICD-EGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2087","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 60 Minutes In A Subsequent Calendar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCA1","description":"ICD-GFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUB1","description":"ICD-CAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0951T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","description":"CPT-0951T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening tapentadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80372","description":"Drug screening tapentadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","description":"CPT-00740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA1","description":"ICD-GBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED1","description":"ICD-JDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylenedioxyamphetamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80359","description":"Methylenedioxyamphetamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture othr specimn aerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87070","description":"Culture othr specimn aerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVA0","description":"ICD-KFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB0","description":"ICD-DFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF1","description":"ICD-CIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC1","description":"ICD-EACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE1","description":"ICD-IGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC0","description":"ICD-CBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE1","description":"ICD-OFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF1","description":"ICD-BDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75561","description":"Cardiac MRI for morph w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA0","description":"ICD-GEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE1","description":"ICD-MBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA1","description":"ICD-KHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYE0","description":"ICD-PEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0967T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","description":"CPT-0967T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC0","description":"ICD-IDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB0","description":"ICD-GCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64625","description":"Radiofrequency Ablation_ Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray aorta leg arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75630","description":"X-ray aorta leg arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rsa lower extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0350T","description":"Rsa lower extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE0","description":"ICD-KFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1110","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITB1","description":"ICD-KITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD0","description":"ICD-GCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC0","description":"ICD-EGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC0","description":"ICD-OCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lifts elevation metal extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3330","description":"Lifts elevation metal extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/bone grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21408","description":"Opn tx orbit fx w/bone grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC0","description":"ICD-BBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311U","description":"Infectious disease (bacterial)_ quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELF1","description":"ICD-MELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC0","description":"ICD-ODFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc taa repr incl subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33880","description":"Endovasc taa repr incl subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF0","description":"ICD-CCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD126","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB0","description":"ICD-OARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient progr_ neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1787","description":"Patient progr_ neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD1","description":"ICD-KBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF0","description":"ICD-LFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIB0","description":"ICD-KCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC1","description":"ICD-OKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQF0","description":"ICD-GFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing care_ in the home; b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9124","description":"Nursing care_ in the home; b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD0","description":"ICD-GBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC1","description":"ICD-NCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB1","description":"ICD-NHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0C","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/o implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21406","description":"Opn tx orbit fx w/o implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6027","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); diagnostic_ including collection of specimen(s) by brushing or washing when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA1","description":"ICD-GHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOF1","description":"ICD-PEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ldr prostate brachy comp rat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0458","description":"Ldr prostate brachy comp rat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96380","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection_ with counseling by physician or other qualified health care profe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66682","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC0","description":"ICD-GFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA0","description":"ICD-NJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27570","description":"Fixation of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE0","description":"ICD-AEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7509","description":"Bronchoscopy_ rigid or flexible_ diagnostic with cell washing(s) when performed_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose monitor home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0607","description":"Blood glucose monitor home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv sr wire occ/man pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0160","description":"Cerv sr wire occ/man pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no statin med disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8817","description":"Doc reas no statin med disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"U1 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2365","description":"U1 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat dental ridge fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21445","description":"Treat dental ridge fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise pharynx lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42808","description":"Excise pharynx lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a doula birth worker_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1033","description":"Services performed by a doula birth worker_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/ove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2206","description":"Lens sphcy bifocal 4.00d/ove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49614","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81322","description":"Pten gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB0","description":"ICD-OFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prednisone_ oral_ per 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7506","description":"Prednisone_ oral_ per 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0011","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50360","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYA1","description":"ICD-GAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2021","description":"Injection_ linezolid (hospira) not therapeutically equivalent to j2020_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9583","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE1","description":"ICD-ADAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0787T","description":"Revision or removal of neurostimulator electrode array_ sacral_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57530","description":"Removal of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0532","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","description":"HCPCS-G0532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLC0","description":"ICD-MFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","description":"CPT-00470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel pad & depress for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3480","description":"Shoe heel pad & depress for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red cell survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78135","description":"Red cell survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0095U","description":"Inflamation (eosinophilic esophagitis)_ ELISA analysis of eotaxin-3 (CCL26 [C-C motif chemokine ligand 26]) and major basic protein (PRG2 [proteoglycan 2_ pro eosinophil major","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF1","description":"ICD-HHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE1","description":"ICD-IBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD1","description":"ICD-ICBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45388","description":"Colonoscopy w/ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8428","description":"Ready gradient gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tenecteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3101","description":"Tenecteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rep perf anoper fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46715","description":"Rep perf anoper fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC0","description":"ICD-KDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF0","description":"ICD-FCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386U","description":"Gastroenterology (Barrett’s esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 methylation analysis_ prognostic and predictive algorithm reported as a risk score for progression to high-g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavyduty/wide commode chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0168","description":"Heavyduty/wide commode chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE0","description":"ICD-MFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHE1","description":"ICD-IDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHF1","description":"ICD-NBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC1","description":"ICD-MIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB45","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC0","description":"ICD-CDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF0","description":"ICD-FDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection torsemide 10 mg/ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3265","description":"Injection torsemide 10 mg/ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC1","description":"ICD-FGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0702","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0702","description":"CDT-D0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33513","description":"Cabg vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA1","description":"ICD-EATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB0","description":"ICD-KGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAB0","description":"ICD-MGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTB1","description":"ICD-NHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE0","description":"ICD-LAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF0","description":"ICD-JICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abduct control hip semi-flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1630","description":"Abduct control hip semi-flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy c/th facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64634","description":"Destroy c/th facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto w/ureter stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52341","description":"Cysto w/ureter stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0401U","description":"Cardiology (coronary heart disease [CAD])_ 9 genes (12 variants)_ targeted variant genotyping_ blood_ saliva_ or buccal swab_ algorithm reported as a genetic risk score for a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEA0","description":"ICD-KEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA0","description":"ICD-JIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ bupivacaine liposome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9290","description":"Inj_ bupivacaine liposome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXB0","description":"ICD-OAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC1","description":"ICD-KFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph scope w/sclerosis inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43204","description":"Esoph scope w/sclerosis inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB0","description":"ICD-KHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF0","description":"ICD-ODGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0322","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e._ remote patient monitoring)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC0","description":"ICD-IGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE0","description":"ICD-LHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE1","description":"ICD-OFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXF0","description":"ICD-KFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl pt no el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8665","description":"Fun stat score shdl pt no el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB0","description":"ICD-DBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPE0","description":"ICD-CBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAA1","description":"ICD-AIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/maint cont hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4890","description":"Repair/maint cont hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit interim cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5502","description":"Hit interim cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch to home by day#7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8818","description":"Pt disch to home by day#7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA0","description":"ICD-KGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy rem totl cortex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32652","description":"Thoracoscopy rem totl cortex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8841","description":"No sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no compl antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9300","description":"Doc medrsn no compl antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473U","description":"Oncology (solid tumor)_ next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont insulin diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9353","description":"Hit cont insulin diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92511","description":"Nasopharyngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rehabilitative support for musculoskeletal care mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1370","description":"Rehabilitative support for musculoskeletal care mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD1","description":"ICD-GHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/biopsy eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67400","description":"Explore/biopsy eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostatic microwave thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53850","description":"Prostatic microwave thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Access thoracic lymph duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38794","description":"Access thoracic lymph duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC0","description":"ICD-OIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CaregraFT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4322","description":"CaregraFT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF1","description":"ICD-PDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD1","description":"ICD-CHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42405","description":"Biopsy of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC1","description":"ICD-NGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE0","description":"ICD-FGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PalinGen or PalinGen XPlus_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4173","description":"PalinGen or PalinGen XPlus_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC0","description":"ICD-MEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1339","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0028","description":"Documentation Of Medical Reason(S) For Not Screening For Tobacco Use (E.G._ Limited Life Expectancy_ Other Medical Reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Co-morbid condition assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1026F","description":"Co-morbid condition assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC0","description":"ICD-GBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB1","description":"ICD-FDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC0","description":"ICD-ECUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB0","description":"ICD-GIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE1","description":"ICD-KAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF1","description":"ICD-GGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDME0","description":"ICD-GDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF0","description":"ICD-KDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD1","description":"ICD-FFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUC0","description":"ICD-BCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE1","description":"ICD-FAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96547","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; first 60 minutes (List separately in ad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF0","description":"ICD-JCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_ transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0087U","description":"Cardiology (heart transplant)_ mRNA gene expression profiling by microarray of 1283 genes_ transplant biopsy tissue_ allograft rejection and injury algorithm reported as a pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61140","description":"Pierce skull for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj multihance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9577","description":"Inj multihance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALD1","description":"ICD-GALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pralidoxime chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2730","description":"Pralidoxime chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC1","description":"ICD-NAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2192","description":"Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFA0","description":"ICD-GGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC0","description":"ICD-GEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD1","description":"ICD-OJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLD0","description":"ICD-JHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Double transfer toe-hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26554","description":"Double transfer toe-hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3A","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF0","description":"ICD-EIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film >16<=48 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6258","description":"Transparent film >16<=48 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA1","description":"ICD-CBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0007","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD225","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2054","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gtt-added samples","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82952","description":"Gtt-added samples","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Handgrip for cane etc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4636","description":"Handgrip for cane etc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFA0","description":"ICD-BIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLD1","description":"ICD-IBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKF0","description":"ICD-NEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWB1","description":"ICD-GEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD0","description":"ICD-NBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD0","description":"ICD-OKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate (hope)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0209","description":"Injection_ sodium thiosulfate (hope)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2076","description":"Intake Activities_ Including Initial Medical Examination That Is A Complete_ Fully Documented Physical Evaluation And Initial Assessment By A Program Physician Or A Primary Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE0","description":"ICD-CCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multipo locking shoulder jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6646","description":"Multipo locking shoulder jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB1","description":"ICD-GIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4337","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","description":"HCPCS-Q4337","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24310","description":"Revision of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Direct advanced life support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99288","description":"Direct advanced life support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF0","description":"ICD-JGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lev 1 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0380","description":"Lev 1 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJB0","description":"ICD-JAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC1","description":"ICD-CDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVF1","description":"ICD-NCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Set-Up Fees)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7335","description":"Community Transition Svcs (Set-Up Fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special eye exam initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92225","description":"Special eye exam initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA0","description":"ICD-BGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5B","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJD1","description":"ICD-GCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decoronation or submergence of an erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3921","description":"Decoronation or submergence of an erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting body mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7945","description":"Bone cutting body mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC1","description":"ICD-NDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQE0","description":"ICD-LFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4C","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33417","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSE1","description":"ICD-ODSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVF0","description":"ICD-JGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin copper sulfate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83026","description":"Hemoglobin copper sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD0","description":"ICD-NGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAA1","description":"ICD-CBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA0","description":"ICD-FINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte immune globulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7504","description":"Lymphocyte immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90684","description":"Pneumococcal conjugate vaccine_ 21 valent (PCV21)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC1","description":"ICD-IIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr stand fxd arm ft rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1130","description":"Whlchr stand fxd arm ft rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA0","description":"ICD-CBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAE1","description":"ICD-IFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Warfrn or othr antcog no rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8971","description":"Warfrn or othr antcog no rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB1","description":"ICD-CBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20D","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCA1","description":"ICD-JFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99192","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF0","description":"ICD-BDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF0","description":"ICD-CIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC204","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC201","description":"Reduced Physical Function _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE1","description":"ICD-EGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVE1","description":"ICD-BEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1121","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE136","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1150F","description":"Doc pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/bypass exten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33256","description":"Ablate atria w/bypass exten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB1","description":"ICD-IHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2012","description":"Brief communication technology-based service_ e.g._ virtual check-in_ by a physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME1","description":"ICD-AIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC0","description":"ICD-HIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC31","description":"ICD-3DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protein e-phoresis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84166","description":"Protein e-phoresis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA0","description":"ICD-ICAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF1","description":"ICD-MKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1300","description":"Whirlpool portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iop down <15% of pre-svc lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3285F","description":"Iop down <15% of pre-svc lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB41","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB205","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB0","description":"ICD-JIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE1","description":"ICD-GATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60254","description":"Extensive thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol response panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80415","description":"Estradiol response panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Water pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0187","description":"Water pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; first 30 minutes of patient face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0040","description":"Patient Already Receiving Physical/Occupational/Speech/Recreational Therapy During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILB0","description":"ICD-EILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSA1","description":"ICD-KBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvf assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3020F","description":"Lvf assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of tibia nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28035","description":"Decompression of tibia nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12015","description":"Rpr f/e/e/n/l/m 7.6-12.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7533","description":"Percutaneous transluminal coronary angioplasty_ single major coronary artery or branch with transcatheter placement of radiation delivery device for subsequent coronary intrav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC1","description":"ICD-PGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99201","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesiolysis tube ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58740","description":"Adhesiolysis tube ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73615","description":"Contrast x-ray of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC13","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML54","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHD1","description":"ICD-KEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61531","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHE1","description":"ICD-CIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73620","description":"X-ray exam of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYE1","description":"ICD-CCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31237","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA1","description":"ICD-BEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD1","description":"ICD-ICHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBE1","description":"ICD-BIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove intra-aortic balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33974","description":"Remove intra-aortic balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attached to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0920","description":"Fracture frame attached to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHF1","description":"ICD-EEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF1","description":"ICD-FCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22325","description":"Treat spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB1","description":"ICD-NFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCC1","description":"ICD-KCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove collar bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23180","description":"Remove collar bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF1","description":"ICD-CASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5180","description":"Hearing aid_ CROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3A","description":"Default_ /PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC1","description":"ICD-CAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA1","description":"ICD-GIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME0","description":"ICD-OKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC0","description":"ICD-BDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA1","description":"ICD-IEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE0","description":"ICD-MDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB0","description":"ICD-LDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69633","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC1","description":"ICD-JHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB1","description":"ICD-EFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF0","description":"ICD-JCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0580U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","description":"CPT-0580U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open aortofemor prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34832","description":"Open aortofemor prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA1","description":"ICD-CFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD1","description":"ICD-PDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88160","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mohs surg addl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17315","description":"Mohs surg addl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1136","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA1","description":"ICD-BFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFF0","description":"ICD-BIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nutrition/Dietician Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4017","description":"Nutrition/Dietician Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61892","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Belt/vest elec/combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0499","description":"Belt/vest elec/combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58150","description":"Total hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB1","description":"ICD-JIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove mandible cyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21046","description":"Remove mandible cyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Yersinia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86793","description":"Yersinia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE0","description":"ICD-OEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHA0","description":"ICD-NIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD220","description":"Clinically Complex _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar wedge ro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3400","description":"Shoe metatarsal bar wedge ro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq sacral augmt bilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201T","description":"Perq sacral augmt bilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5171","description":"Hearing aid_ contralateral routing device_ monaural_ in the ear (ITE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB1","description":"ICD-MELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQA1","description":"ICD-CDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTC0","description":"ICD-EFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA1","description":"ICD-NLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB14","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abciximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0130","description":"Abciximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54385","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXD0","description":"ICD-FAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD0","description":"ICD-FIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA0","description":"ICD-EEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD0","description":"ICD-NFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esano ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4274","description":"Esano ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMC1","description":"ICD-BBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9362","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9362","description":"HCPCS-J9362","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC0","description":"ICD-PHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC1","description":"ICD-NDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1458","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","description":"HCPCS-M1458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUB1","description":"ICD-JEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92603","description":"Cochlear implt f/up exam 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVF1","description":"ICD-NDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27427","description":"Reconstruction knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE0","description":"ICD-CHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC0","description":"ICD-BCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE1","description":"ICD-OFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEF0","description":"ICD-CBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmnioArmor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4188","description":"AmnioArmor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acute gi blood loss imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78278","description":"Acute gi blood loss imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74022","description":"Radiologic examination_ abdomen; complete acute abdomen series_ including supine_ erect_ and/or decubitus views_ single view chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC0","description":"ICD-IADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPC0","description":"ICD-GAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA60","description":"Default_ /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30450","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01444","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","description":"CPT-01444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE0","description":"ICD-NHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Internal eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92287","description":"Internal eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0503U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","description":"CPT-0503U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fungi identification yeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87106","description":"Fungi identification yeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens spher single plano 4.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2100","description":"Lens spher single plano 4.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I&d p-spine c/t/cerv-thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22010","description":"I&d p-spine c/t/cerv-thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA36","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD1","description":"ICD-FDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462U","description":"Melatonin levels test_ sleep study_ 7 or 9 sample melatonin profile (cortisol optional)_ enzyme-linked immunosorbent assay (ELISA)_ saliva_ screening/preliminary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB1","description":"ICD-JGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance (eg_ vibration) elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76391","description":"Magnetic resonance (eg_ vibration) elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevating whlchair leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0195","description":"Elevating whlchair leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE1","description":"ICD-GEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRC1","description":"ICD-GBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB1","description":"ICD-GBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9630","description":"No vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD0","description":"ICD-GAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBED1","description":"ICD-FBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23076","description":"Exc shoulder tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC0","description":"ICD-PEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triptorelin_ extended-release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3316","description":"Injection_ triptorelin_ extended-release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC0","description":"ICD-PBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBB0","description":"ICD-FCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77772","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA44","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB1","description":"ICD-ACEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC1","description":"ICD-AEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0391U","description":"Oncology (solid tumor)_ DNA and RNA by next-generation sequencing_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_ 437 genes_ interpretive report for single nucleoti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB0","description":"ICD-MIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33503","description":"Coronary artery graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPA1","description":"ICD-CDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF0","description":"ICD-BITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLC0","description":"ICD-NDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC1","description":"ICD-OAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81211","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie_ ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE0","description":"ICD-JBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB1","description":"ICD-OCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0565U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","description":"CPT-0565U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal sperm detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89321","description":"Semen anal sperm detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFA0","description":"ICD-OIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant from hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26320","description":"Removal of implant from hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA0","description":"ICD-GEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38381","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF1","description":"ICD-BCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6088","description":"Implant Supported Crown - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adlt disp und/pull on abv xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4544","description":"Adlt disp und/pull on abv xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEME1","description":"ICD-NEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45120","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6980","description":"Bridge repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE1","description":"ICD-DFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA1","description":"ICD-GAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary bladder retention","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78730","description":"Urinary bladder retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete ivf nos case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4015","description":"Complete ivf nos case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1050T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1050T","description":"CPT-1050T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA21","description":"ICD-3KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-2a inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9213","description":"Interferon alfa-2a inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI fetal ea addl gestation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74713","description":"MRI fetal ea addl gestation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEC1","description":"ICD-AEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66625","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr convex <=4 sq i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4409","description":"Ost skn barr convex <=4 sq i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE1","description":"ICD-EEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0645T","description":"Transcatheter implantation of coronary sinus reduction device including vascular access and closure_ right heart catheterization_ venous angiography_ coronary sinus angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCE1","description":"ICD-NFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF0","description":"ICD-GIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexmedetomidine_ oral_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1105","description":"Dexmedetomidine_ oral_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB1","description":"ICD-JAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - bitewing radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0708","description":"Intraoral - bitewing radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frame depth less than 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2203","description":"Frame depth less than 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24D","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28820","description":"Amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD0","description":"ICD-GDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA1","description":"ICD-KAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hm gest dm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9214","description":"Hm gest dm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD1","description":"ICD-IIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22838","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracic vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97154","description":"Group adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC1","description":"ICD-HISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB1","description":"ICD-ACTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35539","description":"Art byp grft aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1052T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1052T","description":"CPT-1052T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB03","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1370","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","description":"HCPCS-J1370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE0","description":"ICD-BAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPE1","description":"ICD-KCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8G","description":"Low Rehab_ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Humate-p_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7187","description":"Humate-p_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg & 1 cast chg ak/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5420","description":"Postop dsg & 1 cast chg ak/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA1","description":"ICD-ECLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27590","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB0","description":"ICD-CEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF0","description":"ICD-GHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD0","description":"ICD-NJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inner ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69949","description":"Inner ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD0","description":"ICD-NJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB31","description":"ICD-3AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA0","description":"ICD-BEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTA0","description":"ICD-BGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD1","description":"ICD-OJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA1","description":"ICD-NBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTA0","description":"ICD-KDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47630","description":"Biliary duct stone extraction_ percutaneous via t-tube tract_ basket_ o snare (eg_ burhenne technique)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63082","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22869","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without open decompression or fusion_ including image guidance when performed_ lumbar; single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD1","description":"ICD-NBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD105","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 16 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNF1","description":"ICD-OGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice long term care_ r&b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2046","description":"Hospice long term care_ r&b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0488U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","description":"CPT-0488U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME1","description":"ICD-CEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC1","description":"ICD-OKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCF0","description":"ICD-NLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHME0","description":"ICD-FHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE1","description":"ICD-JALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB1","description":"ICD-HDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA1","description":"ICD-CFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB104","description":"Special Care High _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA1","description":"ICD-NKPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breath test analysis c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78268","description":"Breath test analysis c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA1","description":"ICD-ODEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80332","description":"Antidepressants class 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta non esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0888","description":"Epoetin beta non esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF1","description":"ICD-KACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE0","description":"ICD-GHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nitrogen n-13 ammonia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9526","description":"Nitrogen n-13 ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29806","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF1","description":"ICD-CIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81323","description":"Pten gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPD1","description":"ICD-FAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD1","description":"ICD-KAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA1","description":"ICD-KBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce radius and ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25492","description":"Reinforce radius and ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40761","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB1","description":"ICD-GENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE0","description":"ICD-GIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB0","description":"ICD-GHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7023","description":"Mechanical allergen particle barrier/inhalation filter_ cream_ nasal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide Injectable_ Camcevi_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1952","description":"Leuprolide Injectable_ Camcevi_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXD1","description":"ICD-KGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDC0","description":"ICD-CIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD1","description":"ICD-BETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKF0","description":"ICD-OHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC126","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder flexion-abduction j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6645","description":"Shoulder flexion-abduction j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF0","description":"ICD-NKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0064U","description":"Antibody_ Treponema pallidum_ total and rapid plasma reagin (RPR)_ immunoassay_ qualitativ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a chlamydia screening test with proper follow-up","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9820","description":"Documentation of a chlamydia screening test with proper follow-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME1","description":"ICD-MDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy care kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4629","description":"Tracheostomy care kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF0","description":"ICD-OGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","description":"HCPCS-J1299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKD1","description":"ICD-OKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE1","description":"ICD-JCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3807","description":"Whfo w/o joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted e&m service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99499","description":"Unlisted e&m service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUA1","description":"ICD-OGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra over 3l diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9377","description":"Hit hydra over 3l diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC0","description":"ICD-KIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE1","description":"ICD-OGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB1","description":"ICD-FBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA0","description":"ICD-NHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC146","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of methemalbumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83857","description":"Assay of methemalbumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ trunk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0677","description":"Non-pneumatic sequential compression garment_ trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA0","description":"ICD-GAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1174","description":"Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84702","description":"Chorionic gonadotropin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGB1","description":"ICD-NBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for the same high-risk medications not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9638","description":"At least two orders for the same high-risk medications not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43252","description":"Egd optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ublituximab-xiiy_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2329","description":"Injection_ ublituximab-xiiy_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXE0","description":"ICD-CBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD1","description":"ICD-CIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCF1","description":"ICD-MFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA20","description":"Very High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC0","description":"ICD-MCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36260","description":"Insertion of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED1","description":"ICD-OHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electromagntic tx for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0329","description":"Electromagntic tx for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBB1","description":"ICD-MCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF1","description":"ICD-DBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF0","description":"ICD-EGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64784","description":"Remove nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor ii prothrom spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85210","description":"Clot factor ii prothrom spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC0","description":"ICD-GGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC1","description":"ICD-EAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSC0","description":"ICD-DGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE0","description":"ICD-CBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2109","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOB0","description":"ICD-HBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68040","description":"Treatment of eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA1","description":"ICD-CGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23031","description":"Drain shoulder bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8666","description":"Fun stat score shdl not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA126","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB1","description":"ICD-JBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF0","description":"ICD-FDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CYTOMEGALOVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87332","description":"IAAD IA CYTOMEGALOVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80376","description":"Drug/substance nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE0","description":"ICD-PIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AA21","description":"ICD-2AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0826","description":"Pwc gp 2 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy_ in the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9129","description":"Occupational therapy_ in the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB1","description":"ICD-EHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA0","description":"ICD-FGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF0","description":"ICD-FFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD1","description":"ICD-KDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC1","description":"ICD-AFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD0","description":"ICD-BHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant hormone pellet(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11980","description":"Implant hormone pellet(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB0","description":"ICD-MCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDE0","description":"ICD-BBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOA1","description":"ICD-OBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain blood from under nail","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11740","description":"Drain blood from under nail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tb test cell immun measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86480","description":"Tb test cell immun measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD1","description":"ICD-KIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73702","description":"Ct lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incid ct liver/kid/adre fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9547","description":"Incid ct liver/kid/adre fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE0","description":"ICD-OLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB1","description":"ICD-OHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meperidine hydrochl /100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2175","description":"Meperidine hydrochl /100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE0","description":"ICD-BABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB1","description":"ICD-EGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide intestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74355","description":"X-ray guide intestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection alemtuzumab 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9979","description":"Injection alemtuzumab 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE0","description":"ICD-KBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC1","description":"ICD-FGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMF0","description":"ICD-EFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pne not given norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9280","description":"Pne not given norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA1","description":"ICD-MDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC0","description":"ICD-MJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC11","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92986","description":"Revision of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB1","description":"ICD-ABCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indirect immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0483","description":"Indirect immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81107","description":"Human Platelet Antigen 3 genotyping (HPA-3)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex]_ antigen CD41 [GPIIb]) (eg_ neonatal alloimmune thrombo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE1","description":"ICD-JBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092U","description":"Oncology (lung)_ three protein biomarkers_ immunoassay using magnetic nanosensor technology_ plasma_ algorithm reported as risk score for likelihood of malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","description":"HCPCS-L6032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC1","description":"ICD-FDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID0","description":"ICD-CAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient education materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99071","description":"Patient education materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB230","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF0","description":"ICD-JGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE0","description":"ICD-MHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62281","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7318","description":"Hyaluronan (sodium hyaluronate) or derivative_ durolane_ intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB217","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRB0","description":"ICD-PCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1103","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21610","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQF0","description":"ICD-CEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legionella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86713","description":"Legionella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF0","description":"ICD-NAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sildenafil citrate_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0090","description":"Sildenafil citrate_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD0","description":"ICD-ICAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","description":"HCPCS-M1400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9892","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA0","description":"ICD-IFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD0","description":"ICD-FBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facial replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5929","description":"Facial replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD1","description":"ICD-KCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGB1","description":"ICD-GEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC1","description":"ICD-HAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost be/wd_ ultlite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7400","description":"Add ue prost be/wd_ ultlite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGC0","description":"ICD-FCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF0","description":"ICD-BDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4052F","description":"Hemodialysis via av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64051","description":"Anesth spine manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped dynamic seating frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2295","description":"Ped dynamic seating frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244T","description":"Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0799","description":"Fda approved prescription drug_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove carotid body lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60605","description":"Remove carotid body lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0873","description":"Injection_ daptomycin (xellia) not therapeutically equivalent to j0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43882","description":"Revise/remove electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC0","description":"ICD-BFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26750","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD1","description":"ICD-FDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD0","description":"ICD-DFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27284","description":"Fusion of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test socket hemipelvectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5628","description":"Test socket hemipelvectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB0","description":"ICD-OEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucose monitor platforms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4255","description":"Glucose monitor platforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC60","description":"Very High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Islet cell antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86341","description":"Islet cell antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for 6 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1134F","description":"Epsd bk pain for 6 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE1","description":"ICD-CAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD0","description":"ICD-GGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gabapentin non-blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80355","description":"Gabapentin non-blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSE1","description":"ICD-GHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE0","description":"ICD-GFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQF0","description":"ICD-LCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surg redct fibrous tuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7972","description":"Surg redct fibrous tuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quality care in mental health and substance use disorders mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1369","description":"Quality care in mental health and substance use disorders mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB0","description":"ICD-GHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy unspecified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96549","description":"Chemotherapy unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87526","description":"Hepatitis g dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biological materials","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3431","description":"Biological materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93460","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC0","description":"ICD-CFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE0","description":"ICD-MKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX03","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xii hageman","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85280","description":"Clot factor xii hageman","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9997","description":"Documentation Of Patient Pregnancy Anytime During The Measurement Period Prior To And Including The Current Encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14C","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guided tiss regen resorble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4266","description":"Guided tiss regen resorble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10004","description":"Fine needle aspiration biopsy_ without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSF1","description":"ICD-DBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF0","description":"ICD-CBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB1","description":"ICD-JDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3357","description":"Ustekinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2180","description":"Clinician documented that patient was not an eligible candidate for evaluation of footwear as patient is bilateral lower extremity amputee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft great toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20973","description":"Bone/skin graft great toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98984","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","description":"CPT-98984","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open nasoethmoid fx w/o fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21338","description":"Open nasoethmoid fx w/o fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA0","description":"ICD-GDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv flex n/adj foam pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0120","description":"Cerv flex n/adj foam pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84234","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6011","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95708","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE0","description":"ICD-OCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB1","description":"ICD-NETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8932","description":"Mra_ w/o dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF1","description":"ICD-BDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast gap flap reconst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2066","description":"Breast gap flap reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE1","description":"ICD-ODBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove intrvas foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37197","description":"Remove intrvas foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED0","description":"ICD-AEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7540","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator_ dual lead system_ with insertion of pacing electrode_ cardiac venous system_ for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA1","description":"ICD-CEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust elbow ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1800","description":"Adjust elbow ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB0","description":"ICD-NEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIF1","description":"ICD-MIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glucarpidase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9293","description":"Injection_ glucarpidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01682","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","description":"CPT-01682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9524","description":"I131 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA0","description":"ICD-OHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA24D","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC1","description":"ICD-NFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81189","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE1","description":"ICD-JEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJE1","description":"ICD-FGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Bezlotoxumab 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9490","description":"Injection Bezlotoxumab 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC1","description":"ICD-IBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC1","description":"ICD-OHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC1","description":"ICD-KIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE1","description":"ICD-GERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC1","description":"ICD-FDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD134","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE1","description":"ICD-DISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC1","description":"ICD-FDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAC0","description":"ICD-NGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inclisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1306","description":"Injection_ inclisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC1","description":"ICD-GBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017M","description":"Oncology (Diffuse Large B-Cell Lymphoma [Dlbcl])_ Mrna_ Gene Expression Profiling By Fluorescent Probe Hybridization Of 20 Genes_ Formalin-Fixed Paraffin-Embedded Tissue_ Algo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40800","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62324","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","description":"CPT-76016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8618","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99220","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB0","description":"ICD-NINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLB1","description":"ICD-OGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMA0","description":"ICD-JGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6456","description":"Zinc paste band w >=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27357","description":"Remove femur lesion/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tiss ex molecul study add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88388","description":"Tiss ex molecul study add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36901","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig; scrn clin dep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8433","description":"Pt inelig; scrn clin dep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA1","description":"ICD-BDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18X","description":"Clinically Complex _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23540","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids quan 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82139","description":"Amino acids quan 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3572F","description":"Pt consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKC0","description":"ICD-BBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp screen mammogram add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77052","description":"Comp screen mammogram add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC1","description":"ICD-OBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis auto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81003","description":"Urinalysis auto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC0","description":"ICD-JBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUF0","description":"ICD-KGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82626","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND1","description":"ICD-NLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1604","description":"HCPCS-A1604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78609","description":"Brain imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg3/4 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9115","description":"Onc dx ovarian stg3/4 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB0","description":"ICD-IBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21255","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0883T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIA0","description":"ICD-MLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endocrine nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78099","description":"Endocrine nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX17","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA1","description":"ICD-BFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis west eqne antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86654","description":"Encephaltis west eqne antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate liver cryosurg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47371","description":"Laparo ablate liver cryosurg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of pyloric muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43520","description":"Incision of pyloric muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD1","description":"ICD-PIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC1","description":"ICD-GFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA205","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAB1","description":"ICD-KBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044U","description":"Tick-borne relapsing fever Borrelia group_ antibody detection to 4 recombinant protein groups_ by immunoblot_ IgG","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC0","description":"ICD-BDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225U","description":"NFCT DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ptrsn no gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9229","description":"Ptrsn no gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE1","description":"ICD-BGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBA0","description":"ICD-KFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE121","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE1","description":"ICD-JFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB0","description":"ICD-GIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMB0","description":"ICD-FHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBE1","description":"ICD-FDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12057","description":"Intmd rpr face/mm >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC0","description":"ICD-KAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD1","description":"ICD-PESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0915T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","description":"CPT-0915T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calcium infusion test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82331","description":"Calcium infusion test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB1","description":"ICD-BGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA0","description":"ICD-NALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC1","description":"ICD-MLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXD0","description":"ICD-NHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE1","description":"ICD-FCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Front castr compl pneum tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0071","description":"Front castr compl pneum tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAF0","description":"ICD-MLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF1","description":"ICD-KGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERA0","description":"ICD-HERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn for gc chl syp test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9230","description":"Norsn for gc chl syp test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer water collec devic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7012","description":"Nebulizer water collec devic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF0","description":"ICD-OCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF0","description":"ICD-OCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7608","description":"Acetylcysteine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID1","description":"ICD-GEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC1","description":"ICD-PEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF1","description":"ICD-GBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee leather socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5642","description":"Above knee leather socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3105","description":"Terbutaline sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIA0","description":"ICD-IHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Circumcision w/regionl block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54150","description":"Circumcision w/regionl block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA0","description":"ICD-FHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9261","description":"Doc surv no stroke after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67975","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screen mammo doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3014F","description":"Screen mammo doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging limited area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78300","description":"Bone imaging limited area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA0","description":"ICD-FHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of hemorrhoid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46221","description":"Ligation of hemorrhoid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPB0","description":"ICD-FBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23145","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/o leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1171","description":"Wheelchair amputee w/o leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC11","description":"ICD-3KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81271","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC1","description":"ICD-CBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC0","description":"ICD-NKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEB1","description":"ICD-FFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tkr intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9234","description":"Tkr intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD1","description":"ICD-CIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODME0","description":"ICD-ODME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKD1","description":"ICD-OJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB0","description":"ICD-IGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF1","description":"ICD-DDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69645","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOF0","description":"ICD-HCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA1","description":"ICD-HFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC1","description":"ICD-OIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow molded w/ expand inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6205","description":"Elbow molded w/ expand inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28322","description":"Repair of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE1","description":"ICD-IBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Poliovirus ipv sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90713","description":"Poliovirus ipv sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA1","description":"ICD-PGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC0","description":"ICD-PJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0808T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (CT) ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abl1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81170","description":"Abl1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF0","description":"ICD-KETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA12","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB1","description":"ICD-OJKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWD0","description":"ICD-PCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nortriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6037","description":"Nortriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE1","description":"ICD-JGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF0","description":"ICD-CDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB1","description":"ICD-CEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27502","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5213","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4341","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23184","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC0","description":"ICD-BHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27323","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE0","description":"ICD-ABEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJF0","description":"ICD-NGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complement/function activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86161","description":"Complement/function activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2023","description":"Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ any specimen source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHB1","description":"ICD-IEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGF0","description":"ICD-GHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Six volt bat otto bock/eq ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7360","description":"Six volt bat otto bock/eq ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC0","description":"ICD-BADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB0","description":"ICD-GDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant nerve end","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64787","description":"Implant nerve end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trnslum dil eye canal w/stnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66175","description":"Trnslum dil eye canal w/stnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glassia injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0257","description":"Glassia injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETE1","description":"ICD-CETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise knuckle with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26531","description":"Revise knuckle with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF1","description":"ICD-CFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","description":"CPT-00190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49000","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD0","description":"ICD-NGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262U","description":"Oncology (solid tumor)_ gene expression profiling by real-time RT-PCR of 7 gene pathways (ER_ AR_ PI3K_ MAPK_ HH_ TGFB_ Notch)_ formalin-fixed paraffin-embedded (FFPE)_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC0","description":"ICD-IEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD0","description":"ICD-BCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer with compression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0570","description":"Nebulizer with compression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMA1","description":"ICD-CFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt reas no hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9453","description":"Pt reas no hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hook vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6706","description":"Term dev mech hook vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg2 no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9064","description":"Onc dx nsclc stg2 no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA1","description":"ICD-CEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE0","description":"ICD-MFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0431U","description":"Glycine receptor alpha1 IgG_ serum or cerebrospinal fluid (CSF)_ live cell-binding assay (LCBA)_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9047","description":"Albumin (human)_ 25%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4026","description":"Cast sup hip spica fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA141","description":"Clinically Complex _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0990T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","description":"CPT-0990T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC1","description":"ICD-KDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIC1","description":"ICD-MJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4044","description":"Cast sup lng leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seo mobile arm sup att to wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2626","description":"Seo mobile arm sup att to wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB106","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io anal gast n-stim subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95981","description":"Io anal gast n-stim subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE1","description":"ICD-FFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE1","description":"ICD-BGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF1","description":"ICD-IGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE0","description":"ICD-EBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication & fitting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2628","description":"Fabrication & fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC116","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB0","description":"ICD-LFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vanomycin dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87500","description":"Vanomycin dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt lithium 3.6 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0604","description":"Repl batt lithium 3.6 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICD1","description":"ICD-NICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC52","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bekesy audiometry diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92561","description":"Bekesy audiometry diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIF1","description":"ICD-GBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD1","description":"ICD-OIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supra SDRM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2011","description":"Supra SDRM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF0","description":"ICD-NIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facial moulage sectional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5911","description":"Facial moulage sectional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2135","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess cat in dbase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"7020F","description":"Mammo assess cat in dbase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of parathormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83970","description":"Assay of parathormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1503","description":"CDT-D1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care level rationale doc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6005F","description":"Care level rationale doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1055","description":"Aspirin or another antiplatelet therapy used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF1","description":"ICD-OGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCC1","description":"ICD-MBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9464","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27250","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE230","description":"Reduced Physical Function _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABF1","description":"ICD-IABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval appros surg thxpy epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5200F","description":"Eval appros surg thxpy epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release eye tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67343","description":"Release eye tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval amniotic fluid protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84112","description":"Eval amniotic fluid protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE144","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52051","description":"Anesth chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB1","description":"ICD-CAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43336","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF1","description":"ICD-BHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0672U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672U","description":"CPT-0672U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61686","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB1","description":"ICD-MIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPF1","description":"ICD-CIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0527U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","description":"CPT-0527U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA1","description":"ICD-EALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2220","description":"Lens bifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC0","description":"ICD-OCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC1","description":"ICD-DEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgh risk for thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3552F","description":"Hgh risk for thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB1","description":"ICD-GALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUC1","description":"ICD-GBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD1","description":"ICD-OHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late closure of wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13160","description":"Late closure of wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIE0","description":"ICD-MIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC1","description":"ICD-ICDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Hpc 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9986","description":"Injection Hpc 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64565","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89342","description":"Storage/year embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE0","description":"ICD-KAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Department of Veterans Affairs Whole Health Partner Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9004","description":"Department of Veterans Affairs Whole Health Partner Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC0","description":"ICD-GCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vc lesion scope/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31546","description":"Remove vc lesion scope/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic passive restor comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6360","description":"Thoracic passive restor comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA1","description":"ICD-LGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16374","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16374","description":"CPT-16374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78607","description":"Brain imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC1","description":"ICD-GIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biovance 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4154","description":"Biovance 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0806T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); open femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA1","description":"ICD-CGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB0","description":"ICD-MDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocollator unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0225","description":"Hydrocollator unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bypass graft patency/patch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35685","description":"Bypass graft patency/patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB0","description":"ICD-IEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB0","description":"ICD-OIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD1","description":"ICD-AAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0544T","description":"Transcatheter mitral valve annulus reconstruction_ with implantation of adjustable annulus reconstruction device_ percutaneous approach including transseptal puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA0","description":"ICD-CBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2806","description":"Injection_ sincalide (maia) not therapeutically equivalent to j2805_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD0","description":"ICD-OGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB205","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC1","description":"ICD-PFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE0","description":"ICD-BFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Misc vision item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2799","description":"Misc vision item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9191","description":"Pt reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE1","description":"ICD-NJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6794","description":"Crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36596","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB1","description":"ICD-IEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8911","description":"Pt doc no fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF0","description":"ICD-OKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clotting funct activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85397","description":"Clotting funct activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC1","description":"ICD-CEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB0","description":"ICD-KBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC210","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","description":"HCPCS-J9601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA0","description":"ICD-OJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB1","description":"ICD-OKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2387","description":"Foam filled caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE1","description":"ICD-GFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEA0","description":"ICD-IBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASC0","description":"ICD-GASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFB1","description":"ICD-KFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYA0","description":"ICD-CAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB0","description":"ICD-BGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB1","description":"ICD-BGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL56","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND0","description":"ICD-GBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392U","description":"Drug metabolism (depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ gene-drug interactions_ variant analysis of 16 genes_ including deletion/duplication an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF0","description":"ICD-BCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0511","description":"Rural health clinic or federally qualified health center (RHC or FQHC) only_ general care management_ 20 minutes or more of clinical staff time for chronic care management ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA0","description":"ICD-OIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA0","description":"ICD-BDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA0","description":"ICD-KGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA0","description":"ICD-FIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; unilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8904","description":"Magnetic resonance imaging without contrast_ breast; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCB0","description":"ICD-NBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA1","description":"ICD-FHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF0","description":"ICD-GBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4530","description":"Ped size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long tongue stirrup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2265","description":"Long tongue stirrup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCB1","description":"ICD-NLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB21","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elb mold sock flex hinge pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6100","description":"Elb mold sock flex hinge pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1826","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","description":"HCPCS-E1826","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA11","description":"ICD-3BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34151","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC0","description":"ICD-KEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUD0","description":"ICD-MDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA1","description":"ICD-FDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSC0","description":"ICD-HGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE0","description":"ICD-GBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF1","description":"ICD-EGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA0","description":"ICD-CIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part hand thumb rem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6000","description":"Part hand thumb rem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD0","description":"ICD-GIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD1","description":"ICD-BIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDF1","description":"ICD-CCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB15B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28086","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJC1","description":"ICD-OLJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3299","description":"Injection_ triamcinolone acetonide (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8D","description":"Medium Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQD1","description":"ICD-OBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC1","description":"ICD-FEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0646U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0646U","description":"CPT-0646U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX41","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF1","description":"ICD-EHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","description":"HCPCS-A9612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3B","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9062","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9062","description":"HCPCS-J9062","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTE1","description":"ICD-MDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSC1","description":"ICD-OCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD0","description":"ICD-FFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62200","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA23","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAE0","description":"ICD-NGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cine/vid x-ray throat/esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74230","description":"Cine/vid x-ray throat/esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25040","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49321","description":"Laparoscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84295","description":"Assay of serum sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69660","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQE0","description":"ICD-OBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescent antibody titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86256","description":"Fluorescent antibody titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD0","description":"ICD-OKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4132F","description":"No syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87555","description":"M.tuberculo dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA0","description":"ICD-AIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bls defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0384","description":"Bls defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVB0","description":"ICD-GFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21089","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHA0","description":"ICD-JDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0248","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring in the home or residence; this includes a beneficiary_s home that has been made provider","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anticoagulant mgmt subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99364","description":"Anticoagulant mgmt subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCA0","description":"ICD-JDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE1","description":"ICD-ICLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Performance Met: Multimodal Pain Management Was Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2148","description":"Performance Met: Multimodal Pain Management Was Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE0","description":"ICD-HBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tap block bi injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64488","description":"Tap block bi injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC0","description":"ICD-MDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC1","description":"ICD-FBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB0","description":"ICD-KCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD0","description":"ICD-FEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALD0","description":"ICD-FALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","description":"HCPCS-J2002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA0","description":"ICD-OAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB0","description":"ICD-IHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ppps_ initial visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0438","description":"Ppps_ initial visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD1","description":"ICD-OCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor immunohistochem/manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88360","description":"Tumor immunohistochem/manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC0","description":"ICD-HBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB0","description":"ICD-FGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC0","description":"ICD-LCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB0","description":"ICD-BAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTB1","description":"ICD-ECTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF1","description":"ICD-GEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF1","description":"ICD-HAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD0","description":"ICD-JFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAE1","description":"ICD-MHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hip prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27090","description":"Removal of hip prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRA1","description":"ICD-GFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAA0","description":"ICD-MEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHID0","description":"ICD-BHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE0","description":"ICD-GEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1448","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","description":"HCPCS-M1448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYF1","description":"ICD-PKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB117","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect face/scalp tum < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21015","description":"Resect face/scalp tum < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC0","description":"ICD-IHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD1","description":"ICD-KEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB0","description":"ICD-OKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home vent non-invasive inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0466","description":"Home vent non-invasive inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD0","description":"ICD-LCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAF0","description":"ICD-BDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vaginal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57415","description":"Remove vaginal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA1","description":"ICD-IFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electric wound treatment dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0769","description":"Electric wound treatment dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTF0","description":"ICD-FFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gross exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0472","description":"Gross exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA11","description":"ICD-4DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHC0","description":"ICD-CAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0477T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction_ technical analysis_ and result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC1","description":"ICD-MGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ spesolimab-sbzo_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1747","description":"Injection_ spesolimab-sbzo_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE1","description":"ICD-GEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0878","description":"Pwc gp4 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8532","description":"Clinician Documented That Patient Recevied Vascular Access Other Than Autogenous AV Fistula_ Reason not Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJC0","description":"ICD-BIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB0","description":"ICD-JFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1394","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","description":"HCPCS-M1394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTB0","description":"ICD-FHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA0","description":"ICD-JBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA0","description":"ICD-CAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64630","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE256","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain neck/chest lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21501","description":"Drain neck/chest lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC1","description":"ICD-NFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA1","description":"ICD-GDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD0","description":"ICD-CFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46260","description":"Remove in/ex hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE0","description":"ICD-DDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF1","description":"ICD-OEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLC1","description":"ICD-BBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB1","description":"ICD-JACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27265","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit wound care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9097","description":"Home visit wound care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOE1","description":"ICD-DGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB0","description":"ICD-AIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA1","description":"ICD-KIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA22","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHME1","description":"ICD-NHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC0","description":"ICD-GGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Induction of vomiting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99175","description":"Induction of vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fev >/=40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3042F","description":"Fev >/=40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0555","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","description":"HCPCS-G0555","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE1","description":"ICD-OCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE0","description":"ICD-FFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE1","description":"ICD-CHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1921","description":"Injection_ labetalol hydrochloride (hikma) not therapeutically equivalent to j1820_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0314","description":"Imm counseling by a physician or other qualified health care prof for COVID-19_ ages under 21_ 16-30 minutes time (This code is used for the Medicaid EPSDT)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0827","description":"Pwc gp vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD1","description":"ICD-GEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE0","description":"ICD-BAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA1","description":"ICD-OBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41899","description":"Dental surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34051","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD1","description":"ICD-KHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fracture assessment via dxa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77086","description":"Fracture assessment via dxa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJD0","description":"ICD-NBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC31","description":"ICD-3AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4047","description":"Cast sup sht leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0182","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AMNIOREPAIR or AltiPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4235","description":"AMNIOREPAIR or AltiPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB1","description":"ICD-KIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD1","description":"ICD-BCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up surgery of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66250","description":"Follow-up surgery of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE0","description":"ICD-PCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEE0","description":"ICD-EBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC46","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42182","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDC1","description":"ICD-EBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0526","description":"Management of established patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lev 3 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0382","description":"Lev 3 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF0","description":"ICD-BFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phleb veins - extrem 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37766","description":"Phleb veins - extrem 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHC0","description":"ICD-NGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26820","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA0","description":"ICD-LBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22902","description":"Exc abd les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE0","description":"ICD-CBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTA1","description":"ICD-FHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB0","description":"ICD-OEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE1","description":"ICD-BBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA0","description":"ICD-MAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSC0","description":"ICD-GFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sotrovimab_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0247","description":"Injection_ sotrovimab_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lobar lung transplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2060","description":"Lobar lung transplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43195","description":"Esophagoscopy rigid balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee joint cam lock each joi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2415","description":"Knee joint cam lock each joi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30160","description":"Removal of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohols biomarkers 1or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80321","description":"Alcohols biomarkers 1or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81402","description":"Mopath procedure level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFA0","description":"ICD-KIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath indw foley 2 way silicn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4344","description":"Cath indw foley 2 way silicn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC1","description":"ICD-NHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE0","description":"ICD-HAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE0","description":"ICD-JIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC0","description":"ICD-CFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB0","description":"ICD-ACIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE1","description":"ICD-OECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA0","description":"ICD-JDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF0","description":"ICD-BEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB0","description":"ICD-AFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA1","description":"ICD-GFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Support broker waiver/15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2041","description":"Support broker waiver/15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA0","description":"ICD-HGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nurse practr visit outs cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0274","description":"Nurse practr visit outs cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD1","description":"ICD-NFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAA1","description":"ICD-FHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3a no progre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9065","description":"Onc dx nsclc stg3a no progre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF1","description":"ICD-OKAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA1","description":"ICD-NGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTB0","description":"ICD-OBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6112","description":"Imp/abut rem dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC0","description":"ICD-EDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSA0","description":"ICD-LCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74270","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE156","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD0","description":"ICD-OECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55815","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBE1","description":"ICD-KFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9755","description":"Documentation of medical reason(s) that follow-up imaging is indicated (e.g._ patient has a known malignancy that can metastasize_ other medical reason(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOD1","description":"ICD-OCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE0","description":"ICD-BINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE1","description":"ICD-JAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diaper serv reusable diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4538","description":"Diaper serv reusable diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWF1","description":"ICD-PGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28760","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0733","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46607","description":"Diagnostic anoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB0","description":"ICD-GGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18F","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALF1","description":"ICD-CALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood viscosity examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85810","description":"Blood viscosity examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for non-ESRD use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0883","description":"Injection_ argatroban_ 1 mg (for non-ESRD use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol hepatic fream","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5200","description":"Parenteral sol hepatic fream","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin mnl lck ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5811","description":"Endo knee-shin mnl lck ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97167","description":"Occupational therapy evaluation_ high complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes review of medical and/or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1mg (Varubi)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9981","description":"Rolapitant_ oral_ 1mg (Varubi)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC11","description":"ICD-2FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: headache radiating to the neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2190","description":"Patients with clinical indications for imaging of the head: headache radiating to the neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBC1","description":"ICD-BDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Head control interface mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2327","description":"Head control interface mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft splenorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35536","description":"Art byp grft splenorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44207","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25440","description":"Repair/graft wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE0","description":"ICD-NLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF1","description":"ICD-FFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21268","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALA0","description":"ICD-BALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA1","description":"ICD-NIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB111","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftrst upper hanger bracket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0044","description":"Ftrst upper hanger bracket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28A","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36568","description":"Insert picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD0","description":"ICD-KGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft contral carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35509","description":"Art byp grft contral carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","description":"HCPCS-M1396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE0","description":"ICD-GCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","description":"HCPCS-Q4428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF1","description":"ICD-MBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE1","description":"ICD-IFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of speech fluency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92521","description":"Evaluation of speech fluency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trim skin lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11055","description":"Trim skin lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test one fiber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95872","description":"Muscle test one fiber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recement supp part denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6093","description":"Recement supp part denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE1","description":"ICD-OKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot lamin/prepreg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3031","description":"Foot lamin/prepreg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD0","description":"ICD-NLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF1","description":"ICD-FFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE1","description":"ICD-MALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA1","description":"ICD-NHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFF0","description":"ICD-NHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC1","description":"ICD-KFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other carot sten 120 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9007F","description":"Other carot sten 120 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3384F","description":"Ajcc cln cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE0","description":"ICD-GDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable 02 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0443","description":"Portable 02 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA1","description":"ICD-MJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81181","description":"ATXN7 (ataxin 7) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6534","description":"Gc stocking thighlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8I","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57020","description":"Drainage of pelvic fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8H","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLC0","description":"ICD-ICLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF0","description":"ICD-OLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL40","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA1","description":"ICD-MKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLE1","description":"ICD-MKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19369","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF0","description":"ICD-BGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preputial stretching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54450","description":"Preputial stretching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9176","description":"Injection_ elotuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB1","description":"ICD-KEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD0","description":"ICD-KCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01850","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","description":"CPT-01850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB0","description":"ICD-PKSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF0","description":"ICD-HCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB213","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9995","description":"Patients Who Use Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDF0","description":"ICD-MLDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8H","description":"Medium Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE1","description":"ICD-ICIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subtemporal decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61340","description":"Subtemporal decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC1","description":"ICD-IHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd accessory noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2599","description":"Sgd accessory noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap colectomy w/proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44211","description":"Lap colectomy w/proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD1","description":"ICD-OAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No assess bone loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8863","description":"No assess bone loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYB1","description":"ICD-KGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJA1","description":"ICD-CCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF1","description":"ICD-JGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF0","description":"ICD-ECUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC1","description":"ICD-KHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whfo nontorsion joint prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3931","description":"Whfo nontorsion joint prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52317","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md certification hha patient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0180","description":"Md certification hha patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGD0","description":"ICD-FDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC0","description":"ICD-FGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKE1","description":"ICD-CIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1023","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF1","description":"ICD-GCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain bladder by trocar/cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51101","description":"Drain bladder by trocar/cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine w/cath crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62318","description":"Inject spine w/cath crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA0","description":"ICD-HISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric bypass for obesity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43846","description":"Gastric bypass for obesity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF0","description":"ICD-NATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOE1","description":"ICD-CHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0729T","description":"Diagnostic analysis of vestibular implant_ unilateral; with subsequent programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA1","description":"ICD-CBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of hymen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56700","description":"Partial removal of hymen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Split flat caliper stirr & p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2230","description":"Split flat caliper stirr & p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA1","description":"ICD-PHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC1","description":"ICD-KHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA1","description":"ICD-GDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88245","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA0","description":"ICD-JGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA11","description":"ICD-2BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC111","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sickle cell test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85660","description":"Rbc sickle cell test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455U","description":"Infectious agents (sexually transmitted infection)_ Chlamydia trachomatis_ Neisseria gonorrhoeae_ and Trichomonas vaginalis_ multiplex amplified probe technique_ vaginal_ endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA1","description":"ICD-HEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho bi thighcuffs w sprdr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1652","description":"Ho bi thighcuffs w sprdr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES340","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95979","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ battery status_ electrode selectability and polarity_ impedanc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85705","description":"Thromboplastin inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA0","description":"ICD-NDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary cath leg strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4334","description":"Urinary cath leg strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9790","description":"Histotripsy (i.e._ nonthermal ablation via acoustic energy delivery) of malignant renal tissue_ including image gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC1","description":"ICD-GGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 6-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87506","description":"Iadna-dna/rna probe tq 6-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB1","description":"ICD-KDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRB1","description":"ICD-DFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88366","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TAG_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4261","description":"TAG_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24B","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIE1","description":"ICD-OEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucagon hydrochloride/1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1610","description":"Glucagon hydrochloride/1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9803","description":"Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ any specimen source)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection into brain canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61026","description":"Injection into brain canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX36","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1024","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED0","description":"ICD-MDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ketorolac tromethamine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1885","description":"Ketorolac tromethamine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECE0","description":"ICD-IECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6199","description":"Implant procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCC0","description":"ICD-AHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB1","description":"ICD-FACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56820","description":"Exam of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage mouth roof lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42000","description":"Drainage mouth roof lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD1","description":"ICD-BBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC0","description":"ICD-EHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC0","description":"ICD-HGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA1","description":"ICD-HCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKE0","description":"ICD-BBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97170","description":"Athletic training evaluation_ moderate complexity_ requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical acti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOF0","description":"ICD-DBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYC0","description":"ICD-GHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain open retroperi abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49060","description":"Drain open retroperi abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso flex no ri stays pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0628","description":"Lso flex no ri stays pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX54","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC1","description":"ICD-CGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBB0","description":"ICD-JGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE1","description":"ICD-OIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9329","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","description":"HCPCS-J9329","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWF1","description":"ICD-GCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE0","description":"ICD-FHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor renal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50325","description":"Prep donor renal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28072","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35051","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYD1","description":"ICD-HEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC1","description":"ICD-IDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ventrl hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49565","description":"Rerepair ventrl hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC140","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB1","description":"ICD-IAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSD1","description":"ICD-GFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA0","description":"ICD-NKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27158","description":"Revision of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Work hardening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97545","description":"Work hardening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF1","description":"ICD-GFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA0","description":"ICD-LAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA134","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5135","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","description":"HCPCS-Q5135","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB1","description":"ICD-KGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF0","description":"ICD-CFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat eyelid by injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68200","description":"Treat eyelid by injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB1","description":"ICD-GCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inlay composite/resin two su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2651","description":"Inlay composite/resin two su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA0","description":"ICD-AHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB0","description":"ICD-DDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA41","description":"Low Rehab_ ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neonatal emergency transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0225","description":"Neonatal emergency transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype infect agent drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87900","description":"Phenotype infect agent drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE0","description":"ICD-GHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC1","description":"ICD-JIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opiates 1 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80361","description":"Opiates 1 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF0","description":"ICD-ABBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cine/video x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76120","description":"Cine/video x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36010","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB0","description":"ICD-PAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUD1","description":"ICD-NDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB1","description":"ICD-IADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9873","description":"First Medicare Diabetes Prevention Program (MDPP) core session was attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP service tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOF0","description":"ICD-OBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD1","description":"ICD-BCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0970","description":"Tlso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSC0","description":"ICD-DBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35207","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genetic counseling 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96040","description":"Genetic counseling 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED0","description":"ICD-BFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB0","description":"ICD-EDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow adolescent myoelectron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7190","description":"Elbow adolescent myoelectron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB12","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75956","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME1","description":"ICD-MAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct compd maxilla fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7720","description":"Clsd reduct compd maxilla fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skull base/brainstem surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61576","description":"Skull base/brainstem surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0623T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tibper revasc w/ather add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37233","description":"Tibper revasc w/ather add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB1","description":"ICD-OEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUA1","description":"ICD-CBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUF1","description":"ICD-CGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy control bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46614","description":"Anoscopy control bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF1","description":"ICD-JHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB11","description":"ICD-4BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD0","description":"ICD-NIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay porc/crmc 2 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6608","description":"Onlay porc/crmc 2 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC0","description":"ICD-NHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD0","description":"ICD-EEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML33","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5261","description":"Hearing aid_ digit_ bin_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCC1","description":"ICD-NCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB0","description":"ICD-BDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD0","description":"ICD-NHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1210","description":"At least two orders for high-risk medications from the same drug class_ (table 4)_ not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD1","description":"ICD-BIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0820T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; first physician or other qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF1","description":"ICD-JCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung cx bx rpt no doc class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9421","description":"Lung cx bx rpt no doc class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7684","description":"Triamcinolone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Approp anticonvuls tstng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4191F","description":"Approp anticonvuls tstng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tr retinal les preterm inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67229","description":"Tr retinal les preterm inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC1","description":"ICD-KGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF0","description":"ICD-FEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB0","description":"ICD-OEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8X","description":"Very High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test for acetone/ketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82009","description":"Test for acetone/ketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHC0","description":"ICD-MIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD0","description":"ICD-IILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHB0","description":"ICD-ODHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEC1","description":"ICD-AHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA10","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp iliorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35634","description":"Art byp iliorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0816","description":"Pwc gp 1 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flexhd/allopatchhd/matrixhd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4128","description":"Flexhd/allopatchhd/matrixhd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA1","description":"ICD-BDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE0","description":"ICD-OICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF0","description":"ICD-CFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewings four films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0274","description":"Dental bitewings four films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cefotaxime sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0698","description":"Cefotaxime sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPA1","description":"ICD-CGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0623U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","description":"CPT-0623U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHE1","description":"ICD-OKHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate renal mass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50542","description":"Laparo ablate renal mass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33945","description":"Transplantation of heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputee adapter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0959","description":"Amputee adapter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD0","description":"ICD-MALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE0","description":"ICD-LIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE1","description":"ICD-MACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0521T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording_ and disconnection per patient encounter_ wireless cardiac stimula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID1","description":"ICD-FDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF1","description":"ICD-CGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEB0","description":"ICD-JBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYE1","description":"ICD-LHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF0","description":"ICD-CFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC214","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRF1","description":"ICD-HCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5143","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","description":"HCPCS-Q5143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD1","description":"ICD-ACTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 21-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98968","description":"Hc pro phone call 21-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1102","description":"Radiation Therapy For Upper Gi Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA0","description":"ICD-NAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28A","description":"Special Care Low _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add march bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3595","description":"Ortho shoe add march bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA1","description":"ICD-IDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical conference_ 60 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0221","description":"Medical conference_ 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l5-s1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22586","description":"Prescrl fuse w/ instr l5-s1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL42","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit chemo per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9329","description":"Hit chemo per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA0","description":"ICD-LHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34702","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME1","description":"ICD-AGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC0","description":"ICD-GICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB0","description":"ICD-IDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC214","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD0","description":"ICD-GHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis modification","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5875","description":"Prosthesis modification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPC1","description":"ICD-NIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIED0","description":"ICD-OIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD0","description":"ICD-OEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE0","description":"ICD-MEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDD0","description":"ICD-GDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD0","description":"ICD-OFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC14","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB0","description":"ICD-EFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC0","description":"ICD-ODVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD1","description":"ICD-CDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1246","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGF1","description":"ICD-KAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3061F","description":"Neg microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB1","description":"ICD-JAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg <=16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6212","description":"Foam drg <=16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAC0","description":"ICD-NDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA1","description":"ICD-PAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate pharynx/uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42145","description":"Repair palate pharynx/uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIC1","description":"ICD-JEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA1","description":"ICD-FIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD216","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Determine refractive state","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92015","description":"Determine refractive state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0183","description":"Prochlorperazine 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ guiding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1887","description":"Catheter_ guiding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alveoloplasty not w/extracts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7321","description":"Alveoloplasty not w/extracts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRB0","description":"ICD-HHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bundle of his recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93600","description":"Bundle of his recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFB1","description":"ICD-GAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWB1","description":"ICD-OCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD1","description":"ICD-BEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8H","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD1","description":"ICD-PIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB0","description":"ICD-DHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of copper","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82525","description":"Assay of copper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA1","description":"ICD-KBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86603","description":"Adenovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0603","description":"Continuous Home Care - A flat per hourly rate before area wage adjustment for intensive home nursing care delivered by personnel when the need for such care exceeds 8 hours","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","description":"HCPCS-E1807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB1","description":"ICD-IDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00580","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","description":"CPT-00580","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWA0","description":"ICD-LEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86619","description":"Borrelia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip midline cath insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5523","description":"Hip midline cath insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC1","description":"ICD-LCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC1","description":"ICD-MJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA1","description":"ICD-GDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vabra aspirator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4480","description":"Vabra aspirator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB21","description":"Very High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE1","description":"ICD-FHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD1","description":"ICD-CHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (ces) system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0732","description":"Cranial electrotherapy stimulation (ces) system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITF1","description":"ICD-BITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID0","description":"ICD-CFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXA1","description":"ICD-NEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Waiver service_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2025","description":"Waiver service_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4D","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB1","description":"ICD-IAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8672","description":"Fun stat score neck/ts < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3D","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE104","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB02","description":"High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE1","description":"ICD-EICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB0","description":"ICD-LHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","description":"CPT-00924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 20-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88264","description":"Chromosome analysis 20-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA0","description":"ICD-BHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB206","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20A","description":"Special Care Low _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51600","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF0","description":"ICD-AFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ranitidine hydrochloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2780","description":"Ranitidine hydrochloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA1","description":"ICD-KGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4437","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","description":"HCPCS-Q4437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB0","description":"ICD-GGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD0","description":"ICD-BAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46753","description":"Reconstruction of anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXA1","description":"ICD-NIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ethmoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31200","description":"Removal of ethmoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0014","description":"Other power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC255","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC256","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEA1","description":"ICD-EAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96934","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1002T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","description":"CPT-1002T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD0","description":"ICD-BGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd inj >24h/gcs >15/no res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9596","description":"Hd inj >24h/gcs >15/no res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNF0","description":"ICD-GBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE0","description":"ICD-EGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9632","description":"Pt not elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC1","description":"ICD-KFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF1","description":"ICD-NEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGC0","description":"ICD-OBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB02","description":"Very High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt talk eval hlthwkr re mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2060F","description":"Pt talk eval hlthwkr re mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo pn/gastr stimul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64590","description":"Insrt/redo pn/gastr stimul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF1","description":"ICD-BFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLD0","description":"ICD-MJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQA1","description":"ICD-OHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25320","description":"Repair/revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cranial surg nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21051","description":"Anesth cranial surg nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400U","description":"Obstetrics (expanded carrier screening)_ 145 genes by nextgeneration sequencing_ fragment analysis and multiplex ligationdependent probe amplification_ DNA_ reported as carrie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF1","description":"ICD-FFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD1","description":"ICD-ECTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8520","description":"Capecitabine_ oral_ 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telescopic intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1840","description":"Telescopic intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia interven rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4526F","description":"Neuropsychia interven rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB0","description":"ICD-JHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA0","description":"ICD-OKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tibiofibular joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27871","description":"Fusion of tibiofibular joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTC1","description":"ICD-EDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE0","description":"ICD-JIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE1","description":"ICD-OEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0403","description":"HCPCS-B0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHB1","description":"ICD-OFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSD0","description":"ICD-CCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23480","description":"Revision of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF1","description":"ICD-BICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA0","description":"ICD-OGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture partial mandib","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5866","description":"Overdenture partial mandib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27831","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lancet device each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4258","description":"Lancet device each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED0","description":"ICD-NLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calibrator solution/chips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4256","description":"Calibrator solution/chips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOF0","description":"ICD-HHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7512","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with transendoscopic endobronchial ultrasound (ebus)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC0","description":"ICD-HHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sm 153 lexidronam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9604","description":"Sm 153 lexidronam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD0","description":"ICD-GAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB255","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCF0","description":"ICD-JFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glasses bone conduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5080","description":"Glasses bone conduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay carboxyhb qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82376","description":"Assay carboxyhb qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYA0","description":"ICD-OBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC0","description":"ICD-GGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95717","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB0","description":"ICD-IFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","description":"HCPCS-Q4342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFD1","description":"ICD-FHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso/shoulder_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6569","description":"Gradient compression garment_ torso/shoulder_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC0","description":"ICD-CHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped size pull-on sm/med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4531","description":"Ped size pull-on sm/med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test myo musclr dyst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3853","description":"Gene test myo musclr dyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC0","description":"ICD-DEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA25","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCB1","description":"ICD-GGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA0","description":"ICD-DGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTD0","description":"ICD-BBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC1","description":"ICD-KIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31380","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15734","description":"Muscle-skin graft trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq revasc byp graft 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92937","description":"Prq revasc byp graft 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB1","description":"ICD-ABIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBA1","description":"ICD-OHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE1","description":"ICD-NCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXC0","description":"ICD-JIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8X","description":"Low Rehab_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD245","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD0","description":"ICD-OFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented and no reason is given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1314","description":"Bmi not documented and no reason is given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Geriatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4008","description":"Geriatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alkaloids_ urine_ quantitative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6041","description":"Alkaloids_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metacarp fx orthosis pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3917","description":"Metacarp fx orthosis pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB0","description":"ICD-OIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA1","description":"ICD-MDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAE1","description":"ICD-OEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED0","description":"ICD-JIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD1","description":"ICD-KCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC112","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18C","description":"Clinically Complex _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF1","description":"ICD-JETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect forarm/wrist tum 3cm>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25078","description":"Resect forarm/wrist tum 3cm>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26434","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27310","description":"Exploration of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE1","description":"ICD-NCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPC1","description":"ICD-GBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76988","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; placement_ manipulation of transducer_ and image acquisition only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF1","description":"ICD-KCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA0","description":"ICD-JDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11305","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0667U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0667U","description":"CPT-0667U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB0","description":"ICD-OJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDC1","description":"ICD-KCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDE0","description":"ICD-FGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA41","description":"Medium Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90650","description":"2vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inhaled corticosteroids rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4140F","description":"Inhaled corticosteroids rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF0","description":"ICD-MJUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92517","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC0","description":"ICD-EDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA0","description":"ICD-KEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatases","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84080","description":"Assay alkaline phosphatases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap revise gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43771","description":"Lap revise gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD0","description":"ICD-NJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA0","description":"ICD-FGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo hip ultra-light materia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5960","description":"Endo hip ultra-light materia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9064","description":"Injection_ cabazitaxel (Sandoz)_ not therapeutically equivalent to J9043_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD211","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anastrozole 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0170","description":"Anastrozole 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Musc test done w/n test comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95886","description":"Musc test done w/n test comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl exhalation port for pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7045","description":"Repl exhalation port for pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD0","description":"ICD-CCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay nephelometry not spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83883","description":"Assay nephelometry not spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37277","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","description":"CPT-37277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbow hosmer swit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7170","description":"Electronic elbow hosmer swit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58952","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"4-bar link above knee w/swng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5614","description":"4-bar link above knee w/swng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood thaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86931","description":"Frozen blood thaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62350","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0851T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; initial single probe stain p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB1","description":"ICD-ICUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF0","description":"ICD-BEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/pseudobulb affect/als","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3756F","description":"Pt w/pseudobulb affect/als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF0","description":"ICD-JGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE0","description":"ICD-NJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB1","description":"ICD-NALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22901","description":"Exc abdl tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone response","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80414","description":"Testosterone response","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","description":"CPT-64654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD115","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX21","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC0","description":"ICD-BDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00912","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","description":"CPT-00912","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE1","description":"ICD-OBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC1","description":"ICD-GFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GA21","description":"ICD-1GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9313","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9313","description":"HCPCS-C9313","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1001","description":"CDT-D1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC1","description":"ICD-JCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9875","description":"Nine total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXC1","description":"ICD-BDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUA1","description":"ICD-IAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Locm 100-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9965","description":"Locm 100-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE0","description":"ICD-KAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF1","description":"ICD-JAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE0","description":"ICD-NLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB1","description":"ICD-CEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast supplies unlisted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4050","description":"Cast supplies unlisted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cognit impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3720F","description":"Cognit impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB0","description":"ICD-IFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE0","description":"ICD-PGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humeral externally controlled intramedullary device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0595T","description":"Removal of humeral externally controlled intramedullary device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD1","description":"ICD-OKSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF1","description":"ICD-IHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1273","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Formoterol fumarate_ inh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7606","description":"Formoterol fumarate_ inh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC154","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nail plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11730","description":"Removal of nail plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PROTON THERAPY","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77524","description":"PROTON THERAPY","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retr bone flap to fix skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62148","description":"Retr bone flap to fix skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD1","description":"ICD-NJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC1","description":"ICD-NINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62325","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC1","description":"ICD-OHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25210","description":"Removal of wrist bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test panel pricing code_ 22+ tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP22","description":"Auto.test panel pricing code_ 22+ tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nonunion hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26546","description":"Repair nonunion hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED1","description":"ICD-FAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cephapirin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0710","description":"Cephapirin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF1","description":"ICD-CGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND1","description":"ICD-OHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9947","description":"Leg pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD156","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUD1","description":"ICD-EDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of head injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62010","description":"Treatment of head injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99417","description":"Prolonged Office Or Other Outpatient Evaluation And Management Service(S) Beyond The Minimum Required Time Of The Primary Procedure Which Has Been Selected Using Total Time_ R","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA0","description":"ICD-CAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF1","description":"ICD-JIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC0","description":"ICD-OEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hmatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4134","description":"Hmatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray head for orthodontia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70350","description":"X-ray head for orthodontia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77610","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF0","description":"ICD-EAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD1","description":"ICD-FEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ft prosth multiaxial ankl/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5978","description":"Ft prosth multiaxial ankl/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microfluid analy tears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83861","description":"Microfluid analy tears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58294","description":"Vag hyst w/enterocele compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471U","description":"Oncology (colorectal cancer)_ qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2_ 3_ 4)_ formalin-fixed paraffin-embedded (FFPE)_ predictive_ identificat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB113","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA1","description":"ICD-FDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVE0","description":"ICD-JBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33322","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA1","description":"ICD-NBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHF0","description":"ICD-CFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC1","description":"ICD-NLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD1","description":"ICD-OFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug interven","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0022","description":"Alcohol and/or drug interven","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1233","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXC0","description":"ICD-NGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","description":"CPT-01832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA1","description":"ICD-OLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF1","description":"ICD-AHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 resin-based compos","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2712","description":"Crown 3/4 resin-based compos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54435","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWF0","description":"ICD-LCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC1","description":"ICD-FFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB0","description":"ICD-BGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA40","description":"Default_ /60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport case worker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0160","description":"Noner transport case worker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smoking cessation gum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4995","description":"Smoking cessation gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWF1","description":"ICD-HCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD0","description":"ICD-OJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF1","description":"ICD-IBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA0","description":"ICD-KBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD0","description":"ICD-NLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA1","description":"ICD-KIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD231","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80503","description":"Pathology Clinical Consultation; For A Clinical Problem_ With Limited Review Of Patient_S History And Medical Records And Straightforward Medical Decision Making When Using Ti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA0","description":"ICD-KBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE230","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHB0","description":"ICD-CCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous laser vein addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36479","description":"Endovenous laser vein addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyalomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4117","description":"Hyalomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB0","description":"ICD-HFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged service inpatient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99357","description":"Prolonged service inpatient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens polycarb or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2784","description":"Lens polycarb or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD1","description":"ICD-FGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC0","description":"ICD-KIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF0","description":"ICD-GHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shock wv tx ms nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019T","description":"Extracorp shock wv tx ms nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0035","description":"Patient Has Any Emergency Department Encounter During The Performance Period With Place Of Service Indicator 23","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF0","description":"ICD-JAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC106","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA0","description":"ICD-CDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUC1","description":"ICD-KCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRC1","description":"ICD-GIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ automated sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0147","description":"Scr c/v cyto_ automated sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm adult fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4006","description":"Cast sup long arm adult fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision constricting tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26596","description":"Excision constricting tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFA1","description":"ICD-NFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDE1","description":"ICD-BCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lower jaw bone graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21215","description":"Lower jaw bone graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachy_non-str_ytterbium-169","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2637","description":"Brachy_non-str_ytterbium-169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laa closure w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0281T","description":"Laa closure w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARE0","description":"ICD-GARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assessment by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9001","description":"Assessment by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43410","description":"Repair esophagus wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnion bio or Axobiomembrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4211","description":"Amnion bio or Axobiomembrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmptr ophth dx img ant segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92132","description":"Cmptr ophth dx img ant segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibiotic not pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8708","description":"Antibiotic not pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1701","description":"HCPCS-A1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Anifrolumab-Fnia_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9086","description":"Injection_ Anifrolumab-Fnia_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61690","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED1","description":"ICD-JBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay iga/igd/igg/igm each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82784","description":"Assay iga/igd/igg/igm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0755T","description":"Digitization of glass microscope slides for level VI_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE0","description":"ICD-FCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1005","description":"Disposable Collection And Storage Bag For Breast Milk_ Any Size_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA0","description":"ICD-JCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE244","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC1","description":"ICD-BEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD0","description":"ICD-NCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED1","description":"ICD-JGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD1","description":"ICD-CGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antid glbln rcvd w/in 26wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4178F","description":"Antid glbln rcvd w/in 26wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA1","description":"ICD-JGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC1","description":"ICD-NBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHD1","description":"ICD-KFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC1","description":"ICD-GCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Balance lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2700","description":"Balance lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial laminated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5590","description":"Prep ak ischial laminated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB0","description":"ICD-KAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4B","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB0","description":"ICD-LBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF1","description":"ICD-GHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No rev_ comm_ track biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8885","description":"No rev_ comm_ track biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD144","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE1","description":"ICD-CBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC0","description":"ICD-NEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobilize erupted/malpos toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7282","description":"Mobilize erupted/malpos toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar artif diskectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22857","description":"Lumbar artif diskectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUF0","description":"ICD-BCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDA1","description":"ICD-BHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGA0","description":"ICD-NIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24582","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo bk ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5940","description":"Endo bk ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF1","description":"ICD-FFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA0","description":"ICD-KGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRA0","description":"ICD-LGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMD1","description":"ICD-MCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE1","description":"ICD-KHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1109T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1109T","description":"CPT-1109T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB0","description":"ICD-JEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC0","description":"ICD-ABMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0893T","description":"Noninvasive assessment of blood oxygenation_ gas exchange efficiency_ and cardiorespiratory status_ with physician or other qualified health care professional interpretation a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm isolation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89261","description":"Sperm isolation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA1","description":"ICD-OIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD0","description":"ICD-MKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom fab w/c back cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2617","description":"Custom fab w/c back cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial hosp prog service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0129","description":"Partial hosp prog service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDME1","description":"ICD-NDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC0","description":"ICD-NLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81520","description":"Oncology (breast)_ mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA1","description":"ICD-KCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Linezolid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2020","description":"Linezolid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant related per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9975","description":"Transplant related per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD0","description":"ICD-CEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD0","description":"ICD-JHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imatinib 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0088","description":"Imatinib 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMD1","description":"ICD-KGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8I","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF1","description":"ICD-CCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9037","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 7-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4176","description":"Parenteral sol amino acid 7-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHA1","description":"ICD-GHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove exostosis maxilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21032","description":"Remove exostosis maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surg w/iol 1 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66984","description":"Cataract surg w/iol 1 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12B","description":"Clinically Complex _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC1","description":"ICD-NJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIME0","description":"ICD-BIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of big toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28310","description":"Revision of big toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE0","description":"ICD-CAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88323","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC0","description":"ICD-GFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD0","description":"ICD-ODRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMB1","description":"ICD-AFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND1","description":"ICD-KAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","description":"CPT-76014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11450","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA0","description":"ICD-PKQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8845","description":"Pos airway press prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5284","description":"Removable Unilateral Partial Denture - One Piece Flexible Base - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen one/mult class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80303","description":"Drug screen one/mult class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE0","description":"ICD-GCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCF1","description":"ICD-JBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83527","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9420","description":"Hospital call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXF1","description":"ICD-JFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31725","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"History of or active diagnosis of familial or pure hypercholesterolemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9782","description":"History of or active diagnosis of familial or pure hypercholesterolemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDA1","description":"ICD-MEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA32","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHE1","description":"ICD-ABHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHB1","description":"ICD-IDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE1","description":"ICD-ABDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIA1","description":"ICD-OGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICA0","description":"ICD-CICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB110","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9803","description":"Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vit d 1 25-dihydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82652","description":"Vit d 1 25-dihydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental Case Management - Patients With Special Health Care Needs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9997","description":"Dental Case Management - Patients With Special Health Care Needs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF1","description":"ICD-KECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calculus analysis qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82355","description":"Calculus analysis qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA1","description":"ICD-OHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB0","description":"ICD-CCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8F","description":"Medium Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB1","description":"ICD-DDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pure tone hearing test air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92551","description":"Pure tone hearing test air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA1","description":"ICD-AEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","description":"CPT-90635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDF0","description":"ICD-FCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA06","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD220","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA1","description":"ICD-BFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA0","description":"ICD-OLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0016","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Novafix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4208","description":"Novafix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKE0","description":"ICD-FGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD1","description":"ICD-GCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy hand joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26100","description":"Biopsy hand joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47610","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD1","description":"ICD-KFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF0","description":"ICD-DAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng epo thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4095F","description":"Pt not rcvng epo thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC0","description":"ICD-JHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62380","description":"Endoscopic decompression of spinal cord_ nerve root(s)_ including laminotomy_ partial facetectomy_ foraminotomy_ discectomy and/or excision of herniated intervertebral disc_ 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND1","description":"ICD-JIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC135","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00140","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","description":"CPT-00140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76984","description":"Ultrasound_ intraoperative thoracic aorta (eg_ epiaortic)_ diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant artery each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35697","description":"Reimplant artery each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD1","description":"ICD-OACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC41","description":"Medium Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB0","description":"ICD-LGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64774","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE1","description":"ICD-OIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 3 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90740","description":"Hepb vacc 3 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte culture primed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86822","description":"Lymphocyte culture primed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temporal bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69979","description":"Temporal bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA0","description":"ICD-BAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert bladder catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51701","description":"Insert bladder catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29405","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF1","description":"ICD-NHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOB1","description":"ICD-LDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75980","description":"Percutaneous transhepatic biliary drainage with contrast monitoring_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA1","description":"ICD-MGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD1","description":"ICD-NKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE0","description":"ICD-CELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF0","description":"ICD-FGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA0","description":"ICD-GGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC1","description":"ICD-GHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45111","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF1","description":"ICD-JCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPF1","description":"ICD-FIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMF0","description":"ICD-OHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385U","description":"Nephrology (chronic kidney disease)_ apolipoprotein A4 (ApoA4)_ CD5 antigen-like (CD5L)_ and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB1","description":"ICD-PFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF1","description":"ICD-KEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8913","description":"Mra w/o cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16<=48 sq in watr/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6229","description":"Gauze >16<=48 sq in watr/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA0","description":"ICD-HBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8658","description":"Fun stat score le not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1305","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED0","description":"ICD-JHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb >= 10 g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8976","description":"Hgb >= 10 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10B","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil res waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2016","description":"Habil res waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLD0","description":"ICD-CBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA1","description":"ICD-FBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA41","description":"Default_ /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLE0","description":"ICD-IGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0621U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","description":"CPT-0621U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA1","description":"ICD-OHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB256","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyqvia 100mg immuneglobulin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1575","description":"Hyqvia 100mg immuneglobulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hips bi 5/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73523","description":"X-ray exam hips bi 5/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tap block bi by infusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64489","description":"Tap block bi by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vestibular test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92533","description":"Caloric vestibular test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9452","description":"(Zerbaxa) Injection_ Ceftolozane 50mg And Tazobactam 25 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12C","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEB1","description":"ICD-EDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRF0","description":"ICD-OJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9076","description":"Lisocabtagene maraleucel_ up to 110 million autologous anti-cd19 car-positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLC1","description":"ICD-AGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB0","description":"ICD-MGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX41","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOD0","description":"ICD-KFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens pmma color vision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2503","description":"Cntct lens pmma color vision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protein analysis w/probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88372","description":"Protein analysis w/probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE0","description":"ICD-GGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA0","description":"ICD-GAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp sphincter pressure meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43263","description":"Ercp sphincter pressure meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB1","description":"ICD-MDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aldosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82088","description":"Assay of aldosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQF1","description":"ICD-PCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF1","description":"ICD-GAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi delay w/kub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74241","description":"X-ray upper gi delay w/kub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2B","description":"Low Rehab_ ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF0","description":"ICD-IAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBB1","description":"ICD-ECBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Throat muscle surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43030","description":"Throat muscle surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB1","description":"ICD-CHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42205","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheterize for urine spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9612","description":"Catheterize for urine spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA1","description":"ICD-MDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1323","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB0","description":"ICD-BAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCE0","description":"ICD-BBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDA1","description":"ICD-OKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB0","description":"ICD-KBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vbac delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59612","description":"Vbac delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device without flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7300","description":"Removal of temporary anchorage device without flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB1","description":"ICD-MFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD0","description":"ICD-CCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Filleted finger/toe flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14350","description":"Filleted finger/toe flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6583","description":"Gradient compression wrap with adjustable straps_ below knee_ 30-50 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0904","description":"HCPCS-C0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA1","description":"ICD-ADMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE0","description":"ICD-FGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imported lipodox inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2049","description":"Imported lipodox inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC1","description":"ICD-JFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00147","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","description":"CPT-00147","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59855","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-vertebrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35645","description":"Art byp subclav-vertebrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc leukoreduced irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9040","description":"Rbc leukoreduced irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21249","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ ns_ non-hdrir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1719","description":"Brachytx_ ns_ non-hdrir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF1","description":"ICD-AAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene intron poly t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81224","description":"Cftr gene intron poly t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB1","description":"ICD-GFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"History of mole changes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1050F","description":"History of mole changes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF1","description":"ICD-KASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB1","description":"ICD-FENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC0","description":"ICD-OLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measure kidney pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50396","description":"Measure kidney pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC1","description":"ICD-JINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Simple cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51725","description":"Simple cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ granisetron extended release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9486","description":"Injection_ granisetron extended release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF1","description":"ICD-NDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC21","description":"ICD-3DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA0","description":"ICD-HAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test alpha-thalassemia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3845","description":"Gene test alpha-thalassemia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF0","description":"ICD-MLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE1","description":"ICD-FIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon alfa-n3 inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9215","description":"Interferon alfa-n3 inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD1","description":"ICD-KDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9686","description":"Onsite nursing facility conference_ that is separate and distinct from an Evaluation and Management visit_ including qualified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC0","description":"ICD-CIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80362","description":"Opioids & opiate analogs 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93642","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Static str shldr dev rom adj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1841","description":"Static str shldr dev rom adj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVA0","description":"ICD-OBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43261","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQD1","description":"ICD-OKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWD1","description":"ICD-DFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect recurrent gyn mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58957","description":"Resect recurrent gyn mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","description":"CPT-00922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF1","description":"ICD-AGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup body cast plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4001","description":"Cast sup body cast plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENF0","description":"ICD-GENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA1","description":"ICD-NLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF1","description":"ICD-NEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF1","description":"ICD-DIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJA1","description":"ICD-OGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFE1","description":"ICD-JHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD0","description":"ICD-IALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJE1","description":"ICD-BFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD1","description":"ICD-KFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC0","description":"ICD-EHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF0","description":"ICD-GIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE1","description":"ICD-BELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11B","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/fhdw/o lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21159","description":"Lefort iii w/fhdw/o lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26540","description":"Repair hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC1","description":"ICD-NILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxy suppl heater for nebuliz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1372","description":"Oxy suppl heater for nebuliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32400","description":"Needle biopsy chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rig ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1233","description":"Rig ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOA0","description":"ICD-KCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC0","description":"ICD-PIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80377","description":"Drug/substance nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx chron care addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99489","description":"Cmplx chron care addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGE1","description":"ICD-FHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hmes/trachvalve adhesivedisk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7506","description":"Hmes/trachvalve adhesivedisk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE1","description":"ICD-BCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA11","description":"ICD-1KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7537","description":"Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricular pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ socket bel elbow/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6687","description":"Frame typ socket bel elbow/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD241","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE1","description":"ICD-HAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pca3/klk3 antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81313","description":"Pca3/klk3 antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Child sitting services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1009","description":"Child sitting services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB1","description":"ICD-OISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE0","description":"ICD-GIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCD1","description":"ICD-BHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD1","description":"ICD-CGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99355","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB40","description":"Ultra High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0744T","description":"Insertion of bioprosthetic valve_ open_ femoral vein_ including duplex ultrasound imaging guidance_ when performed_ including autogenous or nonautogenous patch graft (eg_ poly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72129","description":"Ct chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE1","description":"ICD-JCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC231","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB1","description":"ICD-FIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ femur_ two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73550","description":"Radiologic examination_ femur_ two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skin ext/per/atrunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40051","description":"Anesth skin ext/per/atrunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE1","description":"ICD-PGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47715","description":"Excision of bile duct cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA1","description":"ICD-GIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD1","description":"ICD-NIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED1","description":"ICD-ACED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0028","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64417","description":"N block inj axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC0","description":"ICD-AEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85384","description":"Fibrinogen activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD0","description":"ICD-JEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewings two films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0272","description":"Dental bitewings two films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE1","description":"ICD-FHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87542","description":"Legion pneumo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25263","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB1","description":"ICD-FCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAB1","description":"ICD-KGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB1","description":"ICD-NIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALE0","description":"ICD-JALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF1","description":"ICD-KDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC1","description":"ICD-KDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB124","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESB1","description":"ICD-HESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE1","description":"ICD-LHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1015","description":"Clinical decision support mechanism Reliant medical group_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC0","description":"ICD-GEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upr/lxtr art stdy 3+ lvls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93923","description":"Upr/lxtr art stdy 3+ lvls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISC1","description":"ICD-DISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOE0","description":"ICD-DAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHE0","description":"ICD-MCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA1","description":"ICD-BIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBA0","description":"ICD-OLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1318","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC15","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF1","description":"ICD-IEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB1","description":"ICD-FDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1250","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYE1","description":"ICD-KGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icm device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93290","description":"Icm device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 2-3 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22808","description":"Ant fusion 2-3 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFND0","description":"ICD-JFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFA0","description":"ICD-JFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0296T","description":"Ext ecg recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phenylketones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84035","description":"Assay of phenylketones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD0","description":"ICD-BDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infuse radioactive materials","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77750","description":"Infuse radioactive materials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC0","description":"ICD-OEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNC1","description":"ICD-OBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BA31","description":"ICD-2BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB154","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam caster tire any size ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2219","description":"Foam caster tire any size ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA1","description":"ICD-CEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1743","description":"HCPCS-C1743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHED0","description":"ICD-BHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD1","description":"ICD-OHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release thumb contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26508","description":"Release thumb contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD0","description":"ICD-JIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap revise/remv eltrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43648","description":"Lap revise/remv eltrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF1","description":"ICD-FIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF1","description":"ICD-BGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAB1","description":"ICD-BBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE1","description":"ICD-BGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","description":"HCPCS-J9038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6195","description":"Abutment Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63101","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADB0","description":"ICD-JADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC0","description":"ICD-JICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Memoderm/derma/tranz/integup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4126","description":"Memoderm/derma/tranz/integup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32440","description":"Remove lung pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ othr than cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1733","description":"Cath_ ep_ othr than cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reass appr remo filt 3ms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9542","description":"Doc reass appr remo filt 3ms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB1","description":"ICD-BFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair commode seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0968","description":"Wheelchair commode seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWF0","description":"ICD-GAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE0","description":"ICD-MJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nsg aide service up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1004","description":"Nsg aide service up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC1","description":"ICD-OFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1704","description":"CDT-D1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78013","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal over 10mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0575","description":"Bupren/nal over 10mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE0","description":"ICD-FDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colectomy w/neo-rectum pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44158","description":"Colectomy w/neo-rectum pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE1","description":"ICD-CDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC0","description":"ICD-KBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pad band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6441","description":"Pad band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC1","description":"ICD-MFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRE1","description":"ICD-GGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion/fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27358","description":"Remove femur lesion/fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin pedicle flap arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15572","description":"Skin pedicle flap arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC0","description":"ICD-PHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDF1","description":"ICD-ICDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31239","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81176","description":"ASXL1 (additional sex combs like 1_ transcriptional regulator) (eg_ myelodysplastic syndrome_ myeloproliferative neoplasms_ chronic myelomonocytic leukemia)_ gene analysis; ta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB0","description":"ICD-HDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENE0","description":"ICD-OENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB1","description":"ICD-GEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyoid myotomy & suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21685","description":"Hyoid myotomy & suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC1","description":"ICD-ODBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy with ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44401","description":"Colonoscopy with ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD0","description":"ICD-OJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELE0","description":"ICD-BELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72195","description":"MRI pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt neurostim elctr each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8680","description":"Implt neurostim elctr each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47553","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWD1","description":"ICD-OHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41252","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0773T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIF0","description":"ICD-AAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPD1","description":"ICD-FEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF0","description":"ICD-OLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81193","description":"Ntrk3 (Neurotrophic Receptor Tyrosine Kinase 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETB0","description":"ICD-BETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF0","description":"ICD-FBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC0","description":"ICD-GCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGF1","description":"ICD-JEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt alive 3 mos post proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9540","description":"Pt alive 3 mos post proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65400","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37279","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","description":"CPT-37279","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE1","description":"ICD-NFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF1","description":"ICD-GEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB0","description":"ICD-IBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCF0","description":"ICD-OFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96112","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA0","description":"ICD-NGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE0","description":"ICD-KEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE1","description":"ICD-NIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKC1","description":"ICD-BAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","description":"HCPCS-J0616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD0","description":"ICD-AFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA0","description":"ICD-PHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFA0","description":"ICD-CEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mh health assess by non-md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0031","description":"Mh health assess by non-md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advnc care plan in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1157F","description":"Advnc care plan in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home care supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99340","description":"Domicil/r-home care supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml remission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9126","description":"Onc dx cml remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA0","description":"ICD-KENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJE0","description":"ICD-JFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA0","description":"ICD-BIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35361","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/fb rmvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29904","description":"Subtalar arthro w/fb rmvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic shoe add rub insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3510","description":"Orthopedic shoe add rub insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCE0","description":"ICD-CGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr pul art unifocal w/o cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33925","description":"Rpr pul art unifocal w/o cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL36","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESB0","description":"ICD-KESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAD1","description":"ICD-GEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii typing hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81378","description":"Hla i & ii typing hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551T","description":"Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME1","description":"ICD-ADME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr epigastric hern blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49572","description":"Rpr epigastric hern blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD0","description":"ICD-EIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB0","description":"ICD-GCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC217","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPF0","description":"ICD-GIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE1","description":"ICD-DGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDE0","description":"ICD-MIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64473","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","description":"CPT-64473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27722","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMD1","description":"ICD-AGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD0","description":"ICD-OHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place rt device/marker pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55876","description":"Place rt device/marker pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF0","description":"ICD-OIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost a/e acrylic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7404","description":"Add ue prost a/e acrylic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASD1","description":"ICD-GASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cad cxr with interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174T","description":"Cad cxr with interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE0","description":"ICD-DCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCD1","description":"ICD-AGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHD0","description":"ICD-CGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61519","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC0","description":"ICD-OHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65175","description":"Removal of ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD154","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB1","description":"ICD-CAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67808","description":"Remove eyelid lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA250","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD1","description":"ICD-OKXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDC0","description":"ICD-MKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32220","description":"Release of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC0","description":"ICD-NFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA1","description":"ICD-OGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC0","description":"ICD-OJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8612","description":"Aqueous shunt prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVA0","description":"ICD-CHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flutter device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8185","description":"Flutter device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC1","description":"ICD-PGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA0","description":"ICD-FAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of quinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84228","description":"Assay of quinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA0","description":"ICD-NEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMF1","description":"ICD-GEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFB0","description":"ICD-GBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20704","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Intra-Articular (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1450","description":"Fluconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC0","description":"ICD-EFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Additional switch_ ext power","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6611","description":"Additional switch_ ext power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF1","description":"ICD-CEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92534","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF0","description":"ICD-GBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC0","description":"ICD-GCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy for mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4210F","description":"Ace/arb thxpy for mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64763","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD154","description":"Special Care High _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVA1","description":"ICD-JDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD0","description":"ICD-IFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEA0","description":"ICD-ACEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9750","description":"Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ full leg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6586","description":"Gradient pressure wrap with adjustable straps_ full leg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOD0","description":"ICD-KEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID0","description":"ICD-IGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tract frame attach headboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0840","description":"Tract frame attach headboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF1","description":"ICD-AAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA0","description":"ICD-ABBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87636","description":"IADNA SARSCOV2& INF A&B MULT AMPLIFIED PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE1","description":"ICD-CIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED1","description":"ICD-OFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hast w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94452","description":"Hast w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech Language Pathology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4034","description":"Speech Language Pathology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA1","description":"ICD-KCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Covers for upright each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1120","description":"Covers for upright each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA1","description":"ICD-NKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB1","description":"ICD-MIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78499","description":"Cardiovascular nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB1","description":"ICD-GBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF0","description":"ICD-PCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD1","description":"ICD-KDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVF1","description":"ICD-GHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ brachytx seed adm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1728","description":"Cath_ brachytx seed adm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2001","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA1","description":"ICD-EDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF0","description":"ICD-OADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8F","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD0","description":"ICD-OCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD1","description":"ICD-EDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67904","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC0","description":"ICD-CBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9814","description":"HCPCS-C9814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAB1","description":"ICD-EEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCF0","description":"ICD-OLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE1","description":"ICD-CFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA0","description":"ICD-EEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE1","description":"ICD-IEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGF1","description":"ICD-OCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWE1","description":"ICD-CHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELB1","description":"ICD-FELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA1","description":"ICD-MHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of total testosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84403","description":"Assay of total testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 9-15","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88188","description":"Flowcytometry/read 9-15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHB1","description":"ICD-JCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ft arch suprt premold longit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3040","description":"Ft arch suprt premold longit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86880","description":"Coombs test direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/lung bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31628","description":"Bronchoscopy/lung bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp preop assess cat surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014F","description":"Comp preop assess cat surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD0","description":"ICD-KALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0076","description":"Prolotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL17","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBC0","description":"ICD-BCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMD1","description":"ICD-GCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1901","description":"HCPCS-B1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB1","description":"ICD-NBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA0","description":"ICD-GDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE0","description":"ICD-JHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lamination collar w/ couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6629","description":"Lamination collar w/ couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer for use w/ regulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0580","description":"Nebulizer for use w/ regulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dry pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0184","description":"Dry pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF1","description":"ICD-KCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA0","description":"ICD-PDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD1","description":"ICD-CAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES310","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA14C","description":"Clinically Complex _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOC1","description":"ICD-OGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm receiver_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5287","description":"Ald fm/dm receiver_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1st course antitnf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8868","description":"1st course antitnf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99251","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fractionation ketosteroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83593","description":"Fractionation ketosteroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9990","description":"Pneumococcal Vaccine Was Not Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF0","description":"ICD-CCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDE1","description":"ICD-CHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0028U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ copy number variants_ common variants with reflex to targeted sequence anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF1","description":"ICD-OJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB0","description":"ICD-IHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF1","description":"ICD-FAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33440","description":"Replacement_ aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE1","description":"ICD-OHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES105","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4115","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55709","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","description":"CPT-55709","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE1","description":"ICD-CHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrode stim brain add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95962","description":"Electrode stim brain add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC1","description":"ICD-FHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & duct catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52010","description":"Cystoscopy & duct catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0261U","description":"Oncology (colorectal cancer)_ image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (CD3 and CD8 within tumor-stroma border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD1","description":"ICD-GFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMB1","description":"ICD-NIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC1","description":"ICD-KCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE0","description":"ICD-OKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43832","description":"Place gastrostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB0","description":"ICD-LAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC0","description":"ICD-NKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD0","description":"ICD-CHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Actin (Smooth Muscle) Antibody (Asma)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86015","description":"Actin (Smooth Muscle) Antibody (Asma)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD0","description":"ICD-KFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78466","description":"Heart infarct image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOE1","description":"ICD-KEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF1","description":"ICD-CHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHF1","description":"ICD-IIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44150","description":"Removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE1","description":"ICD-JEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE1","description":"ICD-HFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA0","description":"ICD-LIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9991","description":"Pneumococcal Vaccine Administered On Or After Patient_S 60Th Birthday And Before The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA0","description":"ICD-LGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16370","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16370","description":"CPT-16370","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUA1","description":"ICD-BAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTE0","description":"ICD-OKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD1","description":"ICD-BICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE1","description":"ICD-KHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRC0","description":"ICD-OBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46946","description":"Remove by ligat int hem grps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF0","description":"ICD-KCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9403","description":"Doc reas no 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB0","description":"ICD-GBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND1","description":"ICD-KGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE1","description":"ICD-OFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Etanercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1438","description":"Etanercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB34","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB251","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTC1","description":"ICD-KBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50065","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA0","description":"ICD-BBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD0","description":"ICD-ACCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUB0","description":"ICD-BBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0921T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","description":"CPT-0921T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97608","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","description":"HCPCS-M1386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0102","description":"HCPCS-C0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA07","description":"Very High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0518","description":"Removal with reinsertion_ non-biodegradable drug delivery implants_ 4 or more (services for subdermal implants)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPE0","description":"ICD-JBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC0","description":"ICD-BIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC0","description":"ICD-EATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB0","description":"ICD-FEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB0","description":"ICD-DDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD0","description":"ICD-AAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTB0","description":"ICD-ACTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA1","description":"ICD-KFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQA1","description":"ICD-PGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD1","description":"ICD-MCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0162","description":"Ondansetron oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33274","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ right ventricular_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ ventriculography_ fe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBE0","description":"ICD-OFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene dup/delet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81324","description":"Pmp22 gene dup/delet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC1","description":"ICD-GAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB1","description":"ICD-PJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF0","description":"ICD-BEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE1","description":"ICD-CGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDF1","description":"ICD-OHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; initial measurement and calibration of cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0662T","description":"Scalp cooling_ mechanical; initial measurement and calibration of cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE1","description":"ICD-FAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7328","description":"Hyaluronan or derivative_ GELSYN-3_ for intra-articular injection_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535F","description":"Dyspnea mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB0","description":"ICD-JEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27510","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phone e/m phys/qhp 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99441","description":"Phone e/m phys/qhp 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0D","description":"High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC1","description":"ICD-FHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND0","description":"ICD-JBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD1","description":"ICD-LGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4288","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","description":"HCPCS-A4288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEB0","description":"ICD-CBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDE0","description":"ICD-JBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58951","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain image < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78600","description":"Brain image < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRB1","description":"ICD-KIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84703","description":"Chorionic gonadotropin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD1","description":"ICD-FFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBF0","description":"ICD-MIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hib prp-t vaccine 4 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90648","description":"Hib prp-t vaccine 4 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF0","description":"ICD-ACBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ sch team conf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9007","description":"Mccd_ sch team conf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC0","description":"ICD-MIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15772","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; Each Additional 50 Cc Injectate_ Or Part Thereof (List Separately In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVD0","description":"ICD-GHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB0","description":"ICD-LEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC0","description":"ICD-IICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch substitute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0118","description":"Crutch substitute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96422","description":"Chemo ia infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF1","description":"ICD-ADMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF1","description":"ICD-DDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450T","description":"Insertion of aqueous drainage device_ without extraocular reservoir_ internal approach_ into the subconjunctival space; each additional device (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFD0","description":"ICD-GDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair arm rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0994","description":"Wheelchair arm rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iris support intraoclr lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2631","description":"Iris support intraoclr lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF1","description":"ICD-IGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA1","description":"ICD-BEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB0","description":"ICD-CCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9981","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each junior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3211","description":"Surgical boot each junior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAE0","description":"ICD-MFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUA0","description":"ICD-GEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77770","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0542U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","description":"CPT-0542U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD1","description":"ICD-CEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens single vision not oth c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2199","description":"Lens single vision not oth c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA0","description":"ICD-AADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stress breaker","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6940","description":"Stress breaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54700","description":"Drainage of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB1","description":"ICD-OEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC0","description":"ICD-OEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9154","description":"Injection_ buprenorphine extended-release (Brixadi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70480","description":"Ct orbit/ear/fossa w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD1","description":"ICD-CBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD1","description":"ICD-FAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA1","description":"ICD-CBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen not intraop image","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8873","description":"Specimen not intraop image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing complete hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81379","description":"Hla i typing complete hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF0","description":"ICD-KBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF1","description":"ICD-NHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54901","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27369","description":"Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvis/hip joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27299","description":"Pelvis/hip joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGD0","description":"ICD-KCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Centruroides immune f(ab)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0716","description":"Centruroides immune f(ab)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0465U","description":"Oncology (urothelial carcinoma)_ DNA_ quantitative methylation-specific PCR of 2 genes (ONECUT2_ VIM)_ algorithmic analysis reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54336","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC1","description":"ICD-OJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ gas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0441","description":"Stationary o2 contents_ gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion suprfl any site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15783","description":"Dermabrasion suprfl any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXE0","description":"ICD-OJXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF1","description":"ICD-GIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELA0","description":"ICD-KELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF1","description":"ICD-BAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","description":"HCPCS-A8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB0","description":"ICD-KIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHA1","description":"ICD-AEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon ca dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81435","description":"Hereditary colon ca dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA0","description":"ICD-HDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA0","description":"ICD-OKWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYD0","description":"ICD-OGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC0","description":"ICD-MKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methadone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6053","description":"Methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32505","description":"Wedge resect of lung initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gel cap app device for trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8515","description":"Gel cap app device for trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB1","description":"ICD-NAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std seat elevate cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0831","description":"Pwc gp2 std seat elevate cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54620","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5136","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","description":"HCPCS-Q5136","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anticoag thx rx at dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4075F","description":"Anticoag thx rx at dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA0","description":"ICD-KGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg digital analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95957","description":"Eeg digital analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1423","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","description":"HCPCS-M1423","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35506","description":"Art byp grft subclav-carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB1","description":"ICD-JHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUA0","description":"ICD-CIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93454","description":"Coronary artery angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryotherapy of skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17340","description":"Cryotherapy of skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1951","description":"Injection_ leuprolide acetate for depot suspension (fensolvi)_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen supplies stand/rack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1355","description":"Oxygen supplies stand/rack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC0","description":"ICD-CEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0223U","description":"Infectious disease (bacterial or viral respiratory tract infection)_ pathogen-specific nucleic acid (DNA or RNA)_ 22 targets including severe acute respiratory syndrome corona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACF0","description":"ICD-KACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen sngl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33212","description":"Insert pulse gen sngl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stenger test pure tone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92565","description":"Stenger test pure tone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMA0","description":"ICD-EDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC251","description":"Special Care High _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISE0","description":"ICD-DISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE0","description":"ICD-EACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87807","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; respiratory syncytial virus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33979","description":"Insert intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84078","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB0","description":"ICD-AHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB1","description":"ICD-OJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Masters two step","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3904","description":"Masters two step","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKC1","description":"ICD-CHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75741","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKD1","description":"ICD-BBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthoptic/pleoptic training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92065","description":"Orthoptic/pleoptic training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB1","description":"ICD-CGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","description":"CPT-01234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4300F","description":"Pt rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA0","description":"ICD-JHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF0","description":"ICD-KFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9832","description":"AJCC stage at breast cancer diagnosis = I (Ia or Ib) and T-stage at breast cancer diagnosis does not equal = T1_ T1a_ T1b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFC1","description":"ICD-NLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA0","description":"ICD-EIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62362","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69728","description":"Removal_ entire osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid and involving a bony defect greater t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD0","description":"ICD-DHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42425","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD1","description":"ICD-CDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB0","description":"ICD-GDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB50","description":"Low Rehab_ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4D","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD1","description":"ICD-GIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flt3 gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81246","description":"Flt3 gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00832","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","description":"CPT-00832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC0","description":"ICD-NJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXD1","description":"ICD-BDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc t-pa admin considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4077F","description":"Doc t-pa admin considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24565","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cipaglucosidase alfa-atga_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1203","description":"Injection_ cipaglucosidase alfa-atga_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF0","description":"ICD-KIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA111","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92990","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of salivary gland","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7981","description":"Excision of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15D","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1047T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1047T","description":"CPT-1047T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pcp proph low cd4 norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9217","description":"No pcp proph low cd4 norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE0","description":"ICD-FDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD1","description":"ICD-GCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA1","description":"ICD-PDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQA1","description":"ICD-GFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis blood pressure cuff","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4663","description":"Dialysis blood pressure cuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD1","description":"ICD-BHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental cephalometric film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0340","description":"Dental cephalometric film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC0","description":"ICD-NFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6411","description":"Non-sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA0","description":"ICD-PFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF1","description":"ICD-NJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE1","description":"ICD-NGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7660","description":"Isoproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC1","description":"ICD-JGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC113","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF0","description":"ICD-DHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB0","description":"ICD-CFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0381","description":"Cone beam ct capt mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLF0","description":"ICD-CGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L2221","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","description":"HCPCS-L2221","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58290","description":"Vag hyst complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients With A Catheter That Have Limited Life Expectancy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0050","description":"Patients With A Catheter That Have Limited Life Expectancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE0","description":"ICD-PAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMC1","description":"ICD-NHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB0","description":"ICD-KBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC1","description":"ICD-MAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm>= 400mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9964","description":"Hocm>= 400mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE217","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE0","description":"ICD-KBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1066T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1066T","description":"CPT-1066T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD0","description":"ICD-BALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTA0","description":"ICD-AFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80402","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker variable wheel resist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0147","description":"Walker variable wheel resist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA1","description":"ICD-BBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81219","description":"Calr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA0","description":"ICD-GEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx dental pain minor proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9110","description":"Tx dental pain minor proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD0","description":"ICD-HERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infus each addl seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96417","description":"Chemo iv infus each addl seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD0","description":"ICD-EHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD1","description":"ICD-FBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I125 iothalamate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9554","description":"I125 iothalamate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX12","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWB0","description":"ICD-PLWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBD1","description":"ICD-ABBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng epi spec sfty issues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4330F","description":"Cnslng epi spec sfty issues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minoxidil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0139","description":"Minoxidil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF1","description":"ICD-MCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF0","description":"ICD-PFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF1","description":"ICD-BFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKF1","description":"ICD-OJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB0","description":"ICD-IBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHF1","description":"ICD-FAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD0","description":"ICD-OFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1414","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","description":"HCPCS-J1414","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE1","description":"ICD-OEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXF1","description":"ICD-CIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30468","description":"Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE1","description":"ICD-NHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD0","description":"ICD-OJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD1","description":"ICD-CGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUD1","description":"ICD-FBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1030","description":"External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt=d(rh)- and unsensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3290F","description":"Pt=d(rh)- and unsensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ travoprost_ intracameral implant_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7355","description":"Injection_ travoprost_ intracameral implant_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF1","description":"ICD-LFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB0","description":"ICD-AAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB0","description":"ICD-LHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA1","description":"ICD-FDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21462","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient spent less than three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9860","description":"Patient spent less than three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE0","description":"ICD-AFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB1","description":"ICD-NIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3978","description":"Sewhfo airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81187","description":"CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg_ myotonic dystrophy type 2) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17280","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB1","description":"ICD-BBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35184","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC0","description":"ICD-NAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy digital artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64820","description":"Sympathectomy digital artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0104","description":"HCPCS-B0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC0","description":"ICD-NJIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD0","description":"ICD-KGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA1","description":"ICD-OKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93597","description":"Right And Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Abnormal Nat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC0","description":"ICD-BDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPF1","description":"ICD-NDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rotator cuff chronic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23412","description":"Repair rotator cuff chronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE0","description":"ICD-KDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26746","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"History cd4+ cell count <350","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3492F","description":"History cd4+ cell count <350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Puraply_ puraply antimic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9349","description":"Puraply_ puraply antimic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJE1","description":"ICD-KBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF1","description":"ICD-OAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","description":"HCPCS-A2030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC1","description":"ICD-KAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC0","description":"ICD-NDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lip with flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40525","description":"Reconstruct lip with flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEA0","description":"ICD-ODEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC0","description":"ICD-FDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXD1","description":"ICD-JAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90612","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","description":"CPT-90612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF0","description":"ICD-BDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA0","description":"ICD-CCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXC0","description":"ICD-CIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place po breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19296","description":"Place po breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF0","description":"ICD-IHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXD1","description":"ICD-GGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113A","description":"Immunization administration by intramuscular injection of severeacute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA\u0002LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF1","description":"ICD-FHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45051","description":"Anesth surgery of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB14","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE1","description":"ICD-PLSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDC0","description":"ICD-KGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv sr 2pc thor ext pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0174","description":"Cerv sr 2pc thor ext pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit device repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5036","description":"Hit device repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF1","description":"ICD-GHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0775T","description":"Arthrodesis_ sacroiliac joint_ percutaneous_ with image guidance_ includes placement of intra-articular implant(s) (eg_ bone allograft[s]_ synthetic device[s])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC1","description":"ICD-JHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00220","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","description":"CPT-00220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVE0","description":"ICD-GEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVC1","description":"ICD-KEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87337","description":"IAAD IA ENTAMOEBA HISTOLYTICA GRP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64912","description":"Nerve repair; with nerve allograft_ each nerve_ first strand (cable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35189","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB1","description":"ICD-OBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina >2 crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63015","description":"Remove spine lamina >2 crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","description":"HCPCS-Q4439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL50","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/markers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31626","description":"Bronchoscopy w/markers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF0","description":"ICD-ICBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED1","description":"ICD-GHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp lesion ablate w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43278","description":"Ercp lesion ablate w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74182","description":"MRI abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","description":"HCPCS-J1163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add leather insol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3500","description":"Ortho shoe add leather insol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC0","description":"ICD-EDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admin ecg contrast agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93352","description":"Admin ecg contrast agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC31","description":"ICD-1EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUF1","description":"ICD-FFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF0","description":"ICD-OEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIB0","description":"ICD-JAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB1","description":"ICD-CEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo rig ant tib prefab tcf/=","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1932","description":"Afo rig ant tib prefab tcf/=","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88028","description":"Autopsy (necropsy) complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12D","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76983","description":"Ultrasound_ elastography; each additional target lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQF0","description":"ICD-OAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL40","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB51","description":"High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No life asst 2x same/decr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9636","description":"No life asst 2x same/decr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove int/ext hem 1 group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46255","description":"Remove int/ext hem 1 group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB23","description":"High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exchange lens prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66986","description":"Exchange lens prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii high defin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86833","description":"Hla class ii high defin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE0","description":"ICD-MDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF1","description":"ICD-CCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29873","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative AI-based facial phenotype analysis with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0731T","description":"Augmentative AI-based facial phenotype analysis with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC1","description":"ICD-ECTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair stomach opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43870","description":"Repair stomach opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF0","description":"ICD-OKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elev bp plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513F","description":"Elev bp plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"General anesthesia_ first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9222","description":"General anesthesia_ first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC1","description":"ICD-FHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF1","description":"ICD-MCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27889","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8922","description":"Tte w or w/o fol w/cont_ f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41116","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE1","description":"ICD-CFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC0","description":"ICD-LGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME0","description":"ICD-OLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJE0","description":"ICD-OCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF0","description":"ICD-IFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna plan care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0575F","description":"Hiv rna plan care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml dx status unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9139","description":"Onc dx cml dx status unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC1","description":"ICD-DDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy adrenalectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60650","description":"Laparoscopy adrenalectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporine oral 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7502","description":"Cyclosporine oral 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHA0","description":"ICD-CIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobile arm support supinator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2633","description":"Mobile arm support supinator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE0","description":"ICD-OLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Filter gone aft 3mos placmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9541","description":"Filter gone aft 3mos placmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE0","description":"ICD-OKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy 2/> injections","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95125","description":"Immunotherapy 2/> injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC0","description":"ICD-MGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOA1","description":"ICD-OEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNC0","description":"ICD-CFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of precision att","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5867","description":"Replacement of precision att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF0","description":"ICD-JFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBB1","description":"ICD-BEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD1","description":"ICD-DHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc elder mal scrn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8536","description":"No doc elder mal scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5D","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90381","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 1 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF0","description":"ICD-PBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78630","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44120","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","description":"CPT-01926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE124","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIE1","description":"ICD-GBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA1","description":"ICD-NJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of astigmatism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65775","description":"Correction of astigmatism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA1","description":"ICD-AAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA1","description":"ICD-EIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0091","description":"Granisetron 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTB1","description":"ICD-AHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0676U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676U","description":"CPT-0676U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC0","description":"ICD-ACTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES217","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNA0","description":"ICD-NKNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD1","description":"ICD-MIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXE0","description":"ICD-FDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL21","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface below knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2820","description":"Soft interface below knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE1","description":"ICD-NDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF1","description":"ICD-OAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD1","description":"ICD-FEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERC1","description":"ICD-HERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was in hospice or receiving palliative care at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1059","description":"Patient was in hospice or receiving palliative care at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Midfacial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8041","description":"Midfacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA0","description":"ICD-NJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE110","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87803","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Clostridium difficile toxin A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA0","description":"ICD-JDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0582","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","description":"HCPCS-J0582","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA0","description":"ICD-AAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE1","description":"ICD-ADLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC1","description":"ICD-OEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGE1","description":"ICD-GGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABE1","description":"ICD-AABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD1","description":"ICD-CIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA0","description":"ICD-GGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown full cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2792","description":"Crown full cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF1","description":"ICD-EAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNE0","description":"ICD-GFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB1","description":"ICD-GHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA0","description":"ICD-ICLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv vaccine pandemic im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90668","description":"Iiv vaccine pandemic im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE0","description":"ICD-NDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLE0","description":"ICD-ADLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQE1","description":"ICD-PCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOC1","description":"ICD-PEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEB1","description":"ICD-KHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB0","description":"ICD-KCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMB0","description":"ICD-IHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA1","description":"ICD-ODBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQA0","description":"ICD-KIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOB1","description":"ICD-DFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs spinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63620","description":"Srs spinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder blade fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23575","description":"Treat shoulder blade fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE1","description":"ICD-NJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRA0","description":"ICD-LCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTB1","description":"ICD-EDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2038","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","description":"HCPCS-A2038","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spacer with mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8101","description":"Spacer with mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26727","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLB0","description":"ICD-JCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditor evoke potent compre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92585","description":"Auditor evoke potent compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43361","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","description":"HCPCS-A2035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRC1","description":"ICD-HDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA1","description":"ICD-KCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA1","description":"ICD-GHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parainfluenza ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87279","description":"Parainfluenza ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27216","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64467","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","description":"CPT-64467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA136","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj intercost sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64420","description":"N block inj intercost sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0898","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD0","description":"ICD-ODMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJE1","description":"ICD-FBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric motility studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91020","description":"Gastric motility studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB0","description":"ICD-GHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD0","description":"ICD-NCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHE1","description":"ICD-JEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF1","description":"ICD-MLCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest follup not rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9556","description":"CT/MRI chest follup not rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7204","description":"Injection_ Factor VIII_ antihemophilic factor (recombinant)_ (Esperoct)_ glycopegylated-exei_ per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB07","description":"Ultra High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME1","description":"ICD-CAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81346","description":"TYMS (thymidylate synthetase) (eg_ 5-fluorouracil/5-FU drug metabolism)_ gene analysis_ common variant(s) (eg_ tandem repeat variant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE0","description":"ICD-BIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA1","description":"ICD-BCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","description":"CPT-00632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHC0","description":"ICD-OHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC0","description":"ICD-CGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9137","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) PEGylated_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0106","description":"HCPCS-C0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93574","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary venous angiography of each distinct pulmo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil sup empl waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2018","description":"Habil sup empl waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKD0","description":"ICD-BHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC1","description":"ICD-FFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0658U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0658U","description":"CPT-0658U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48153","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKF1","description":"ICD-OKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKB0","description":"ICD-NEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77763","description":"Apply intrcav radiat compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC0","description":"ICD-OAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7190","description":"Factor viii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No reas_ no ret or w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9515","description":"No reas_ no ret or w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer not used w oxygen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7017","description":"Nebulizer not used w oxygen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4379","description":"Urinary plastic pouch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB1","description":"ICD-KFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA0","description":"ICD-FIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen fat stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89125","description":"Specimen fat stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCA0","description":"ICD-FDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA0","description":"ICD-BFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB1","description":"ICD-GADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin cartridge 150 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5565","description":"Insulin cartridge 150 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWD1","description":"ICD-CBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB1","description":"ICD-BFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo without joints pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3923","description":"Hfo without joints pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018M","description":"Transplantation medicine (allograft rejection_ renal)_ measurement of donor and third-party-induced CD154+T-cytotoxic memory cells_ utilizing whole peripheral blood_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE0","description":"ICD-AICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE0","description":"ICD-OABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thumb fusion with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26842","description":"Thumb fusion with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64583","description":"Revision Or Replacement Of Hypoglossal Nerve Neurostimulator Array And Distal Respiratory Sensor Electrode Or Electrode Array_ Including Connection To Existing Pulse Generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB1","description":"ICD-EATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE1","description":"ICD-MHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdomen vessel surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88051","description":"Anesth abdomen vessel surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD1","description":"ICD-GEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0658","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","description":"HCPCS-E0658","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","description":"HCPCS-Q4440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA1","description":"ICD-IGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47130","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHB0","description":"ICD-IAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23335","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27558","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allowrap ds or dry 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4150","description":"Allowrap ds or dry 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC0","description":"ICD-AAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE0","description":"ICD-BCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61708","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES254","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97158","description":"Group adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ face-to-face with multiple patients_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA42","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic refl threshold tst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92568","description":"Acoustic refl threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSB1","description":"ICD-LHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC0","description":"ICD-CCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB0","description":"ICD-NDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC150","description":"Special Care High _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 1 visit p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90956","description":"Esrd srv 1 visit p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0674T","description":"Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including An Implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monitoring feature/devicenoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9279","description":"Monitoring feature/devicenoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD1","description":"ICD-PAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC1","description":"ICD-GEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE0","description":"ICD-DERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC0","description":"ICD-FFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBF0","description":"ICD-KEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4210","description":"Gingivectomy/plasty per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE1","description":"ICD-MLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA1","description":"ICD-IIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1107T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1107T","description":"CPT-1107T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1193","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF0","description":"ICD-KFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF0","description":"ICD-JAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB0","description":"ICD-BDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Salivary gland imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78230","description":"Salivary gland imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No oder pjp for med reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9219","description":"No oder pjp for med reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD1","description":"ICD-PHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","description":"HCPCS-J1171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1289","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1289","description":"HCPCS-J1289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcondylar approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61597","description":"Transcondylar approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMA0","description":"ICD-NIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRA1","description":"ICD-KGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF0","description":"ICD-FIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC1","description":"ICD-FCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC0","description":"ICD-CAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA16","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9365","description":"Hit tpn 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2086","description":"Office-Based Treatment For Opioid Use Disorder_ Including Development Of The Treatment Plan_ Care Coordination_ Individual Therapy And Group Therapy And Counseling; At Least 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTB1","description":"ICD-NLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC0","description":"ICD-EAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA1","description":"ICD-CBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF1","description":"ICD-NHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE1","description":"ICD-OBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9760","description":"Nonrandomized_ nonblinded procedure for NYHA Class II_ III_ IV heart failure; transcatheter implantation of interatrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block other peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64450","description":"N block other peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stat lab home/nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3601","description":"Stat lab home/nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rear whl complete solid tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0069","description":"Rear whl complete solid tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","description":"HCPCS-Q0155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC0","description":"ICD-ADHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDE0","description":"ICD-CFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE0","description":"ICD-KBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRF0","description":"ICD-ODRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB235","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYA1","description":"ICD-HGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE0","description":"ICD-NFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYE0","description":"ICD-DCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36471","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia)_ same leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB1","description":"ICD-AHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME1","description":"ICD-KHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sialidase enzyme assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87905","description":"Sialidase enzyme assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD1","description":"ICD-OCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC0","description":"ICD-NDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genetic testing als","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3800","description":"Genetic testing als","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMC1","description":"ICD-EIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pertechnetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9512","description":"Tc99m pertechnetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of chest wall respiratory sensor electrode or electrode array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468T","description":"Removal of chest wall respiratory sensor electrode or electrode array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11404","description":"Exc tr-ext b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF0","description":"ICD-NCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC1","description":"ICD-NDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51880","description":"Repair of bladder opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDA0","description":"ICD-CIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB0","description":"ICD-NLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81307","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Full Gene Sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC1","description":"ICD-IAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGA1","description":"ICD-KAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med service out of office","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99056","description":"Med service out of office","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30110","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3208","description":"Surgical boot each infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repeat thyroid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60260","description":"Repeat thyroid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB0","description":"ICD-MAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE0","description":"ICD-CBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA1","description":"ICD-PHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD1","description":"ICD-CDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE0","description":"ICD-CBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC1","description":"ICD-EIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","description":"CPT-00930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF1","description":"ICD-KBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESE1","description":"ICD-GESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB31","description":"ICD-3CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUB0","description":"ICD-EHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD0","description":"ICD-JCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uvl sys panel 6 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0693","description":"Uvl sys panel 6 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC43","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61888","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD1","description":"ICD-EALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2174","description":"Uri episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to or on the episode date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF0","description":"ICD-OJCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC0","description":"ICD-PKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD1","description":"ICD-CAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTB1","description":"ICD-BGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE1","description":"ICD-CATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUF1","description":"ICD-ECUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMB0","description":"ICD-BAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spoke protectors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0065","description":"Spoke protectors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVE0","description":"ICD-JAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee orth pos locking joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1831","description":"Knee orth pos locking joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB1","description":"ICD-CDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6517","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","description":"HCPCS-A6517","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBA1","description":"ICD-EIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of midfoot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28800","description":"Amputation of midfoot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJC0","description":"ICD-CDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped wc modify width adjustm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1011","description":"Ped wc modify width adjustm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microdissection laser","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88380","description":"Microdissection laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC1","description":"ICD-MEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD0","description":"ICD-CBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medrsn no pt category","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9292","description":"Medrsn no pt category","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIC1","description":"ICD-KCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA215","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF1","description":"ICD-EHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXF1","description":"ICD-FGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB1","description":"ICD-IDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF0","description":"ICD-KIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 5-6 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98927","description":"Osteopath manj 5-6 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC1","description":"ICD-FFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC135","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE1","description":"ICD-FAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA1","description":"ICD-MACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 VAC AD26 .5ML B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034A","description":"ADM SARSCOV2 VAC AD26 .5ML B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28B","description":"Clinically Complex _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85610","description":"Prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA130","description":"Reduced Physical Function _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA21","description":"ICD-3EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC21","description":"ICD-2JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB0","description":"ICD-CGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRE1","description":"ICD-PGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE0","description":"ICD-LGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC205","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1805","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1805","description":"CDT-D1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD0","description":"ICD-MAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB1","description":"ICD-HCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fats/lipids feces qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82705","description":"Fats/lipids feces qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES145","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA31","description":"ICD-4JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA0","description":"ICD-NIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m sestamibi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9500","description":"Tc99m sestamibi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHE1","description":"ICD-MLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB60","description":"Very High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face tum deep < 2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21013","description":"Exc face tum deep < 2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB43","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27640","description":"Partial removal of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC0","description":"ICD-OFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trapeze bar free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0940","description":"Trapeze bar free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA0","description":"ICD-MDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC0","description":"ICD-FABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC1","description":"ICD-CIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic ring fx treat int fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0414","description":"Pelvic ring fx treat int fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vbac class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9439","description":"Vbac class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA1","description":"ICD-GDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF1","description":"ICD-NIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE1","description":"ICD-PKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1263","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA0","description":"ICD-BDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av fuse uppr arm cephalic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36818","description":"Av fuse uppr arm cephalic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tendon transfer with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26492","description":"Tendon transfer with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF1","description":"ICD-EFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0563","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","description":"HCPCS-G0563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVA1","description":"ICD-OKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOE1","description":"ICD-CCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Refill/maint portable pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96521","description":"Refill/maint portable pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C diff amplified probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87493","description":"C diff amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF0","description":"ICD-JFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29837","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD1","description":"ICD-OEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA1","description":"ICD-BBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE1","description":"ICD-HHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental saliography","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0310","description":"Dental saliography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA14","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYB0","description":"ICD-GHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB1","description":"ICD-PCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flebogamma injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1572","description":"Flebogamma injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB1","description":"ICD-AGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBA1","description":"ICD-KCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLD1","description":"ICD-AHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2596","description":"Probe_ Image-Guided_ Robotic_ Waterjet Ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD1","description":"ICD-CAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE1","description":"ICD-KHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmchoPlast_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4316","description":"AmchoPlast_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE1","description":"ICD-NIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC0","description":"ICD-PDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wc planar back cush wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2620","description":"Wc planar back cush wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relese_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4257","description":"Relese_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC0","description":"ICD-HHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB1","description":"ICD-BIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA0","description":"ICD-NBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF0","description":"ICD-LBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXF1","description":"ICD-NAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped power wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1239","description":"Ped power wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE0","description":"ICD-NBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB0","description":"ICD-OLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of natriuretic peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83880","description":"Assay of natriuretic peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC0","description":"ICD-PAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC1","description":"ICD-KAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0085U","description":"Cytolethal distending toxin B (CdtB) and vinculin IgG antibodies by immunoassay (ie_ ELISA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59515","description":"Cesarean delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31595","description":"Section recurrent laryngeal nerve_ therapeutic (separate procedure)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE0","description":"ICD-BGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78018","description":"Thyroid met imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMA0","description":"ICD-NHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging mult areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78801","description":"Tumor imaging mult areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC1","description":"ICD-PJWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73051","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg > 40 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2506","description":"Sgd prerec msg > 40 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWF0","description":"ICD-GEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE1","description":"ICD-BAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","description":"CPT-00865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILF0","description":"ICD-GILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23400","description":"Fixation of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0860","description":"Pwc gp3 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND1","description":"ICD-GGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs other vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36406","description":"Bl draw <3 yrs other vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recon_ cta for surg plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0288","description":"Recon_ cta for surg plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC215","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB21","description":"ICD-3AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27550","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endometr ablate thermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58353","description":"Endometr ablate thermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ven thrombosis images bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78458","description":"Ven thrombosis images bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE0","description":"ICD-KEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychoanalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90845","description":"Psychoanalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE0","description":"ICD-FEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA0","description":"ICD-OBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo frct swg & sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5718","description":"Knee-shin exo frct swg & sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMD1","description":"ICD-MFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE117","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB1","description":"ICD-DIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHD0","description":"ICD-OIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKB0","description":"ICD-CHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45349","description":"Sigmoidoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0219T","description":"Plmt post facet implt cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj celiac pelus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64530","description":"N block inj celiac pelus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75051","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69716","description":"Implantation_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIB1","description":"ICD-FFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58400","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulm funct test oscillometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94728","description":"Pulm funct test oscillometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB1","description":"ICD-FBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9203","description":"Injection_ gemtuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA0","description":"ICD-KFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93016","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD1","description":"ICD-NBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB0","description":"ICD-GHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBB1","description":"ICD-ACBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dysphagia screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5364","description":"Dysphagia screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF1","description":"ICD-NKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3204","description":"Hightop w/ supp/pronator inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB1","description":"ICD-IAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF0","description":"ICD-EDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0665U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0665U","description":"CPT-0665U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE1","description":"ICD-CITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBB1","description":"ICD-CBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo calf/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4090","description":"Repl met band kafo-afo calf/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF0","description":"ICD-NGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86053","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE1","description":"ICD-CGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0002","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHB0","description":"ICD-BDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL26","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE0","description":"ICD-NFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFD0","description":"ICD-NIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61640","description":"Dilate ic vasospasm init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9160","description":"Lang comp goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81120","description":"IDH1 (isocitrate dehydrogenase 1 [NADP+]_ soluble) (eg_ glioma)_ common variants (eg_ R132H_ R132C)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLA1","description":"ICD-BBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84590","description":"Assay of vitamin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7296","description":"Levonorgestrel-releasing intrauterine contraceptive system_ (Kyleena)_ 19.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","description":"CPT-01638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD106","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43840","description":"Repair of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10D","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLE0","description":"ICD-MGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26770","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8611","description":"Methotrexate (Jylamvo)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24363","description":"Replace elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA1","description":"ICD-OCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Twist drill hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61105","description":"Twist drill hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC1","description":"ICD-OHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26485","description":"Transplant palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC1","description":"ICD-KHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC1","description":"ICD-OLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC0","description":"ICD-KIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC0","description":"ICD-AABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD211","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21194","description":"Reconst lwr jaw w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB1","description":"ICD-IHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove mastoid structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69505","description":"Remove mastoid structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE0","description":"ICD-BHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC0","description":"ICD-EBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92631","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","description":"CPT-92631","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq sacral augmt unilat inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0200T","description":"Perq sacral augmt unilat inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE1","description":"ICD-OJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE0","description":"ICD-NDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIA0","description":"ICD-IEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58280","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF0","description":"ICD-OILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user received brief counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2200","description":"Patient identified as an unhealthy alcohol user received brief counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFD0","description":"ICD-KGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD1","description":"ICD-FITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE1","description":"ICD-NHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC1","description":"ICD-NHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE0","description":"ICD-FEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31367","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skin wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15829","description":"Removal of skin wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB0","description":"ICD-HFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF1","description":"ICD-ACTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"American amnion ac_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4306","description":"American amnion ac_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD0","description":"ICD-OLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE0","description":"ICD-FGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALD1","description":"ICD-KALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLB1","description":"ICD-FGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB1","description":"ICD-GFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61868","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c genotype prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9207","description":"Hep c genotype prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plnning pt spec fenest graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34839","description":"Plnning pt spec fenest graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD0","description":"ICD-OHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermavest_ plurivest sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4153","description":"Dermavest_ plurivest sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC1","description":"ICD-MBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80204","description":"Methotrexate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise & drain bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51040","description":"Incise & drain bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1175","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g._ prior anaphylaxis due to the zoster vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXC0","description":"ICD-OAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITE1","description":"ICD-EITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA0","description":"ICD-FHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE0","description":"ICD-CFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA0","description":"ICD-NGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of leg at hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27295","description":"Amputation of leg at hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE0","description":"ICD-JEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC1","description":"ICD-MCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA1","description":"ICD-MCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC1","description":"ICD-OIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrog device eval heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93289","description":"Interrog device eval heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF0","description":"ICD-PLYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonmed family planning ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1010","description":"Nonmed family planning ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94851","description":"Anesth repair of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA0","description":"ICD-KFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBE1","description":"ICD-MKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD1","description":"ICD-JDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCB1","description":"ICD-MBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0520","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0520","description":"HCPCS-Q0520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein l3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82107","description":"Alpha-fetoprotein l3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna analysis deafness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3844","description":"Dna analysis deafness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Garamycin gentamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1580","description":"Garamycin gentamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC1","description":"ICD-OEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQA0","description":"ICD-DIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43116","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE1","description":"ICD-GIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33820","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC0","description":"ICD-CAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE0","description":"ICD-CBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0B","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45378","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA1","description":"ICD-CIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSF0","description":"ICD-CDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81345","description":"TERT (telomerase reverse transcriptase) (eg_ thyroid carcinoma_ glioblastoma multiforme) gene analysis_ targeted sequence analysis (eg_ promoter region)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRC1","description":"ICD-KIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB0","description":"ICD-CFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX33","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOF1","description":"ICD-GBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMC1","description":"ICD-GCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE1","description":"ICD-CGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE1","description":"ICD-EHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC0","description":"ICD-OBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35450","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNC1","description":"ICD-GHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 5 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95134","description":"Immntx 5 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2B","description":"Low Rehab_ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMA0","description":"ICD-OAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB0","description":"ICD-OHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFF0","description":"ICD-GAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63103","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDD0","description":"ICD-KDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB1","description":"ICD-MGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE1","description":"ICD-GAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC1","description":"ICD-HHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86663","description":"Epstein-barr antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA1","description":"ICD-PHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53060","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD0","description":"ICD-JFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9016","description":"Rbc leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB0","description":"ICD-GGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63706","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medroxyprogesterone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1050","description":"Medroxyprogesterone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB201","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0624U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","description":"CPT-0624U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27086","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA0","description":"ICD-FCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAB0","description":"ICD-IEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID1","description":"ICD-FCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27818","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDC0","description":"ICD-ICDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA0","description":"ICD-NFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9597","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAD1","description":"ICD-AFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD0","description":"ICD-MJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9793","description":"Patient is currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB0","description":"ICD-JIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2007","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ doxercalciferol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1270","description":"Injection_ doxercalciferol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHB0","description":"ICD-MBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90281","description":"Human ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA0","description":"ICD-MIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of mammary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77053","description":"X-ray of mammary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65730","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD0","description":"ICD-IGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA1","description":"ICD-KEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD1","description":"ICD-NGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPA0","description":"ICD-ODPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0226U","description":"Surrogate viral neutralization test (sVNT)_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ ELISA_ plasma_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0506","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1255","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eptifibatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1327","description":"Eptifibatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE1","description":"ICD-GABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0687T","description":"Treatment Of Amblyopia Using An Online Digital Program; Device Supply_ Educational Set-Up_ And Initial Session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26545","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Misoprostol_ oral_ 200 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0191","description":"Misoprostol_ oral_ 200 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUF1","description":"ICD-OJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA0","description":"ICD-HIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","description":"HCPCS-M1379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA1","description":"ICD-IGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leishmania antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86717","description":"Leishmania antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD1","description":"ICD-CAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9474","description":"Injection_ irinotecan liposome_ 1 mg (Onivyde)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9751","description":"Bronchoscopy_ rigid or flexible_ transbronchial ablation of lesion(s) by microwave energy_ including fluoroscopic guidance_ whe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB105","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF0","description":"ICD-GEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE1","description":"ICD-JHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE1","description":"ICD-GBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC1","description":"ICD-OIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow harvest autolog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38232","description":"Bone marrow harvest autolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCB0","description":"ICD-NCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC1","description":"ICD-FGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0224","description":"Injection_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB0","description":"ICD-PJSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fixed ht w/ mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0250","description":"Hosp bed fixed ht w/ mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alprostadil urethral suppos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0275","description":"Alprostadil urethral suppos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti rheum drugthxpyrxd/gvn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4187F","description":"Anti rheum drugthxpyrxd/gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvas vasc dx study proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93998","description":"Noninvas vasc dx study proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52265","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect neck thorax tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21557","description":"Resect neck thorax tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heterophile antibody absrbj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86310","description":"Heterophile antibody absrbj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB0","description":"ICD-OBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-H0053","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","description":"HCPCS-H0053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB1","description":"ICD-ECIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD1","description":"ICD-OKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1063T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1063T","description":"CPT-1063T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93592","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1062","description":"Intravertebral body fracture augmentation with implant (e.g._ metal_ polymer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87472","description":"Bartonella dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE0","description":"ICD-NENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX31","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX34","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8C","description":"Medium Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFA0","description":"ICD-CIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9966","description":"Children who were screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray eye for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70030","description":"X-ray eye for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE1","description":"ICD-MAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin cartridge 300 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5566","description":"Insulin cartridge 300 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0197","description":"Air pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD0","description":"ICD-GIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1036T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1036T","description":"CPT-1036T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFD0","description":"ICD-FAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cptr-asst dir ms px","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20985","description":"Cptr-asst dir ms px","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ transvenous vdd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1779","description":"Lead_ pmkr_ transvenous vdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0499U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","description":"CPT-0499U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD0","description":"ICD-FCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB0","description":"ICD-OALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6037","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","description":"HCPCS-L6037","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36261","description":"Revision of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTD0","description":"ICD-AGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJA0","description":"ICD-OCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5919","description":"Facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE0","description":"ICD-CCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc surv no stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9259","description":"Doc surv no stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCD1","description":"ICD-FCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB1","description":"ICD-AADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE0","description":"ICD-NHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD1","description":"ICD-NATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC1","description":"ICD-PBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB1","description":"ICD-NBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA54","description":"Very High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMF0","description":"ICD-JIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF0","description":"ICD-OLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cur meds not document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8428","description":"Cur meds not document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC50","description":"Medium Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76826","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0402","description":"HCPCS-C0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME0","description":"ICD-GAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC1","description":"ICD-NGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1905","description":"Virtual reality cognitive behavioral therapy device (cbt)_ including pre-programmed therapy software","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC240","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sugars multiple quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84379","description":"Sugars multiple quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLB1","description":"ICD-NDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEE0","description":"ICD-MAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35221","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNC1","description":"ICD-NFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC1","description":"ICD-BGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX05","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & polypectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45333","description":"Sigmoidoscopy & polypectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCC0","description":"ICD-GFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA0","description":"ICD-NKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant spine infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62361","description":"Implant spine infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen amphetamines 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80324","description":"Drug screen amphetamines 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0558","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","description":"HCPCS-G0558","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure reading not documented_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1281","description":"Blood pressure reading not documented_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bis xtracell fluid analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93702","description":"Bis xtracell fluid analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27524","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA1","description":"ICD-GFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME0","description":"ICD-GEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC1","description":"ICD-PDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ non sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1896","description":"Lead_ aicd_ non sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xcell amnio matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4280","description":"Xcell amnio matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9624","description":"Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user_ reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented below normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1287","description":"Bmi is documented below normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF1","description":"ICD-BIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYF1","description":"ICD-LCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF1","description":"ICD-EBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE220","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB1","description":"ICD-EBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polysom 6/> yrs 4/> param","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95810","description":"Polysom 6/> yrs 4/> param","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87812","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","description":"CPT-87812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD0","description":"ICD-BGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB0","description":"ICD-NKXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB0","description":"ICD-FGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF1","description":"ICD-NJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automatic bp monitor_ dial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4670","description":"Automatic bp monitor_ dial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer tendon to pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27098","description":"Transfer tendon to pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rx corneoscleral cntact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92317","description":"Rx corneoscleral cntact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANB1","description":"ICD-NANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC134","description":"Special Care High _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chiropractic medicine mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0065","description":"Chiropractic medicine mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJB1","description":"ICD-FBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shunt accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4740","description":"Shunt accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE0","description":"ICD-DDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB0","description":"ICD-AHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA1","description":"ICD-BBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5277","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD0","description":"ICD-KIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01961","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","description":"CPT-01961","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAD1","description":"ICD-NCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fancc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81242","description":"Fancc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC0","description":"ICD-NEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stress tte complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93351","description":"Stress tte complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1049","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB120","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB1","description":"ICD-NKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC05","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90693","description":"Typhoid vaccine_ acetone-killed_ dried (akd)_ for subcutaneous or jetinjection use (u.s. military)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3386","description":"HCPCS-J3386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays transcath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75894","description":"X-rays transcath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMD0","description":"ICD-EAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC1","description":"ICD-KDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","description":"HCPCS-Q4376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40808","description":"Biopsy of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFF1","description":"ICD-FFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF0","description":"ICD-HASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE1","description":"ICD-OIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55840","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC1","description":"ICD-KBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"4vhpv vaccine 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90649","description":"4vhpv vaccine 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC1","description":"ICD-ODPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF0","description":"ICD-NCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD1","description":"ICD-NBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC0","description":"ICD-JDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE0","description":"ICD-AEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004U","description":"Infect disease (bact)_ DNA_ 27 resistance genes_ PCR amplification and probe hybridization in microarray format (molecular detection and identification of AmpC_ carbapenemas)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ moxifloxacin 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2280","description":"Inj_ moxifloxacin 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","description":"HCPCS-Q4416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE1","description":"ICD-NEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28705","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD0","description":"ICD-JGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC1","description":"ICD-BCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF1","description":"ICD-CAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB1","description":"ICD-CFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28750","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo tibial fracture soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2112","description":"Afo tibial fracture soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJF0","description":"ICD-GAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB21","description":"ICD-3BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA0","description":"ICD-BDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5104","description":"HCPCS-A5104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4032","description":"Rheumatology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAE1","description":"ICD-BGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE0","description":"ICD-NKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANF0","description":"ICD-CANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA30","description":"Very High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD0","description":"ICD-OIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31510","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA1","description":"ICD-HGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC0","description":"ICD-OFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent w/angio 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92928","description":"Prq card stent w/angio 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF1","description":"ICD-NIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8913","description":"Pt doc no wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUE0","description":"ICD-CDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE1","description":"ICD-GIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48146","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA0","description":"ICD-AFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB0","description":"ICD-OLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB1","description":"ICD-GDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE0","description":"ICD-GIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC0","description":"ICD-MHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Expiratory positive airway pressure intranasal resistance valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7049","description":"Expiratory positive airway pressure intranasal resistance valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25350","description":"Revision of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap enterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44202","description":"Lap enterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA0","description":"ICD-OAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC220","description":"Reduced Physical Function _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD0","description":"ICD-CHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF1","description":"ICD-NJKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9985","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVC1","description":"ICD-NCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem_ vaborbactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2186","description":"Injection_ meropenem_ vaborbactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC1","description":"ICD-IIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of procainamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80192","description":"Assay of procainamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB06","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRA0","description":"ICD-HFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74280","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHA0","description":"ICD-KIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no scr uter malig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9619","description":"Doc rsn no scr uter malig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nervous system nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78699","description":"Nervous system nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC0","description":"ICD-OBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA0","description":"ICD-FEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use txmnt pharmacol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4001F","description":"Tobacco use txmnt pharmacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC0","description":"ICD-BCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND1","description":"ICD-FGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDE0","description":"ICD-NIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87581","description":"M.pneumon dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75805","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUE1","description":"ICD-FGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA1","description":"ICD-JETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF0","description":"ICD-BCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD204","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD0","description":"ICD-NIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF0","description":"ICD-OHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB1","description":"ICD-NEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB0","description":"ICD-CDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1093T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1093T","description":"CPT-1093T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - occlusal radiographic image - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0706","description":"Intraoral - occlusal radiographic image - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metoclopramide hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2765","description":"Metoclopramide hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAB0","description":"ICD-NAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64795","description":"Biopsy of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9153","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of androsterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82160","description":"Assay of androsterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBE0","description":"ICD-MLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSF0","description":"ICD-DDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test urine urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84578","description":"Test urine urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay nonendocrine receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84238","description":"Assay nonendocrine receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33500","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE0","description":"ICD-IHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC0","description":"ICD-KDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55877","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","description":"CPT-55877","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Internal root repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3333","description":"Internal root repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0468","description":"Tlso rig fram pelvic pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA0","description":"ICD-OFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resin one surface-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2330","description":"Resin one surface-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE1","description":"ICD-BGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVC0","description":"ICD-GHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC0","description":"ICD-DBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJC1","description":"ICD-NEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUA0","description":"ICD-FBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC225","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB1","description":"ICD-LAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFA0","description":"ICD-KEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corticorelin ovine triflutal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0795","description":"Corticorelin ovine triflutal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMC0","description":"ICD-BCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibody detection nos if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87299","description":"Antibody detection nos if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm each no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0116","description":"Crutch underarm each no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDE0","description":"ICD-NJDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9142","description":"Injection_ bevacizumab-maly_ biosimilar_ (Alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sulfamethoxazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0039","description":"Injection_ sulfamethoxazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meg evoked each addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95967","description":"Meg evoked each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium ph inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1710","description":"Hydrocortisone sodium ph inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9301","description":"HCPCS-C9301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef hydrolyzed/amino acids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4153","description":"Ef hydrolyzed/amino acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L colectomy/coloproctostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44208","description":"L colectomy/coloproctostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOD1","description":"ICD-DFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML53","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE0","description":"ICD-GBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTD1","description":"ICD-NCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t4_n_m0 no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9093","description":"Onc dx rectal t4_n_m0 no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32670","description":"Thoracoscopy bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoid synthetic 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80352","description":"Cannabinoid synthetic 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body jawbone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41806","description":"Removal foreign body jawbone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXC1","description":"ICD-OIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXA0","description":"ICD-ODXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF1","description":"ICD-PJWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC1","description":"ICD-KIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA42","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB1","description":"ICD-PGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC1","description":"ICD-HGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FlowerAmnioPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4178","description":"FlowerAmnioPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt cat/pn cat/hist grd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3260F","description":"Pt cat/pn cat/hist grd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26426","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB1","description":"ICD-NECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB0","description":"ICD-JFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF0","description":"ICD-KCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33977","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0044A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emapalumab-lzsg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9210","description":"Injection_ emapalumab-lzsg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0239","description":"Intravenous infusion_ bamlanivimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB0","description":"ICD-BCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD1","description":"ICD-LDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add half sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3530","description":"Ortho shoe add half sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation upper jaw artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30920","description":"Ligation upper jaw artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36561","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCA0","description":"ICD-NJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc sinus ct 28d or dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9350","description":"No doc sinus ct 28d or dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDF1","description":"ICD-NCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPC0","description":"ICD-ODPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND1","description":"ICD-OFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64575","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA1","description":"ICD-FBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD116","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tdap vaccine 7 yrs/> im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90715","description":"Tdap vaccine 7 yrs/> im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINA1","description":"ICD-OINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGD0","description":"ICD-CIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cefepime hcl for injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0692","description":"Cefepime hcl for injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1177","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 60th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB1","description":"ICD-FHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE0","description":"ICD-LESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE1","description":"ICD-NETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8852","description":"Pos air press prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD0","description":"ICD-NIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of a-v fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37607","description":"Ligation of a-v fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWA0","description":"ICD-HCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB1","description":"ICD-BHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263T","description":"Im b1 mrw cel ther cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD101","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA1","description":"ICD-MFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0480U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","description":"CPT-0480U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99418","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44603","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF0","description":"ICD-KBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE0","description":"ICD-BIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELC0","description":"ICD-NELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC0","description":"ICD-NLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB11","description":"ICD-1DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA60","description":"Ultra High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE0","description":"ICD-NJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC0","description":"ICD-EEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45300","description":"Proctosigmoidoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDED0","description":"ICD-KDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22903","description":"Exc abd les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine reagent strips/tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4250","description":"Urine reagent strips/tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD0","description":"ICD-GAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALA0","description":"ICD-EALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who received cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9806","description":"Patients who received cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc no pain comfort 48hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9251","description":"Doc no pain comfort 48hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD151","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9738","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF1","description":"ICD-NDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB0","description":"ICD-GEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE0","description":"ICD-CCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA15","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC1","description":"ICD-BEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF1","description":"ICD-EFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67902","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93042","description":"Rhythm ecg report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermabind dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4287","description":"Dermabind dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs bil 3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71110","description":"X-ray exam ribs bil 3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID1","description":"ICD-NJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC1","description":"ICD-JFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBD1","description":"ICD-OBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD0","description":"ICD-FFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOD1","description":"ICD-DBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25A","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mdd moderate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3089F","description":"Mdd moderate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pneumococcal admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8867","description":"No pneumococcal admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24138","description":"Remove elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36823","description":"Insertion of cannula(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9290","description":"No doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADA0","description":"ICD-JADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0519","description":"Management of new patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Next gen aco model<10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9868","description":"Next gen aco model<10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82491","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); single analyte not elsewhere specified_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC0","description":"ICD-KIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25270","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67030","description":"Incise inner eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eardrum revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69450","description":"Eardrum revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD1","description":"ICD-CILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD0","description":"ICD-KBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME0","description":"ICD-OFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent assess vol mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8955","description":"Most recent assess vol mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB21","description":"ICD-1AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABA1","description":"ICD-CABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1301","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6599","description":"Gradient compression bandage roll_ inelastic short stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWF0","description":"ICD-DEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0170","description":"Commode chair electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE240","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8X","description":"Very High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD0","description":"ICD-EAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0473T","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg_ retinal prosthesis)_ in person_ including reprogramming and visual training_ when performed_ wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69501","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electro connect btw control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2310","description":"Electro connect btw control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 pc ost pou w built-in conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5057","description":"1 pc ost pou w built-in conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB0","description":"ICD-GAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA1","description":"ICD-KCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not initial eval for cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1501F","description":"Not initial eval for cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us detailed addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76812","description":"Ob us detailed addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transparent film > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6259","description":"Transparent film > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD0","description":"ICD-CFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51525","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKF0","description":"ICD-GAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harness figure of 8 dual con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6676","description":"Harness figure of 8 dual con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD0","description":"ICD-CEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGME0","description":"ICD-AGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc supervision palliative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9054","description":"Onc supervision palliative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vacc no prsv 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90656","description":"Iiv3 vacc no prsv 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE1","description":"ICD-CEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC1","description":"ICD-KBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD0","description":"ICD-PLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC0","description":"ICD-LGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUF1","description":"ICD-NFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD0","description":"ICD-PLRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF0","description":"ICD-KGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93970","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump adpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4282","description":"Replacement breastpump adpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQE0","description":"ICD-GAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFED1","description":"ICD-NFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6062","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate speech production","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92522","description":"Evaluate speech production","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucose tolerance test (gtt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82951","description":"Glucose tolerance test (gtt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydroceles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55041","description":"Removal of hydroceles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWA0","description":"ICD-CEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0054","description":"Coordinating Stroke Care To Promote Prevention And Cultivate Positive Outcomes Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF1","description":"ICD-KIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monitor elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0483","description":"Monitor elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF1","description":"ICD-CINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD0","description":"ICD-LFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE0","description":"ICD-GGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC0","description":"ICD-AEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motor &/ sens nrve cndj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95905","description":"Motor &/ sens nrve cndj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical pneum trac equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0849","description":"Cervical pneum trac equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc99m arcitumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9568","description":"Technetium tc99m arcitumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD0","description":"ICD-GHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE1","description":"ICD-JDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63076","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatic elastase fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82656","description":"Pancreatic elastase fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amisulpride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0184","description":"Injection_ amisulpride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9733","description":"Patient unable to complete the FOTO lumbar intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an ade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMA1","description":"ICD-KFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE1","description":"ICD-AIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHF1","description":"ICD-IHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF1","description":"ICD-KBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lowr extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5999","description":"Lowr extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27220","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0668U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0668U","description":"CPT-0668U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB0","description":"ICD-KBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","description":"CPT-01382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEF0","description":"ICD-IAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAD1","description":"ICD-JHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHC0","description":"ICD-EAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRC1","description":"ICD-HFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETA1","description":"ICD-NETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70487","description":"Ct maxillofacial w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21436","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64484","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percut allergy skin tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95004","description":"Percut allergy skin tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYC0","description":"ICD-PGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLA0","description":"ICD-EBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA0","description":"ICD-MLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC0","description":"ICD-CFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSE1","description":"ICD-LHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24330","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC0","description":"ICD-GDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA0","description":"ICD-AHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amp no reqd in48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9639","description":"Amp no reqd in48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC0","description":"ICD-GETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB0","description":"ICD-ODPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID1","description":"ICD-OEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCF1","description":"ICD-CDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0735T","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL33","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of calcium deposits","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23000","description":"Removal of calcium deposits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35665","description":"Art byp iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove femur lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27355","description":"Remove femur lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB0","description":"ICD-JEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27333","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove aneurysm sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61613","description":"Remove aneurysm sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive chest wall surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19272","description":"Extensive chest wall surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCA1","description":"ICD-ECCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOA0","description":"ICD-HHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUF0","description":"ICD-NDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lev 4 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0383","description":"Lev 4 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHD1","description":"ICD-BGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD1","description":"ICD-NHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBA0","description":"ICD-KBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph imped funct test > 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91038","description":"Esoph imped funct test > 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSE0","description":"ICD-KBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Pembrolizumab_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9027","description":"Injection_ Pembrolizumab_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23460","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSB1","description":"ICD-PKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA1","description":"ICD-CDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE0","description":"ICD-KDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"LU GNOTYP BCAM EXON 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196U","description":"LU GNOTYP BCAM EXON 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE0","description":"ICD-OLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9158","description":"Motor speech d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE216","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD1","description":"ICD-CBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjst forearm pro/sup device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1802","description":"Adjst forearm pro/sup device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE0","description":"ICD-MFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ovulation mgmt per cycle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4042","description":"Ovulation mgmt per cycle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in snf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5004","description":"Hospice in snf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6507","description":"Cmprs burngarment foot-knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49600","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC1","description":"ICD-NHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD0","description":"ICD-JDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNA1","description":"ICD-BBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4357","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","description":"HCPCS-Q4357","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB0","description":"ICD-CFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUC1","description":"ICD-NFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNB1","description":"ICD-FGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB0","description":"ICD-IIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA0","description":"ICD-NFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB0","description":"ICD-AICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE0","description":"ICD-NFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Path rprt w/ pt pn cat et al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3267F","description":"Path rprt w/ pt pn cat et al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9744","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct maxillofacial w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70488","description":"Ct maxillofacial w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No statin/no order statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9665","description":"No statin/no order statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413U","description":"Oncology (hematolymphoid neoplasm)_ optical genome mapping for copy number alterations_ aneuploidy_ and balanced/complex structural rearrangements_ DNA from blood or bone marr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46270","description":"Remove anal fist subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD0","description":"ICD-KIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXE1","description":"ICD-GHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC1","description":"ICD-AGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24655","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBB1","description":"ICD-OLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE224","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF1","description":"ICD-ECCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1445","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","description":"HCPCS-M1445","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67121","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect talus/calcaneus tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27647","description":"Resect talus/calcaneus tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD0","description":"ICD-OFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC1","description":"ICD-JCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No low pecarn ped head traum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9597","description":"No low pecarn ped head traum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31781","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD1","description":"ICD-OLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC1","description":"ICD-HIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF1","description":"ICD-KAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE0","description":"ICD-GBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB1","description":"ICD-JELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB0","description":"ICD-FDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE1","description":"ICD-GGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF1","description":"ICD-CEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD0","description":"ICD-JGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of liver duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47400","description":"Incision of liver duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX34","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6574","description":"Gradient compression arm sleeve and glove combination_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88150","description":"Cytopath c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag and followup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9548","description":"Abd imag and followup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB0","description":"ICD-OLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD1","description":"ICD-BEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9679","description":"Onsite Ac C Tx Nsg Fac Res W/Pne Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC1","description":"ICD-AGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epieffect_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4278","description":"Epieffect_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advanced life support mileag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0390","description":"Advanced life support mileag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIB0","description":"ICD-NIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB1","description":"ICD-CEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD0","description":"ICD-NEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGA0","description":"ICD-GEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA1","description":"ICD-BAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLD1","description":"ICD-IGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSD0","description":"ICD-CHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62303","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tum incl acetabul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27076","description":"Resect hip tum incl acetabul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0321U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms and identification of 16 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38724","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEA1","description":"ICD-KFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Distal/proximal wedge proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4274","description":"Distal/proximal wedge proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC1","description":"ICD-HBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE156","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEB1","description":"ICD-CHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13120","description":"Cmplx rpr s/a/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE0","description":"ICD-KHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIB0","description":"ICD-CBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIC1","description":"ICD-OAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF0","description":"ICD-JIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ossicular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8613","description":"Ossicular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECME1","description":"ICD-ECME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL43","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0471T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acq_ interpretation_ and report; each additional lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko single upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0901","description":"Ko single upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA0","description":"ICD-CFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87537","description":"Hiv-2 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1039F","description":"Intermittent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCED1","description":"ICD-BCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte f-up or lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93308","description":"Tte f-up or lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC1","description":"ICD-PHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; carotid sinus (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64508","description":"Injection_ anesthetic agent; carotid sinus (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE1","description":"ICD-CDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft trunk add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15201","description":"Skin full graft trunk add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBD1","description":"ICD-CIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine documented as administered or previously received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1064","description":"Shingrix vaccine documented as administered or previously received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/1-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34804","description":"Endovas aaa repr w/1-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANF0","description":"ICD-NANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWA0","description":"ICD-GIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB1","description":"ICD-FGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB0","description":"ICD-KEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD1","description":"ICD-BHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24515","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93281","description":"Pm device progr eval multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC1","description":"ICD-OKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl devital tis 20 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97597","description":"Rmvl devital tis 20 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluorescent study_ each antibody; indirect method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88347","description":"Immunofluorescent study_ each antibody; indirect method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dornase alfa non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7639","description":"Dornase alfa non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE1","description":"ICD-CIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB10","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy infusion method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96425","description":"Chemotherapy infusion method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWF0","description":"ICD-PEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD1","description":"ICD-CHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUD0","description":"ICD-NGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen site not prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8798","description":"Specimen site not prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD1","description":"ICD-FACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortobifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35646","description":"Art byp aortobifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAE0","description":"ICD-CCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWD0","description":"ICD-KHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Con tissue w dble ped graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4276","description":"Con tissue w dble ped graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB1","description":"ICD-IBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSA1","description":"ICD-OKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF0","description":"ICD-FEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD0","description":"ICD-EHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC1","description":"ICD-GDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0499T","description":"Cystourethroscopy_ with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis_ including fluoroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB1","description":"ICD-KETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC0","description":"ICD-CHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast 1st lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19083","description":"Bx breast 1st lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICC0","description":"ICD-AICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLB1","description":"ICD-CCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening tramadol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80373","description":"Drug screening tramadol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD1","description":"ICD-BFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAA1","description":"ICD-NLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOC1","description":"ICD-GGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cerclage suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59871","description":"Remove cerclage suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93247","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv vaccine 4-6 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90696","description":"Dtap-ipv vaccine 4-6 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17262","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen probe used w oximeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4606","description":"Oxygen probe used w oximeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL07","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC0","description":"ICD-FHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE0","description":"ICD-IBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB0","description":"ICD-AIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF0","description":"ICD-EHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0A","description":"Medium Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9297","description":"Injection_ pemetrexed (sandoz)_ not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES121","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD1","description":"ICD-GEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93930","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85366","description":"Fibrinogen test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Itraconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80189","description":"Itraconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB0","description":"ICD-GCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF0","description":"ICD-GGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB0","description":"ICD-BGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech therapy_ re-eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9152","description":"Speech therapy_ re-eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unskilled respite care /15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5150","description":"Unskilled respite care /15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB1","description":"ICD-CHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE1","description":"ICD-KDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruct b9 lesion 1-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17110","description":"Destruct b9 lesion 1-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvas resp support talk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4550F","description":"Noninvas resp support talk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE112","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTB0","description":"ICD-GHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB0","description":"ICD-EIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE1","description":"ICD-OCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1392","description":"Portable oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69421","description":"Incision of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81522","description":"Oncology (Breast)_ Mrna_ Gene Expression Profiling By Rt-Pcr Of 12 Genes (8 Content And 4 Housekeeping)_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB1","description":"ICD-JGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF1","description":"ICD-JAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0836","description":"Pwc gp2 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9774","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy_ includes angioplasty within the same vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB23","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1443","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","description":"HCPCS-M1443","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE0","description":"ICD-ODYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC0","description":"ICD-CGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC1","description":"ICD-ADMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD1","description":"ICD-JDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA11","description":"ICD-4GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair spigelian hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49590","description":"Repair spigelian hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNF0","description":"ICD-CHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20670","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobility current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8978","description":"Mobility current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB0","description":"ICD-OHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB0","description":"ICD-ACAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67901","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36482","description":"Endovenous ablation therapy of incompetent vein_ extremity_ by transcatheter delivery of a chemical adhesive (eg_ cyanoacrylate) remote from the access site_ inclusive of all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE241","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387T","description":"Transcatheter insertion or replacement of permanent leadless pacemaker_ ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA0","description":"ICD-CHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB1","description":"ICD-JILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441U","description":"Infectious disease (bacterial_ fungal_ or viral infection)_ semiquantitative biomechanical assessment (via deformability cytometry)_ whole blood_ with algorithmic analysis and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE1","description":"ICD-BDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRE1","description":"ICD-PHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB226","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCF0","description":"ICD-CGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLF0","description":"ICD-ABLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43510","description":"Surgical opening of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD1","description":"ICD-BFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9901","description":"Patient age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth procedures on eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14051","description":"Anesth procedures on eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF0","description":"ICD-OEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE1","description":"ICD-MDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC0","description":"ICD-ICMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Consultation with a medical health care professional","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9311","description":"Consultation with a medical health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32998","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19364","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback peri/uro/rectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90911","description":"Biofeedback peri/uro/rectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay free hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83500","description":"Assay free hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pappa serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84163","description":"Pappa serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF0","description":"ICD-KIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIE1","description":"ICD-GHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC0","description":"ICD-KIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I & d vag hematoma non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57023","description":"I & d vag hematoma non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD214","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0482T","description":"Absolute quantitation of myocardial blood flow_ positron emission tomography (PET)_ rest and stress (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDC0","description":"ICD-BCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF1","description":"ICD-ABTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51060","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No dxa no med hx no rv sx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9472","description":"No dxa no med hx no rv sx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE0","description":"ICD-NHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF1","description":"ICD-NBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKD1","description":"ICD-CCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQF0","description":"ICD-LEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC0","description":"ICD-IFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC0","description":"ICD-KAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF1","description":"ICD-NBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPA1","description":"ICD-JIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGF1","description":"ICD-BDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIA1","description":"ICD-FIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF0","description":"ICD-IACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSF0","description":"ICD-CBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB0","description":"ICD-EHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE0","description":"ICD-FAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB1","description":"ICD-NBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL56","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28495","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1502","description":"HCPCS-A1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Loxapine_ inhalation powder_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9497","description":"Loxapine_ inhalation powder_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPB0","description":"ICD-KEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE204","description":"Reduced Physical Function _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD1","description":"ICD-GBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB50","description":"Medium Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB1","description":"ICD-MDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recement inlay onlay or part","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2910","description":"Recement inlay onlay or part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk imaging tst not ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3331F","description":"Bk imaging tst not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22A","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTC0","description":"ICD-ICTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATA0","description":"ICD-BATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA1","description":"ICD-CFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-surg eye measures docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3073F","description":"Pre-surg eye measures docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0592","description":"Hospital Special Treatment Room Support Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF1","description":"ICD-DEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21B","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC0","description":"ICD-OHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAC0","description":"ICD-GEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB1","description":"ICD-KCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC54","description":"Very High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9969","description":"Provider who referred the patient to another provider received a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUA0","description":"ICD-JGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung perf&ventilat diferentl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78598","description":"Lung perf&ventilat diferentl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy thigh soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27324","description":"Biopsy thigh soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer reservoir bottle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7009","description":"Nebulizer reservoir bottle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF0","description":"ICD-EHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carpal tunnel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64721","description":"Carpal tunnel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon extent unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9089","description":"Onc dx colon extent unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA21","description":"ICD-3HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD1","description":"ICD-NKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC0","description":"ICD-BAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0506T","description":"Macular pigment optical density measurement by heterochromatic flicker photometry_ unilateral or bilateral_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt lumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221T","description":"Plmt post facet implt lumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJB0","description":"ICD-NLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1252","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE1","description":"ICD-PCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD0","description":"ICD-CGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA0","description":"ICD-FBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC1","description":"ICD-JIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD214","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26496","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB1","description":"ICD-NDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF0","description":"ICD-NBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE151","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICE1","description":"ICD-CICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD1","description":"ICD-JICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB1","description":"ICD-CBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA0","description":"ICD-OFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD24B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD1","description":"ICD-OLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1002","description":"HCPCS-B1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lower limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5781","description":"Lower limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","description":"CPT-98007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB1","description":"ICD-BHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1012","description":"Clinical decision support mechanism Agile MD_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF0","description":"ICD-HDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC1","description":"ICD-OFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1089","description":"Radiation Therapy For Head And Neck Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23921","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA1","description":"ICD-OAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0698U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698U","description":"CPT-0698U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1044","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44156","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA0","description":"ICD-CECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD120","description":"Special Care High _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16077","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2506","description":"Injection_ pegfilgrastim_ excludes biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of s/l path_ea 15mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0153","description":"Hhcp-svs of s/l path_ea 15mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology breast mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81519","description":"Oncology breast mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB1","description":"ICD-CISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIME0","description":"ICD-EIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radical resection of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24149","description":"Radical resection of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADA1","description":"ICD-FADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB0","description":"ICD-BGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part maxil chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5740","description":"Denture reln part maxil chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA1","description":"ICD-AFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0651","description":"Injection_ levothyroxine sodium (fresenius kabi) not therapeutically equivalent to j0650_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj tst 5-6 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95909","description":"Nrv cndj tst 5-6 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWC0","description":"ICD-PEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVB0","description":"ICD-BCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE0","description":"ICD-DDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA0","description":"ICD-NIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFD0","description":"ICD-GHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0033","description":"Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosis Of Seizure Disorders_ Rapid Eye Movement Sleep Behavior Disorder_ Benzodiazepine Withdrawal_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue homogenization cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87176","description":"Tissue homogenization cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB0","description":"ICD-KIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77331","description":"Special radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE0","description":"ICD-GDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD0","description":"ICD-MECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99451","description":"Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician_ including a written report to the patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add to spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0999","description":"Add to spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE1","description":"ICD-OIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87523","description":"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta)_ quantification_ including reverse transcription_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF0","description":"ICD-DHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44404","description":"Colonoscopy w/injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation at shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23920","description":"Amputation at shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC0","description":"ICD-IGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ edaravone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9493","description":"Injection_ edaravone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE0","description":"ICD-BGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6067","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLE1","description":"ICD-FCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28I","description":"Special Care Low _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYD0","description":"ICD-KEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of large bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44025","description":"Incision of large bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traditional healing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0051","description":"Traditional healing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDB0","description":"ICD-MFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delayed breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19342","description":"Delayed breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31299","description":"Sinus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIC1","description":"ICD-BAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELB0","description":"ICD-AELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95700","description":"Electroencephalogram (Eeg) Continuous Recording_ With Video When Performed_ Setup_ Patient Education_ And Takedown When Performed_ Administered In Person By Eeg Technologist_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp w/fistu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46258","description":"Remove in/ex hem grp w/fistu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRA1","description":"ICD-LIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB0","description":"ICD-DCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF1","description":"ICD-CGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of fibula epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27732","description":"Repair of fibula epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD0","description":"ICD-NBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF0","description":"ICD-GEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA0","description":"ICD-CCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESD1","description":"ICD-DESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD0","description":"ICD-KHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anabolic steroid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80327","description":"Anabolic steroid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Copd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8757","description":"Copd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME1","description":"ICD-BGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Position wc cush wdth <22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2605","description":"Position wc cush wdth <22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of chin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21122","description":"Reconstruction of chin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC0","description":"ICD-IDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76978","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWA0","description":"ICD-LGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA1","description":"ICD-OEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB1","description":"ICD-KDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAE0","description":"ICD-EIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC1","description":"ICD-KEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC105","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA0","description":"ICD-JBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB0","description":"ICD-BFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg 41-60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95812","description":"Eeg 41-60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF1","description":"ICD-OACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF0","description":"ICD-MADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD0","description":"ICD-HEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18C","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9891","description":"MDPP session reported as a line-item on a claim for a payable MDPP Expanded Model (EM) HCPCS code for a session furnished by the billing supplier under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD1","description":"ICD-MJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMD1","description":"ICD-BGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE0","description":"ICD-HDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB0","description":"ICD-OIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA1","description":"ICD-MDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA41","description":"Very High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tech other than surfc cultr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4261F","description":"Tech other than surfc cultr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTF1","description":"ICD-KDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive ear canal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69150","description":"Extensive ear canal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99350","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q4h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9504","description":"Hit antibiotic q4h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB0","description":"ICD-NKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF0","description":"ICD-ODWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA260","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4259","description":"Celera Dual Layer or Celera Dual Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0510U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","description":"CPT-0510U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAC1","description":"ICD-ODAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF1","description":"ICD-NDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB0","description":"ICD-BIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1497","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","description":"HCPCS-M1497","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dissect brain w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62161","description":"Dissect brain w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53451","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; BILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment leotard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6510","description":"Compres burn garment leotard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0809T","description":"Arthrodesis_ sacroiliac joint_ percutaneous or minimally invasive (indirect visualization)_ with image guidance_ placement of transfixing device(s) and intra-articular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBC0","description":"ICD-JFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ikbkap gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81260","description":"Ikbkap gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE1","description":"ICD-OHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Financial mgt waiver/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2040","description":"Financial mgt waiver/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise windpipe scar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31830","description":"Revise windpipe scar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJD0","description":"ICD-OLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD0","description":"ICD-CGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE0","description":"ICD-BIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOF0","description":"ICD-DEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24635","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1516","description":"Space maintainer_ fixed_ bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revas w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37225","description":"Fem/popl revas w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC0","description":"ICD-CBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB11","description":"ICD-1GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc rect tum transanal part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45171","description":"Exc rect tum transanal part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA0","description":"ICD-OIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair pulmonary atresia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33920","description":"Repair pulmonary atresia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE0","description":"ICD-NIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJB1","description":"ICD-GGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01190","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","description":"CPT-01190","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE1","description":"ICD-NHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","description":"HCPCS-J0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD0","description":"ICD-CIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA1","description":"ICD-NBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC1","description":"ICD-LFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB0","description":"ICD-CHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA0","description":"ICD-CEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0137U","description":"Oncology (acute myelogenous leukemia)_ DNA_ genotyping of internal tandem d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA0","description":"ICD-IIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATA0","description":"ICD-CATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert abdomen-venous drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49425","description":"Insert abdomen-venous drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51590","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24587","description":"Treat elbow fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB114","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBE1","description":"ICD-FEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVF1","description":"ICD-NJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB1","description":"ICD-PJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46600","description":"Diagnostic anoscopy spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67440","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA0","description":"ICD-GCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Islet cell tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2102","description":"Islet cell tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE0","description":"ICD-AHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA0","description":"ICD-MCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337T","description":"Endothelial function assessment_ using peripheral vascular response to reactive hyperemia_ non-invasive (eg_ brachial artery ultrasound_ peripheral artery tonometry)_ unilater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCA1","description":"ICD-KGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTB0","description":"ICD-CGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITB0","description":"ICD-JITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0D","description":"High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93010","description":"Electrocardiogram report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC0","description":"ICD-KDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gamunex-c/gammaked","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1561","description":"Gamunex-c/gammaked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90380","description":"Respiratory syncytial virus_ monoclonal antibody_ seasonal dose; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOA0","description":"ICD-DGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUE1","description":"ICD-CBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC24","description":"Medium Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB0","description":"ICD-KEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILC0","description":"ICD-BILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin k phytonadione inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3430","description":"Vitamin k phytonadione inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIC0","description":"ICD-BCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID0","description":"ICD-OGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL01","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC1","description":"ICD-JFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF1","description":"ICD-KFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMB1","description":"ICD-MGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF1","description":"ICD-FDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC1","description":"ICD-NKNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC0","description":"ICD-FGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHME0","description":"ICD-KHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME0","description":"ICD-CBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam one surface permanen","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2140","description":"Amalgam one surface permanen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB0","description":"ICD-KCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5114","description":"Injection_ trastuzumab-dkst_ biosimilar_ (Ogivri)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC0","description":"ICD-FEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55867","description":"Laparoscopy_ surgical prostatectomy_ simple subtotal (including control of postoperative bleeding_ vasectomy_ meatotomy_ urethral calibration and/or dilation_ and internal ure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254T","description":"Endovascular repair of iliac artery bifurcation (eg_ aneurysm_ pseudoaneurysm_ arteriovenous malformation_ trauma_ dissection) using bifurcated endograft from the common iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of pubic bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27282","description":"Fusion of pubic bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB0","description":"ICD-CBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate /3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1950","description":"Leuprolide acetate /3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66830","description":"Removal of lens lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD0","description":"ICD-AGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAF0","description":"ICD-GGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALE0","description":"ICD-BALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXE0","description":"ICD-OIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 4 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90954","description":"Esrd serv 4 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >48 in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6244","description":"Hydrogel drg >48 in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calcitonin stimul panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80410","description":"Calcitonin stimul panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63198","description":"Incise spin&cord 2 stgs crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal monitor w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59050","description":"Fetal monitor w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSC0","description":"ICD-CBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54015","description":"Drain penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRB0","description":"ICD-DIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC0","description":"ICD-OLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trastuzumab administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9835","description":"Trastuzumab administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTD1","description":"ICD-JHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69719","description":"Revision Or Replacement (Including Removal Of Existing Device)_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA0","description":"ICD-FGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMD0","description":"ICD-NCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC0","description":"ICD-OFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below elbow myoelectronic ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6935","description":"Below elbow myoelectronic ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE0","description":"ICD-JGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33997","description":"Removal Of Percutaneous Right Heart Ventricular Assist Device_ Venous Cannula_ At Separate And Distinct Session From Insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow stump activated lock h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6130","description":"Elbow stump activated lock h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symptom&sign symm polyneuro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1500F","description":"Symptom&sign symm polyneuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA1","description":"ICD-KDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF1","description":"ICD-KEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD1","description":"ICD-MIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLC0","description":"ICD-EHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 sod iodide mic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9516","description":"Iodine i-123 sod iodide mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB1","description":"ICD-KHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual funct status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1055F","description":"Visual funct status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE1","description":"ICD-NHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD0","description":"ICD-PIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8H","description":"Very High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noonan spectrum disorders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81442","description":"Noonan spectrum disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adapt/ext_ pacing/neuro lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1883","description":"Adapt/ext_ pacing/neuro lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC1","description":"ICD-KIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/repl vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64569","description":"Revise/repl vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC0","description":"ICD-MFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49495","description":"Rpr ing hernia baby reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC1","description":"ICD-BITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDB0","description":"ICD-NHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF1","description":"ICD-BDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47800","description":"Reconstruction of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enrollment**","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0009","description":"Enrollment**","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFD1","description":"ICD-OIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain ovary abscess percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58822","description":"Drain ovary abscess percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1248","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE1","description":"ICD-NLHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA42","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC1","description":"ICD-KCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1139","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF1","description":"ICD-OHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 300-349mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9962","description":"Hocm 300-349mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD0","description":"ICD-LHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31231","description":"Nasal endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0203","description":"HCPCS-B0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWC1","description":"ICD-KHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKA1","description":"ICD-NIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE1","description":"ICD-JFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonemerg transp mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0215","description":"Nonemerg transp mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJA1","description":"ICD-KBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF0","description":"ICD-FEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJME0","description":"ICD-NJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD0","description":"ICD-CFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech sound lang comprehen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92523","description":"Speech sound lang comprehen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEF0","description":"ICD-IIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTB0","description":"ICD-IHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9141","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ pegylated-aucl (Jivi)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8D","description":"Medium Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMA0","description":"ICD-IHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB1","description":"ICD-DEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert balloon device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33973","description":"Insert balloon device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF1","description":"ICD-IBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8678","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD1","description":"ICD-KHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEB0","description":"ICD-OHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQB1","description":"ICD-PDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD155","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC0","description":"ICD-KABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQF0","description":"ICD-KDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE121","description":"Clinically Complex _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBE1","description":"ICD-EBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28092","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DNA analysis_ fecal_ for colorectal cancer screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3890","description":"DNA analysis_ fecal_ for colorectal cancer screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8H","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTE0","description":"ICD-MFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0930","description":"Fracture frame free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUD1","description":"ICD-FEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB216","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC0","description":"ICD-BEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC11","description":"ICD-1EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC0","description":"ICD-OHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFB0","description":"ICD-BHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA1","description":"ICD-HFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0517F","description":"Glaucoma plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC1","description":"ICD-FEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF1","description":"ICD-FICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2B","description":"High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID1","description":"ICD-BGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ekg interpret & report preve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0405","description":"Ekg interpret & report preve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSB1","description":"ICD-HHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparotomy islet cell transp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0343","description":"Laparotomy islet cell transp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID0","description":"ICD-MFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11471","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sps forearm device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1818","description":"Sps forearm device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect enlarged toe tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28340","description":"Resect enlarged toe tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test socket shldr disart/tho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6684","description":"Test socket shldr disart/tho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF0","description":"ICD-OBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC1","description":"ICD-OGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC1","description":"ICD-OBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lung chest wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54651","description":"Anesth lung chest wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of sperm duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55450","description":"Ligation of sperm duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD1","description":"ICD-JEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68360","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44364","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21407","description":"Opn tx orbit fx w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity class severe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1493F","description":"Dem severity class severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEB1","description":"ICD-OEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINB1","description":"ICD-CINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXB0","description":"ICD-JCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEE0","description":"ICD-NJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9092","description":"Injection_ triamcinolone acetonide_ suprachoroidal (Xipere)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE0","description":"ICD-CEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 1","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1781","description":"vaccine administration-human papillomavirus - Dose 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0470","description":"Fqhc visit_ mh estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Developmental screen w/score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96110","description":"Developmental screen w/score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE204","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF1","description":"ICD-GHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38765","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ascorbic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82180","description":"Assay of ascorbic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF1","description":"ICD-BGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA1","description":"ICD-MAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA1","description":"ICD-BEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb open end socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5535","description":"Prep bk ptb open end socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of forehead wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15824","description":"Removal of forehead wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHB0","description":"ICD-KDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA0","description":"ICD-NGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phentolaine mesylate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2760","description":"Phentolaine mesylate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LB21","description":"ICD-2LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35637","description":"Art byp aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcitonin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82308","description":"Assay of calcitonin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC224","description":"Special Care High _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNA1","description":"ICD-JGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICA1","description":"ICD-OICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag iv inf init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96365","description":"Ther/proph/diag iv inf init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autochondrocyte implant knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27412","description":"Autochondrocyte implant knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFD0","description":"ICD-JFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray stereo frontal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71015","description":"Chest x-ray stereo frontal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE1","description":"ICD-IGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5D","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise finger tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26055","description":"Incise finger tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEE1","description":"ICD-KCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8815","description":"Doc reas no statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA0","description":"ICD-GBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25500","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX23","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mthfr gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81291","description":"Mthfr gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12042","description":"Intmd rpr n-hf/genit2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal vaccine admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8864","description":"Pneumococcal vaccine admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein access cutdown > 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36425","description":"Vein access cutdown > 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEF0","description":"ICD-NLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF0","description":"ICD-EGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1411","description":"Injection_ etranacogene dezaparvovec-drlb_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF1","description":"ICD-GCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA1","description":"ICD-GGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0781T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE1","description":"ICD-CGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat vagina infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57150","description":"Treat vagina infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE1","description":"ICD-ABIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19368","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD1","description":"ICD-HFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of c-peptide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84681","description":"Assay of c-peptide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD0","description":"ICD-KIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0759","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","description":"HCPCS-J0759","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL54","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ faricimab-svoa_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9097","description":"Injection_ faricimab-svoa_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHED0","description":"ICD-OHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palliative care services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1309","description":"Palliative care services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20700","description":"Manual Preparation And Insertion Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8844","description":"No ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF1","description":"ICD-AIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for therapy guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77014","description":"Ct scan for therapy guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7532","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ initial artery_ open or pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua non","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8688","description":"Implt nrostm pls gen dua non","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB0","description":"ICD-JAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4348","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","description":"HCPCS-Q4348","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE0","description":"ICD-PBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCA0","description":"ICD-IDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC1","description":"ICD-FHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv/aids measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8491","description":"Hiv/aids measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD0","description":"ICD-ECDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHF1","description":"ICD-FGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB1","description":"ICD-BDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAB0","description":"ICD-GFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resin retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6549","description":"Resin retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF0","description":"ICD-GIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21A","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDC1","description":"ICD-NHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE0","description":"ICD-FEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9724","description":"Patients who had documentation of use of anticoagulant medications overlapping the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA1","description":"ICD-OBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA0","description":"ICD-BHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19000","description":"Drainage of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF1","description":"ICD-AIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16074","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16074","description":"CPT-16074","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0730T","description":"Trabeculotomy by laser_ including optical coherence tomography (OCT) guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD1","description":"ICD-CHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWD1","description":"ICD-OFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC1","description":"ICD-JBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE1","description":"ICD-AALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impltj ntrstrml crnl rng seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65785","description":"Impltj ntrstrml crnl rng seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWC1","description":"ICD-OEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF0","description":"ICD-KFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ue triple control harness","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6677","description":"Ue triple control harness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"GYPA GNOTYP NTRNS 1 5 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189U","description":"GYPA GNOTYP NTRNS 1 5 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA0","description":"ICD-LHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0861","description":"Pwc gp3 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80439","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1097","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0601","description":"HCPCS-B0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA0","description":"ICD-DEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lifts elevation heel /i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3334","description":"Shoe lifts elevation heel /i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20D","description":"Special Care Low _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate pt use of inhaler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94664","description":"Evaluate pt use of inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mlh1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81288","description":"Mlh1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCB1","description":"ICD-MGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/us guide bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45342","description":"Sigmoidoscopy w/us guide bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGF1","description":"ICD-NGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC1","description":"ICD-KHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE1","description":"ICD-ODHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44369","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pure tone audiometry air","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92552","description":"Pure tone audiometry air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARD0","description":"ICD-OARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 not assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9396","description":"Ini phq9 >9 not assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlorhexidine antisept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4248","description":"Chlorhexidine antisept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical revision intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44680","description":"Surgical revision intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAC0","description":"ICD-OEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB1","description":"ICD-IGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26440","description":"Release palm/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295T","description":"Ext ecg complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA1","description":"ICD-FDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE1","description":"ICD-KFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20902","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4008","description":"Cast sup long arm ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC1","description":"ICD-OHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE1","description":"ICD-GDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-61715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","description":"CPT-61715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTD1","description":"ICD-ODTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTB0","description":"ICD-GGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29834","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57260","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFC1","description":"ICD-CFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA54","description":"Medium Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF0","description":"ICD-JDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44147","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0740T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA0","description":"ICD-GBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHD0","description":"ICD-ACHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35301","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA1","description":"ICD-EFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admin + supply_ tositumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3001","description":"Admin + supply_ tositumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9587","description":"Gallium ga-68_ dotatate_ diagnostic_ 0.1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKA0","description":"ICD-CEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACF1","description":"ICD-JACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGE1","description":"ICD-OLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE0","description":"ICD-EGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38382","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIE1","description":"ICD-MLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD0","description":"ICD-IAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE0","description":"ICD-NEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE0","description":"ICD-GDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC0","description":"ICD-HEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Folding ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1236","description":"Folding ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9351","description":"Topotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTD0","description":"ICD-EDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2526","description":"Th/wght bear nar m-l brim cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2161","description":"Patient Had Prior Adverse Reaction Caused By Zoster Vaccine Or Its Components Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21084","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1942","description":"Injection_ aripiprazole lauroxil_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE0","description":"ICD-GFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray male genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74440","description":"X-ray male genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB1","description":"ICD-NBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXD0","description":"ICD-KEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLA0","description":"ICD-ECLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRF0","description":"ICD-HIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA0","description":"ICD-FGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB33","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC1","description":"ICD-ECAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC1","description":"ICD-MKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXE1","description":"ICD-BHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r ant/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0650","description":"Lso sc r ant/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHD0","description":"ICD-OJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOD0","description":"ICD-HHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA1","description":"ICD-CEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD0","description":"ICD-GETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Homaker service nos per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5130","description":"Homaker service nos per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA0","description":"ICD-JDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDA1","description":"ICD-NIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ gold-198","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1716","description":"Brachytx_ non-str_ gold-198","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB1","description":"ICD-NBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHB0","description":"ICD-ABHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES355","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE0","description":"ICD-OKSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJF0","description":"ICD-OEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ana crown exp 1-3 per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4231","description":"Ana crown exp 1-3 per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig rna no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8460","description":"Pt inelig rna no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA0","description":"ICD-FEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC0","description":"ICD-BAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CA31","description":"ICD-3CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD0","description":"ICD-OKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICD0","description":"ICD-BICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC0","description":"ICD-OIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inter limb compress dev nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0676","description":"Inter limb compress dev nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC211","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHB0","description":"ICD-BGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD1","description":"ICD-GHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB0","description":"ICD-CCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal ca screen doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3017F","description":"Colorectal ca screen doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28E","description":"Clinically Complex _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla typing a b or c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86812","description":"Hla typing a b or c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMA0","description":"ICD-BEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXB1","description":"ICD-JIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC1","description":"ICD-FEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHB1","description":"ICD-GDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat penis lesion graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54111","description":"Treat penis lesion graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9838","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72198","description":"Mr angio pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpt pt cat and pt1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9428","description":"Rpt pt cat and pt1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAD1","description":"ICD-OKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1025","description":"Patient-Months Where There Are More Than One Medicare Capitated Payment (Mcp) Provider Listed For The Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver image (3d) with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78206","description":"Liver image (3d) with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYF1","description":"ICD-PCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERA1","description":"ICD-OERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31505","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD1","description":"ICD-ADCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx orbit w/o manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21400","description":"Closed tx orbit w/o manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quant her2 ihc eval brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3394F","description":"Quant her2 ihc eval brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart infarct image (ef)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78468","description":"Heart infarct image (ef)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC0","description":"ICD-CBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE0","description":"ICD-LFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot longitudinal arch suppo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3010","description":"Foot longitudinal arch suppo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB1","description":"ICD-LFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE1","description":"ICD-HBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWC0","description":"ICD-PJWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINC0","description":"ICD-NINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLC0","description":"ICD-NJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn hearing aid air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5030","description":"Body-worn hearing aid air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB1","description":"ICD-OIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF1","description":"ICD-KDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC0","description":"ICD-NBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF1","description":"ICD-OGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01652","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","description":"CPT-01652","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csf shunt evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78645","description":"Csf shunt evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF1","description":"ICD-IDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC136","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enter feed supkit syr by day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4034","description":"Enter feed supkit syr by day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1C","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF1","description":"ICD-OAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB1","description":"ICD-NLLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA1","description":"ICD-NJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD1","description":"ICD-GHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB0","description":"ICD-JCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ brexanolone_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1632","description":"Injection_ brexanolone_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ASPERGILLUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87305","description":"IAAD IA ASPERGILLUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC0","description":"ICD-PKQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD1","description":"ICD-MFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE1","description":"ICD-OHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appropos mthd offloading rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4269F","description":"Appropos mthd offloading rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD1","description":"ICD-MICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSE0","description":"ICD-CDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGB0","description":"ICD-GIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not consid poss risk fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3573F","description":"Pt not consid poss risk fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2022","description":"A Model Participant (Ambulance Supplier/Provider)_ The Beneficiary Refuses Services Covered Under The Model (Transport To An Alternate Destination/Treatment In Place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC0","description":"ICD-CHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunohistochemical stains","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0478","description":"Immunohistochemical stains","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21152","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB1","description":"ICD-OGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEA1","description":"ICD-IIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas ext transmitter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1036","description":"Art pancreas ext transmitter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3652","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF0","description":"ICD-JDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC1","description":"ICD-BFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01650","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","description":"CPT-01650","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27599","description":"Leg surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3370F","description":"Ajcc brst cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20561","description":"Needle Insertion(S) Without Injection(S); 3 Or More Muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysterectomy/revise vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58275","description":"Hysterectomy/revise vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC11","description":"ICD-4HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB1","description":"ICD-KFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB1","description":"ICD-LBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC0","description":"ICD-BDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF1","description":"ICD-EAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD0","description":"ICD-JDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ureter lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51535","description":"Repair of ureter lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELF1","description":"ICD-NELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFD1","description":"ICD-JCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8008","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8008","description":"HCPCS-C8008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESF0","description":"ICD-DESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF1","description":"ICD-FAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pt category on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9293","description":"No pt category on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHD0","description":"ICD-EFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWE0","description":"ICD-GBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWA0","description":"ICD-GEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26615","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial complete study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93886","description":"Intracranial complete study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51840","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD0","description":"ICD-JAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD0","description":"ICD-BEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD1","description":"ICD-JCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF0","description":"ICD-CAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA121","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ana crown exp 4 or> per quad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4230","description":"Ana crown exp 4 or> per quad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUF0","description":"ICD-JIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC0","description":"ICD-NKPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE212","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8D","description":"High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0301","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0301","description":"CDT-D0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD1","description":"ICD-OCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Focusing on women_s health mips value pathway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1366","description":"Focusing on women_s health mips value pathway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC0","description":"ICD-AITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1162","description":"Patient had encephalitis due to the tetanus_ diphtheria or pertussis vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE1","description":"ICD-CBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUB0","description":"ICD-BGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB0","description":"ICD-GEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE1","description":"ICD-HGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPA0","description":"ICD-OLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA1","description":"ICD-FICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43887","description":"Remove gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA5C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUC1","description":"ICD-MJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF0","description":"ICD-BDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA0","description":"ICD-GDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of intrastromal corneal ring segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0099T","description":"Implantation of intrastromal corneal ring segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXA1","description":"ICD-KGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2662","description":"Dental onlay resin 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB0","description":"ICD-NDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1486","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","description":"HCPCS-M1486","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB0","description":"ICD-GCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC211","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject/aspirate liver cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47015","description":"Inject/aspirate liver cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1023","description":"Clinical decision support mechanism persivia clinical decision support_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0627","description":"Lo sag ri an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIED1","description":"ICD-EIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL16","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD1","description":"ICD-OBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4022","description":"Cast sup sht arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC0","description":"ICD-JEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD0","description":"ICD-PKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRF1","description":"ICD-LDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC16","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46050","description":"Incision of anal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01622","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","description":"CPT-01622","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA1","description":"ICD-KFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE131","description":"Clinically Complex _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXA1","description":"ICD-OKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusion analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9950","description":"Occlusion analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72193","description":"Ct pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23675","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTE0","description":"ICD-JBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg <= 16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6245","description":"Hydrogel drg <= 16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE0","description":"ICD-MADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7685","description":"Tobramycin comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAF0","description":"ICD-OCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block cont infuse b plex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64416","description":"N block cont infuse b plex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25446","description":"Wrist replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD136","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pentamidine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2545","description":"Pentamidine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC1","description":"ICD-JEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUC1","description":"ICD-NDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"A/d tx program_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2036","description":"A/d tx program_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB0","description":"ICD-BCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICD1","description":"ICD-AICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9275","description":"Injection_ hexaminolevulinate HCl_ 100 mg_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD1","description":"ICD-KICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD150","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6206","description":"Contact layer <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50120","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab steel crown primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2934","description":"Prefab steel crown primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Actigraphy testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95803","description":"Actigraphy testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA1","description":"ICD-JIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0858","description":"Pwc gp3 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF1","description":"ICD-IFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOE0","description":"ICD-LHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Architect ecm px fx 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4147","description":"Architect ecm px fx 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1111T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1111T","description":"CPT-1111T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct both jaws","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0383","description":"Cone beam ct both jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLC1","description":"ICD-FDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43420","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND1","description":"ICD-CDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE1","description":"ICD-OBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA0","description":"ICD-NGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinogen antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85385","description":"Fibrinogen antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGE1","description":"ICD-CDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01654","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","description":"CPT-01654","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32480","description":"Partial removal of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD0","description":"ICD-NAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27337","description":"Exc thigh/knee les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD0","description":"ICD-KHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILB1","description":"ICD-NILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB0","description":"ICD-OFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIA1","description":"ICD-IFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA0","description":"ICD-FDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA1","description":"ICD-DHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD1","description":"ICD-AHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA0","description":"ICD-CAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC0","description":"ICD-OBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp 5/>yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99149","description":"Mod sed diff phys/qhp 5/>yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB1","description":"ICD-GITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid trns/vgnl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49407","description":"Image cath fluid trns/vgnl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepagam b im injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1571","description":"Hepagam b im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB1","description":"ICD-JIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2508","description":"Injection_ pegunigalsidase alfa-iwxj_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert needle bone cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36680","description":"Insert needle bone cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0672","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0672","description":"HCPCS-G0672","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1079","description":"Radiation Therapy For Brain Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD1","description":"ICD-BCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMA1","description":"ICD-IIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF0","description":"ICD-KHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALA1","description":"ICD-NALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD234","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRF1","description":"ICD-GHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59618","description":"Attempted vbac delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA1","description":"ICD-PKSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC1","description":"ICD-OGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multisys ther/juvenile 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2033","description":"Multisys ther/juvenile 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF0","description":"ICD-FCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33335","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 21 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP21","description":"Auto test panel pricing code_ 21 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures complete mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5120","description":"Dentures complete mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB0","description":"ICD-FIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate suspnsion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9217","description":"Leuprolide acetate suspnsion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASC1","description":"ICD-PASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA0","description":"ICD-GGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9399","description":"Doc disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of endocrine hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84235","description":"Assay of endocrine hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC1","description":"ICD-CFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coat/cov w/o del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1877","description":"Stent_ non-coat/cov w/o del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9936","description":"Surveillance colonoscopy - personal history of colonic polyps_ colon cancer_ or other malignant neoplasm of rectum_ rectosigmoid junction_ and anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF1","description":"ICD-KDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKD1","description":"ICD-OLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD0","description":"ICD-MLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24505","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services outside us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9989","description":"Services outside us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neutron beam tx simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77422","description":"Neutron beam tx simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0548T","description":"Transperineal periurethral balloon continence device; bilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFC0","description":"ICD-CDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD1","description":"ICD-NCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB54","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGB1","description":"ICD-CCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBF1","description":"ICD-JDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JB31","description":"ICD-1JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interv hlth/behav fam w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96154","description":"Interv hlth/behav fam w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23630","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE1","description":"ICD-OJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj progesterone per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2675","description":"Inj progesterone per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application lower leg splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29515","description":"Application lower leg splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test thor paraspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95869","description":"Muscle test thor paraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKD0","description":"ICD-CDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6237","description":"Hydrocolld drg <=16 in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC0","description":"ICD-LDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGB0","description":"ICD-FIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD0","description":"ICD-GEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF1","description":"ICD-CABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7569","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7569","description":"HCPCS-C7569","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte culture mixed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86821","description":"Lymphocyte culture mixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE1","description":"ICD-GBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC114","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Ultrafiltration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0692T","description":"Therapeutic Ultrafiltration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF1","description":"ICD-MFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0037U","description":"Targeted genomic sequence analysis_ solid organ neoplasm_ DNA analysis of 324 genes_ interrogation for sequence variants_ gene copy number amplifications_ gene rearrangements_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMF0","description":"ICD-MBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED1","description":"ICD-OAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESC1","description":"ICD-OESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77263","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB0","description":"ICD-ECAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUF1","description":"ICD-MHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB0","description":"ICD-BHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87490","description":"Chylmd trach dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28102","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33957","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4030F","description":"Oxygen therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD0","description":"ICD-CCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB0","description":"ICD-BHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ivf package","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4011","description":"Ivf package","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1089T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1089T","description":"CPT-1089T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC1","description":"ICD-PIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurorraphy w/vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64911","description":"Neurorraphy w/vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA1","description":"ICD-AIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complement antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86160","description":"Complement antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient spent greater than or equal to three days in hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9861","description":"Patient spent greater than or equal to three days in hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC1","description":"ICD-AFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE1","description":"ICD-GBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRB1","description":"ICD-KHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0174","description":"Thiethylperazine maleate10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC1","description":"ICD-EIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD251","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJB1","description":"ICD-CIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKD1","description":"ICD-GDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQA1","description":"ICD-CEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGA0","description":"ICD-NJGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC1","description":"ICD-KFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniotext patch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4247","description":"Amniotext patch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8H","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD0","description":"ICD-BDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90867","description":"Tcranial magn stim tx plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEE1","description":"ICD-BFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSB1","description":"ICD-HFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr elctrnc skn surf brchytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0394T","description":"Hdr elctrnc skn surf brchytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24126","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery follow-up add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67331","description":"Eye surgery follow-up add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA31","description":"ICD-1CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE0","description":"ICD-GDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cataract measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8906","description":"Cataract measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIC1","description":"ICD-KAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFF1","description":"ICD-JGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF0","description":"ICD-OHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharm thx for op rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4005F","description":"Pharm thx for op rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE1","description":"ICD-OKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55842","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDC1","description":"ICD-KIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50955","description":"Ureter endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride nail 6 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11721","description":"Debride nail 6 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF1","description":"ICD-NIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC0","description":"ICD-OIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GC31","description":"ICD-1GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDD1","description":"ICD-KIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216T","description":"Njx paravert w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ac5 advanced wound system (ac5)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2020","description":"Ac5 advanced wound system (ac5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC0","description":"ICD-GHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14A","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penile injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54235","description":"Penile injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64490","description":"Inj paravert f jnt c/t 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst t/o & repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58292","description":"Vag hyst t/o & repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB0","description":"ICD-OHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB1","description":"ICD-EGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus Matrix_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4199","description":"Cygnus Matrix_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXF0","description":"ICD-OKXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJD1","description":"ICD-BCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67835","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD1","description":"ICD-JFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nudge control elbow lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6637","description":"Nudge control elbow lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF0","description":"ICD-CBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEC0","description":"ICD-CHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEF0","description":"ICD-OEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF0","description":"ICD-IDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB1","description":"ICD-FEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF1","description":"ICD-FGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA1","description":"ICD-BGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE0","description":"ICD-GGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD1","description":"ICD-GFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67413","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0091U","description":"Oncology (colorectal) screening_ cell enumeration of circulating tumor cells_ utilizing whole blood_ algorithm_ for the presence of adenoma or cancer_ reported as a positive o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1222","description":"Glaucoma plan of care not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD1","description":"ICD-NCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD1","description":"ICD-OBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD1","description":"ICD-FHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF0","description":"ICD-MKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC0","description":"ICD-FDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9908","description":"Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy)_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC0","description":"ICD-BBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEE1","description":"ICD-NLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVF0","description":"ICD-NAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE0","description":"ICD-BBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22558","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACD0","description":"ICD-BACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA0","description":"ICD-OJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQD0","description":"ICD-OLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screeningmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0202","description":"Screeningmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of toe tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28010","description":"Incision of toe tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB0","description":"ICD-NDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA1","description":"ICD-GHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADE1","description":"ICD-NADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1498","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","description":"HCPCS-M1498","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7939","description":"Indexing for osteotomy using dynamic robotic assisted or dynamic navigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Co57 cyano","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9559","description":"Co57 cyano","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOA1","description":"ICD-DBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB1","description":"ICD-GFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery chrgr six volt otto","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7362","description":"Battery chrgr six volt otto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (hepzato)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9248","description":"Injection_ melphalan (hepzato)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD1","description":"ICD-GHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOE0","description":"ICD-GDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWD1","description":"ICD-GBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Note hring tst w/in 6 mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3230F","description":"Note hring tst w/in 6 mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facial augmentation implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5925","description":"Facial augmentation implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1270","description":"Wheelchair lightweight leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA1","description":"ICD-LDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4928","description":"Surgical mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA0","description":"ICD-IDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUA0","description":"ICD-AFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg bk ea add cast ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5410","description":"Postop dsg bk ea add cast ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6065","description":"Implant supported crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGF0","description":"ICD-FGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE0","description":"ICD-NFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE0","description":"ICD-CFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEC0","description":"ICD-KAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWD0","description":"ICD-PHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23182","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOC0","description":"ICD-CGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC1","description":"ICD-OIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in ltch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5007","description":"Hospice in ltch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92987","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0305","description":"HCPCS-B0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE1","description":"ICD-JBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67961","description":"Excision and repair of eyelid_ involving lid margin_ tarsus_ conjunctiva_ canthus_ or full thickness_ may include preparation for skin graft or pedicle flap with adjacent tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF1","description":"ICD-AABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF1","description":"ICD-IGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dwelling lead investigation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1029","description":"Dwelling lead investigation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF0","description":"ICD-CIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCB1","description":"ICD-OGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATD1","description":"ICD-OATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCD1","description":"ICD-FDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID1","description":"ICD-KCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trabectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9352","description":"Injection_ trabectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMB0","description":"ICD-NJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9877","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 10-12 under the MDPP Expanded Model (EM).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guided tiss regen nonresorb","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4267","description":"Guided tiss regen nonresorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1771","description":"Rep dev_ urinary_ w/sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE1","description":"ICD-KCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHA1","description":"ICD-NGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD1","description":"ICD-MGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiemetic drug oral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8597","description":"Antiemetic drug oral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEF0","description":"ICD-ICEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rheumatoid factor quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86431","description":"Rheumatoid factor quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7517","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with iliac and/or femoral artery angiograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi calc_ pt no f/u plan elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8938","description":"Bmi calc_ pt no f/u plan elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01490","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","description":"CPT-01490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA0","description":"ICD-AHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1C","description":"Default_ /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQC1","description":"ICD-GFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4367","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","description":"HCPCS-Q4367","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF1","description":"ICD-EBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1070T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1070T","description":"CPT-1070T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00172","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","description":"CPT-00172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC0","description":"ICD-MAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC0","description":"ICD-NGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMF0","description":"ICD-GDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC21A","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25332","description":"Revise wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/plcmt stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45347","description":"Sigmoidoscopy w/plcmt stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect diaphragm complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39561","description":"Resect diaphragm complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC0","description":"ICD-JDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of csf protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83873","description":"Assay of csf protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF1","description":"ICD-CGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9021","description":"Red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC0","description":"ICD-CHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE0","description":"ICD-KCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28A","description":"Clinically Complex _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF1","description":"ICD-GEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28496","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164T","description":"Remove lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHA1","description":"ICD-FGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDF1","description":"ICD-IEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCF1","description":"ICD-NBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4024","description":"Cast sup sht arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWE0","description":"ICD-HDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB140","description":"Reduced Physical Function _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE1","description":"ICD-KCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL10","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","description":"HCPCS-Q4408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zaire ebolavirus vaccine_ live_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90758","description":"Zaire ebolavirus vaccine_ live_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95147","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31400","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC1","description":"ICD-NJPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC0","description":"ICD-GGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB0","description":"ICD-NCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneum full leg splnt pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4370","description":"Pneum full leg splnt pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 auto platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9571","description":"Indium in-111 auto platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 1200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0244","description":"Injection_ casirivimab and imdevimab_ 1200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE0","description":"ICD-ODTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lang express current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9162","description":"Lang express current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0879","description":"Injection_ difelikefalin_ 0.1 microgram_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD1","description":"ICD-OLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion palate prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42281","description":"Insertion palate prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB0","description":"ICD-GEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC0","description":"ICD-HARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26392","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE0","description":"ICD-BFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLB0","description":"ICD-KDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC0","description":"ICD-BDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKA1","description":"ICD-JDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA21","description":"ICD-4EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF0","description":"ICD-GBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTF0","description":"ICD-EGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD0","description":"ICD-LISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1804","description":"CDT-D1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB0","description":"ICD-KBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins device for rt guide open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49412","description":"Ins device for rt guide open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETD0","description":"ICD-BETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB1","description":"ICD-LCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF0","description":"ICD-NCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQE1","description":"ICD-HCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56740","description":"Remove vagina gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft head/neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15732","description":"Muscle-skin graft head/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1025","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA0","description":"ICD-OAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2721","description":"Crown resin w/ base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2A","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0070U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ common and select rare variants (ie_ *2_ *3_ *4_ *4N_ *5_ *6_ *7_ *8_ *9_ *","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME0","description":"ICD-IDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ neurostimulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1778","description":"Lead_ neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise submaxillary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42440","description":"Excise submaxillary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLC0","description":"ICD-GFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2077","description":"Periodic Assessment; Assessing Periodically By Qualified Personnel To Determine The Most Appropriate Combination Of Services And Treatment (Provision Of The Services By A Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE0","description":"ICD-CIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","description":"HCPCS-J3402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogen_ semiquantitative identification_ DNA from 16 bacterial organisms and 1 fungal organism_ multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGA0","description":"ICD-BGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29898","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0232","description":"HCPCS-M0232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts pt no e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8673","description":"Fun stat scor nek/ts pt no e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grp psych partial hosp 45-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0410","description":"Grp psych partial hosp 45-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy w/taper cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44127","description":"Enterectomy w/taper cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge noble metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6212","description":"Bridge noble metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD115","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artificial larynx_ accessory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8505","description":"Artificial larynx_ accessory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA246","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1243","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Substernal Implantable Defibrillator Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0572T","description":"Insertion Of Substernal Implantable Defibrillator Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99285","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKB1","description":"ICD-GHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forceps esoph biopsy done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3150F","description":"Forceps esoph biopsy done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD0","description":"ICD-NBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA1","description":"ICD-AAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIC1","description":"ICD-AEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90947","description":"Dialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD1","description":"ICD-IAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 0 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3382F","description":"Ajcc cln cncr stage 0 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord vsls crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63250","description":"Revise spinal cord vsls crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB1","description":"ICD-NFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA0","description":"ICD-IFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 4/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2664","description":"Dental onlay resin 4/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 5MCG/0.5ML AS03","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91310","description":"SARSCOV2 VAC 5MCG/0.5ML AS03","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0085","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA0","description":"ICD-FFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External recharg sys extern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8695","description":"External recharg sys extern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft peri each addl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3429","description":"Bone graft peri each addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excellagen_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4149","description":"Excellagen_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMA0","description":"ICD-CEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF1","description":"ICD-GFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam si joints 3/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72202","description":"X-ray exam si joints 3/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5104","description":"Injection_ infliximab-abda_ biosimilar_ (Renflexis)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limit oral eval problm focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0140","description":"Limit oral eval problm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33641","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD1","description":"ICD-NJPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD234","description":"Special Care Low _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD1","description":"ICD-CCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB0","description":"ICD-KDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral solution hepatic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B5100","description":"Parenteral solution hepatic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1229","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ is referred within 1 month of the reactive hcv antibody test to a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shrinker below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8440","description":"Shrinker below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cltx post ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27768","description":"Cltx post ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABB1","description":"ICD-AABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB0","description":"ICD-BFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric symptoms not assessed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9743","description":"Psychiatric symptoms not assessed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA244","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAB0","description":"ICD-EBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA0","description":"ICD-PLOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear canal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69140","description":"Remove ear canal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deep sedation/general anesthesia-each additional 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9221","description":"Deep sedation/general anesthesia-each additional 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ahi or rdi initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8842","description":"Ahi or rdi initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC1","description":"ICD-CFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18D","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE1","description":"ICD-DIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27420","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0224T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ pheresis_ pathogen-reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9073","description":"Platelets_ pheresis_ pathogen-reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF0","description":"ICD-JCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF0","description":"ICD-OLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUB1","description":"ICD-MIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB5D","description":"Medium Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB31","description":"ICD-1DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA212","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC1","description":"ICD-NKFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAD0","description":"ICD-MHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB0","description":"ICD-JEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonstnd lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0581","description":"Nonstnd lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOA1","description":"ICD-HGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteogen ultrasound stimltor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0760","description":"Osteogen ultrasound stimltor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cataract mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8765","description":"Cataract mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heparin neutralization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85525","description":"Heparin neutralization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA1","description":"ICD-GDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65410","description":"Biopsy of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC0","description":"ICD-KEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD0","description":"ICD-HIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical nutrition indiv in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97802","description":"Medical nutrition indiv in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reusable underpad bed size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4537","description":"Reusable underpad bed size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA1","description":"ICD-NLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0556","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","description":"HCPCS-G0556","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9805","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE1","description":"ICD-MKIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILE1","description":"ICD-FILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA1","description":"ICD-NEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace g-j tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49452","description":"Replace g-j tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC0","description":"ICD-OCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59841","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA1","description":"ICD-GEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instll rx agnt into rnal tub","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50391","description":"Instll rx agnt into rnal tub","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo examination procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76999","description":"Echo examination procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54065","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8000","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8000","description":"HCPCS-C8000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99072","description":"Additional supplies_ materials_ and clinical staff time over and above those usually included in an office visit or other non-facility service(s)_ when performed during a PHE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC235","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg wrst/elb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6380","description":"Postop dsg cast chg wrst/elb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD0","description":"ICD-KGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD0","description":"ICD-OJOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3B","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tofersen_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1304","description":"Injection_ tofersen_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1803","description":"CDT-D1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE0","description":"ICD-NHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL40","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx radial 3+ frag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25609","description":"Treat fx radial 3+ frag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML50","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD0","description":"ICD-HCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0904","description":"CDT-D0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCC0","description":"ICD-KHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7527","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC03","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2129","description":"Procedure-Related Bp_S Not Taken During An Outpatient Visit. Examples Include Same Day Surgery_ Ambulatory Service Center_ G.I. Lab_ Dialysis_ Infusion Center_ Chemotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATD0","description":"ICD-EATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUC1","description":"ICD-MDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko supracondylar socket mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1860","description":"Ko supracondylar socket mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB0","description":"ICD-GBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB1","description":"ICD-FHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE0","description":"ICD-PIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interdental fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21110","description":"Interdental fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso r post pnl sj-t9 pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0630","description":"Lso r post pnl sj-t9 pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE1","description":"ICD-CHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMF0","description":"ICD-KGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD1","description":"ICD-BIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX40","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tendon for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20924","description":"Removal of tendon for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triptorelin extended release_ 3.75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9016","description":"Injection_ triptorelin extended release_ 3.75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD1","description":"ICD-DGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF1","description":"ICD-CDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC0","description":"ICD-OBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC1","description":"ICD-GBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5647","description":"Below knee suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIF0","description":"ICD-KIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC1","description":"ICD-MHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE1","description":"ICD-KIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reattach tooth fragment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2921","description":"Reattach tooth fragment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC1","description":"ICD-GITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anes mediascpy & dx thorscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52851","description":"Anes mediascpy & dx thorscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97002","description":"Pt re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE0","description":"ICD-BFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB131","description":"Special Care Low _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME0","description":"ICD-MEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC1","description":"ICD-IBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC0","description":"ICD-MLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPE0","description":"ICD-FBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5D","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC1","description":"ICD-FHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ash fibrosure (tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002M","description":"Ash fibrosure (tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE1","description":"ICD-OBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL16","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain spinal cord cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62268","description":"Drain spinal cord cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00944","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","description":"CPT-00944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPD1","description":"ICD-KFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of imipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6036","description":"Assay of imipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOE0","description":"ICD-DBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIF0","description":"ICD-FFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA0","description":"ICD-OBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy surg colpopexy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57425","description":"Laparoscopy surg colpopexy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24925","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust toe ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1830","description":"Adjust toe ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA1","description":"ICD-NBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0596U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","description":"CPT-0596U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYC1","description":"ICD-CBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6566","description":"Gradient compression garment_ neck/head_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE125","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHE1","description":"ICD-FGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB0","description":"ICD-OHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE0","description":"ICD-PJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0734","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of clot in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35876","description":"Removal of clot in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB1","description":"ICD-GCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Routine venipuncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36415","description":"Routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6578","description":"Gradient compression arm sleeve_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wet-dry dressings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4265F","description":"Wet-dry dressings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF1","description":"ICD-OFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42961","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB211","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA0","description":"ICD-NEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"removal of fixed orthodontic appliances for reasons other than completion of treatm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8695","description":"removal of fixed orthodontic appliances for reasons other than completion of treatm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC0","description":"ICD-OGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8044","description":"Hemi-facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucose other fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82945","description":"Glucose other fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus probe&revrs trns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87498","description":"Enterovirus probe&revrs trns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1105","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0540U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","description":"CPT-0540U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE0","description":"ICD-MGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography head w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70544","description":"Mr angiography head w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2106","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recd cortico >=10mg/day >60d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9467","description":"Recd cortico >=10mg/day >60d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens_ intraocular (new tech)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1780","description":"Lens_ intraocular (new tech)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD0","description":"ICD-FETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE211","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7901","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 30-60 minutes_ provided remotely by hospital staff who are licensed to pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01502","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","description":"CPT-01502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6118","description":"implant/abutment supported interim fixed denture for edentulous arch - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Online service by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98969","description":"Online service by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26037","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMA1","description":"ICD-MCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 2vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72070","description":"X-ray exam thorac spine 2vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6205","description":"Composite drsg > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF1","description":"ICD-BELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD0","description":"ICD-CIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27788","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap remove rectum w/pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45397","description":"Lap remove rectum w/pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADME0","description":"ICD-ADME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUE0","description":"ICD-NCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","description":"HCPCS-Q4429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1494","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","description":"HCPCS-M1494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC0","description":"ICD-FHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQE1","description":"ICD-DBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem urinary collect dev cup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4327","description":"Fem urinary collect dev cup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB1","description":"ICD-GAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOB1","description":"ICD-GCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove exostosis mandible","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21031","description":"Remove exostosis mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB245","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64716","description":"Revision of cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultraviolet light therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96900","description":"Ultraviolet light therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB0","description":"ICD-FDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE0","description":"ICD-MEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF0","description":"ICD-KBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respirator motion mgmt simul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77293","description":"Respirator motion mgmt simul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOF1","description":"ICD-KIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9306","description":"Interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD0","description":"ICD-MIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF1","description":"ICD-OHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLC1","description":"ICD-GCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2104","description":"Eye Imaging Validated To Match Diagnosis From Seven Standard Field Stereoscopic Photos Results Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23C","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBB0","description":"ICD-KIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC1","description":"ICD-EABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILA1","description":"ICD-NILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE0","description":"ICD-GADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo w/o joint multi-axis an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2038","description":"Kafo w/o joint multi-axis an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiometry threshold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0210T","description":"Speech audiometry threshold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAC0","description":"ICD-IBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0B","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct rpt to reg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9327","description":"Ct rpt to reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC0","description":"ICD-KGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF1","description":"ICD-KCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYE1","description":"ICD-CGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA1","description":"ICD-GGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCA1","description":"ICD-JGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ag detection polyval if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87300","description":"Ag detection polyval if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB1","description":"ICD-JBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18X","description":"Clinically Complex _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE0","description":"ICD-OKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rectal sensation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91120","description":"Rectal sensation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81404","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phys blood bank serv authrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86079","description":"Phys blood bank serv authrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0813T","description":"Esophagogastroduodenoscopy_ flexible_ transoral_ with volume adjustment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Color cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0514","description":"Color cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATC1","description":"ICD-GATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHE0","description":"ICD-AEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOF0","description":"ICD-OJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7549","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit with ureteral stricture balloon dilation_ including imaging guidance (eg_ ultrasound and/","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD1","description":"ICD-AHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25900","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB0","description":"ICD-DAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTB1","description":"ICD-OCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology colorectal scr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81528","description":"Oncology colorectal scr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28298","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 2 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95861","description":"Muscle test 2 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8G","description":"Very High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGA1","description":"ICD-NEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0138","description":"Intravenous infusion of cipaglucosidase alfa-atga_ including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of recei","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMF0","description":"ICD-NEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE0","description":"ICD-MHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of arm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23930","description":"Drainage of arm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55175","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF0","description":"ICD-IHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Renal biopsy open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50205","description":"Renal biopsy open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB104","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy muscle graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15841","description":"Nerve palsy muscle graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGA0","description":"ICD-KGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHD0","description":"ICD-FHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1224","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPB0","description":"ICD-CDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF1","description":"ICD-GDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mrgfus strtctc les abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398T","description":"Mrgfus strtctc les abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27846","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 4 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP04","description":"Auto.test pane pricing code_ 4 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUF1","description":"ICD-CCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHD1","description":"ICD-NJHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC11","description":"ICD-2KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE0","description":"ICD-CCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE0","description":"ICD-KERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC0","description":"ICD-AAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Report_ prev care measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8486","description":"Report_ prev care measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHE0","description":"ICD-BGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE1","description":"ICD-LEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLA0","description":"ICD-OFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSF0","description":"ICD-OKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBA0","description":"ICD-MHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1598","description":"Injection_ glycopyrrolate (Fresenius Kabi)_ not therapeutically equivalent to J1596_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC1","description":"ICD-PIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj milrinone lactate / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2260","description":"Inj milrinone lactate / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lat thor/lumb addl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22534","description":"Lat thor/lumb addl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC0B","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA20","description":"Default_ /14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21B","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUB0","description":"ICD-OHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDC0","description":"ICD-ADDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC226","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC251","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9346","description":"Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg_patients with malignant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIF1","description":"ICD-OGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD1","description":"ICD-BGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYF0","description":"ICD-PIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53600","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJD1","description":"ICD-CDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHD0","description":"ICD-OBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHA1","description":"ICD-GGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB1","description":"ICD-OIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD1","description":"ICD-JBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2029","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","description":"HCPCS-A2029","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD0","description":"ICD-JAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD0","description":"ICD-PJSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA31","description":"ICD-4EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB0","description":"ICD-JBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ ablation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1886","description":"Catheter_ ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF1","description":"ICD-FEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6120","description":"Implant Supported Retainer - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE0","description":"ICD-GFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter w/o bag 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4311","description":"Catheter w/o bag 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE0","description":"ICD-DAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNC1","description":"ICD-BGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCF0","description":"ICD-ECCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE254","description":"Clinically Complex _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tremelimumab-actl_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9147","description":"Injection_ tremelimumab-actl_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCD1","description":"ICD-MLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD1","description":"ICD-BCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIF0","description":"ICD-BCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE1","description":"ICD-JBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA0","description":"ICD-PDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRA0","description":"ICD-GHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE1","description":"ICD-OHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43425","description":"Repair esophagus opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1284","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32_ 33_ 34_ 54_ or 56 for more than 90 consecutive days during","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of carnitine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82379","description":"Assay of carnitine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9184","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","description":"HCPCS-J9184","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA1","description":"ICD-KDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB0","description":"ICD-BDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE0","description":"ICD-NIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD1","description":"ICD-FAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB0","description":"ICD-OGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGF0","description":"ICD-KIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46940","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84425","description":"Assay of vitamin b-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair retinal detach cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67113","description":"Repair retinal detach cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA1","description":"ICD-BCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA0","description":"ICD-BAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF1","description":"ICD-CDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","description":"HCPCS-M1383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE0","description":"ICD-GHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4123","description":"Alloskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE1","description":"ICD-PCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replc vagus nerve pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316T","description":"Replc vagus nerve pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy clamp_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4363","description":"Ostomy clamp_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYB0","description":"ICD-PJYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut rem dent part mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6113","description":"Imp/abut rem dent part mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54550","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m mertiatide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9562","description":"Tc99m mertiatide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD1","description":"ICD-IFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDA0","description":"ICD-CDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11623","description":"Exc s/n/h/f/g mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental occlusal guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9940","description":"Dental occlusal guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUF0","description":"ICD-MEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB0","description":"ICD-EDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF0","description":"ICD-BEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB0","description":"ICD-GEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF1","description":"ICD-BFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20939","description":"Bone marrow aspiration for bone grafting_ spine surgery only_ through separate skin or fascial incision (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE1","description":"ICD-NINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLD1","description":"ICD-NCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1016T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","description":"CPT-1016T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavy metal screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83015","description":"Heavy metal screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA1","description":"ICD-KHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp<5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99148","description":"Mod sed diff phys/qhp<5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB1","description":"ICD-EBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon metas evid dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9087","description":"Onc dx colon metas evid dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0D","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD0","description":"ICD-JEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB0","description":"ICD-FEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB151","description":"Clinically Complex _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSE0","description":"ICD-HBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9852","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7345","description":"Aminolevulinic acid hcl for topical administration_ 10% gel_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermabrasion segmental face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15781","description":"Dermabrasion segmental face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair venous blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75978","description":"Repair venous blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone acetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1700","description":"Hydrocortisone acetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGA0","description":"ICD-BIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug_ generic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5000","description":"Prescription drug_ generic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q6h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9503","description":"Hit antibiotic q6h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61610","description":"Transection or ligation_ carotid artery in cavernous sinus_ with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1074T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1074T","description":"CPT-1074T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC213","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8691","description":"Auditory osseointegrated device_ external sound processor_ excludes transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC1","description":"ICD-CGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEE1","description":"ICD-ABEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0621","description":"Hospital Special Treatment Room Support Component (Hstrsc) Fetal Monitoring Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHF0","description":"ICD-NFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anter chamber intraocul lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2630","description":"Anter chamber intraocul lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCA0","description":"ICD-FCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olanzapine_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2359","description":"Injection_ olanzapine_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC44","description":"Very High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intestinal stricturoplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44615","description":"Intestinal stricturoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCF0","description":"ICD-KGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens variable asphericity bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2430","description":"Lens variable asphericity bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA1","description":"ICD-LAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46740","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA0","description":"ICD-MBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD0","description":"ICD-GCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF1","description":"ICD-ABIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incomplete endodontic tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3332","description":"Incomplete endodontic tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33954","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB1","description":"ICD-GIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test sock wrist disart/bel e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6680","description":"Test sock wrist disart/bel e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0995T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","description":"CPT-0995T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDC0","description":"ICD-EIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68505","description":"Partial removal tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEF1","description":"ICD-NGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE0","description":"ICD-FIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"New eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92018","description":"New eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cygnus dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4282","description":"Cygnus dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC1","description":"ICD-PARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF1","description":"ICD-NJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC217","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAB1","description":"ICD-JIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4276","description":"Orion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid check both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92593","description":"Hearing aid check both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXE0","description":"ICD-CDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACE0","description":"ICD-KACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUA1","description":"ICD-MEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF0","description":"ICD-NDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2208","description":"Lens sphcy bifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyzine pamoate 25mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0177","description":"Hydroxyzine pamoate 25mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99222","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBID1","description":"ICD-CBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20560","description":"Needle Insertion(S) Without Injection(S); 1 Or 2 Muscle(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext amb insulin delivery sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9274","description":"Ext amb insulin delivery sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8808","description":"Trans-abdominal or trans-vaginal ultrasound not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interim abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6051","description":"Interim abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF1","description":"ICD-KHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1023T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","description":"CPT-1023T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","description":"CPT-01170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temple bone implant revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69717","description":"Temple bone implant revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBD1","description":"ICD-EFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFID1","description":"ICD-IFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA117","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAF0","description":"ICD-NJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD1","description":"ICD-OGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD0","description":"ICD-OEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51555","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQC0","description":"ICD-KIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB0","description":"ICD-NCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD220","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temporary replacement eqpmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0462","description":"Temporary replacement eqpmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA0","description":"ICD-FBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6208","description":"Contact layer > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUA0","description":"ICD-OHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE1","description":"ICD-EFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7038","description":"Pos airway pressure filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01200","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","description":"CPT-01200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9087","description":"Injection_ Cyclophosphamide_ (Auromedics)_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4148","description":"Neox Cord 1K_ Neox Cord RT_ or Clarix Cord 1K_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD250","description":"Special Care Low _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert palate implants","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9727","description":"Insert palate implants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC0","description":"ICD-JBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1823","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","description":"HCPCS-E1823","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth trach-bronch reconst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53951","description":"Anesth trach-bronch reconst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0803","description":"HCPCS-A0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bleomycin sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9040","description":"Bleomycin sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOA1","description":"ICD-HBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF0","description":"ICD-NCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove rectal obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45915","description":"Remove rectal obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE0","description":"ICD-IIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB1","description":"ICD-BFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5256","description":"Hearing aid_ digit_ mon_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disease management program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0315","description":"Disease management program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB0","description":"ICD-OJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hook_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6712","description":"Ped term dev_ hook_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKB0","description":"ICD-CIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME0","description":"ICD-FEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF1","description":"ICD-CGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADB1","description":"ICD-CADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0518T","description":"Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left ventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0750T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITE0","description":"ICD-IITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE1","description":"ICD-GFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement blood pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1620","description":"Replacement blood pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1351","description":"Patients who had a suicide safety plan initiated_ reviewed_ or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9052","description":"Injection_ ravulizumab-cwvz_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2216","description":"Foam filled propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC0","description":"ICD-GHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Direct refer hospital observ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0379","description":"Direct refer hospital observ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoidectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69502","description":"Mastoidectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD1","description":"ICD-BHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC1","description":"ICD-CADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA0","description":"ICD-FGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVE1","description":"ICD-GCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED0","description":"ICD-GGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2619","description":"Pmkr_ dual_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE1","description":"ICD-OGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zidovudine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3485","description":"Zidovudine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEA0","description":"ICD-MCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQC0","description":"ICD-GBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXA1","description":"ICD-OFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA30","description":"Low Rehab_ ADL Index 0-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIB0","description":"ICD-IEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC1","description":"ICD-NJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC1","description":"ICD-PFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFB0","description":"ICD-FCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOB1","description":"ICD-KIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD0","description":"ICD-BCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate conc pow per pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4765","description":"Dialysate conc pow per pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC1","description":"ICD-NIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted maaa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81599","description":"Unlisted maaa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDF1","description":"ICD-FBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25415","description":"Repair radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB1","description":"ICD-OHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF0","description":"ICD-OJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral rf treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53860","description":"Transurethral rf treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl trach puncture dilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8514","description":"Repl trach puncture dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Monthly Maintenance)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1895","description":"Personal Emergency Response System (Monthly Maintenance)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC1","description":"ICD-OKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMF0","description":"ICD-FGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95723","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006U","description":"Prescription drug monitoring_ 120 or more drugs and substances_ definitive tandem mass spectrometry with chromatography_ urine_ qualitative report of presence (including quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","description":"CPT-00844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0D","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","description":"HCPCS-Q4427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC0","description":"ICD-KCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC0","description":"ICD-OIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50010","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD0","description":"ICD-MLDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Navigational bronchoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31627","description":"Navigational bronchoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE0","description":"ICD-BIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD0","description":"ICD-KIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56606","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20A","description":"Clinically Complex _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKE0","description":"ICD-CFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUE0","description":"ICD-FCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acesso AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4312","description":"Acesso AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF0","description":"ICD-CAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSE1","description":"ICD-OHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB1","description":"ICD-KIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMF1","description":"ICD-CBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","description":"HCPCS-Q4371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC17","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396U","description":"Obstetrics (pre-implantation genetic testing)_ evaluation of 300000 DNA single-nucleotide polymorphisms (SNPs) by microarray_ embryonic tissue_ algorithm reported as a probabi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0088U","description":"Transplantation medicine (kidney allograft rejection)_ microarray gene expression profiling of 1494 genes_ utilizing transplant biopsy tissue_ algorithm reported as a probabil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24576","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA44","description":"Default_ /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE1","description":"ICD-NAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Current cig smoker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9642","description":"Current cig smoker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPD1","description":"ICD-FGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF0","description":"ICD-CEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOC1","description":"ICD-PGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0406","description":"Inpt/tele follow up 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMD1","description":"ICD-MKMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVB1","description":"ICD-FCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA205","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC117","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC0","description":"ICD-EALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil sup empl waiver 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2019","description":"Habil sup empl waiver 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peak expiratory flow rate (p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8110","description":"Peak expiratory flow rate (p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMF0","description":"ICD-NAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB244","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close tear system fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68770","description":"Close tear system fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing assessment/evaluatn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1001","description":"Nursing assessment/evaluatn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE245","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE0","description":"ICD-KCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explr/decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67414","description":"Explr/decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5944","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5944","description":"CDT-D5944","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented above normal parameters and a follow-up plan is documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1293","description":"Bmi is documented above normal parameters and a follow-up plan is documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tezepelumab-ekko_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2356","description":"Injection_ tezepelumab-ekko_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreatic duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48148","description":"Removal of pancreatic duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA0","description":"ICD-BEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Filter_ non disposable w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7039","description":"Filter_ non disposable w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pjp proph ordered cd4 low","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9223","description":"Pjp proph ordered cd4 low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Middle cerebral artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76821","description":"Middle cerebral artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tilt table locking hip sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5270","description":"Tilt table locking hip sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA1","description":"ICD-FFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE1","description":"ICD-LAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF1","description":"ICD-OIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18D","description":"Special Care Low _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acp discuss/dscn mkr docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1123F","description":"Acp discuss/dscn mkr docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE1","description":"ICD-BCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWE0","description":"ICD-GEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA0","description":"ICD-OEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNB1","description":"ICD-CCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC35","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTC1","description":"ICD-FHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID1","description":"ICD-GFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37600","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64494","description":"Inj paravert f jnt l/s 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 4 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95864","description":"Muscle test 4 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert vad art&vein access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33991","description":"Insert vad art&vein access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA1","description":"ICD-NLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Used By Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9992","description":"Palliative Care Services Used By Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIC1","description":"ICD-GGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pin finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26756","description":"Pin finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI low field","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8042","description":"MRI low field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF0","description":"ICD-DBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB0","description":"ICD-GAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEB1","description":"ICD-JGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUE0","description":"ICD-GCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak/bk self-aligning unit ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5617","description":"Ak/bk self-aligning unit ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIC0","description":"ICD-KIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD11B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest allogeneic stem cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38205","description":"Harvest allogeneic stem cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67805","description":"Remove eyelid lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME1","description":"ICD-BCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81363","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); duplication/deletion variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0721T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained without concurrent CT examination of any structure contained in pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug delivery system <=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4306","description":"Drug delivery system <=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB0","description":"ICD-BDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97163","description":"Physical therapy evaluation: high complexity_ requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the pla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4544","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","description":"HCPCS-A4544","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC1","description":"ICD-OLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq transcath closure pda","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93582","description":"Perq transcath closure pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA0","description":"ICD-ADDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37268","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","description":"CPT-37268","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELB0","description":"ICD-IELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hern repair comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49655","description":"Lap inc hern repair comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAC1","description":"ICD-KFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF0","description":"ICD-NGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHE1","description":"ICD-IHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quadrilateral brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2188","description":"Quadrilateral brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF1","description":"ICD-KEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr cbl elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0492","description":"Emr pwr cbl elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6556","description":"Gradient compression stocking_ thigh length_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA1","description":"ICD-BEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam two surfaces permane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2150","description":"Amalgam two surfaces permane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1008T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","description":"CPT-1008T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE1","description":"ICD-NCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69805","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cefazolin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0690","description":"Cefazolin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPD1","description":"ICD-JAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4C","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFA1","description":"ICD-NIFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOF1","description":"ICD-DIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJB0","description":"ICD-OBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leveen/shunt patency exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78291","description":"Leveen/shunt patency exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mercaptopurine 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0108","description":"Mercaptopurine 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96167","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0670T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; arterial anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7165","description":"Injection_ prothrombin complex concentrate_ human-lans_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC1","description":"ICD-DHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF0","description":"ICD-LCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0525","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYD0","description":"ICD-DAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4521","description":"Adult size brief/diaper sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45390","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA0","description":"ICD-BHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND1","description":"ICD-JEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTC0","description":"ICD-NBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alveoloplasty w/extract 1-3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7311","description":"Alveoloplasty w/extract 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFF1","description":"ICD-CBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5139","description":"HCPCS-Q5139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93931","description":"Upper extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF0","description":"ICD-FEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARC0","description":"ICD-OARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA54","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA1","description":"ICD-HARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE1","description":"ICD-KBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCE0","description":"ICD-CBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31635","description":"Bronchoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOC1","description":"ICD-DIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ inflatab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1813","description":"Prosthesis_ penile_ inflatab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23044","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGC1","description":"ICD-NKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAE0","description":"ICD-OHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA13","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKE1","description":"ICD-OCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOD0","description":"ICD-PLOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD1","description":"ICD-ECCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE1","description":"ICD-AHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA1","description":"ICD-KHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay resin 3/mre sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2652","description":"Dental inlay resin 3/mre sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77089","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Using Dual X-Ray Absorptiometry (Dxa) Or Other Imaging Data On Gray-Scale Variogram_ Calculati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE1","description":"ICD-JAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1057T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1057T","description":"CPT-1057T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28150","description":"Removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD125","description":"Special Care High _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Halo cerv into milwaukee typ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0830","description":"Halo cerv into milwaukee typ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC1","description":"ICD-KGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1008","description":"Clinical Decision Support Mechanism Cranberry Peak_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHE1","description":"ICD-BDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFA0","description":"ICD-CDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVB0","description":"ICD-JIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting for tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92071","description":"Contact lens fitting for tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA0","description":"ICD-EHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB1","description":"ICD-KDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHA1","description":"ICD-MEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED1","description":"ICD-CBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIB1","description":"ICD-OEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD1","description":"ICD-CFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETA1","description":"ICD-KETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEA0","description":"ICD-ABEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ neck/head_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6567","description":"Gradient compression garment_ neck/head_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop follow-up visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99024","description":"Postop follow-up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70330","description":"X-ray exam of jaw joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Global eswl kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0400","description":"Global eswl kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX05","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHA1","description":"ICD-EIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metalic 1 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2510","description":"Dental inlay metalic 1 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBA0","description":"ICD-NBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC0","description":"ICD-IFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8X","description":"Low Rehab_ ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA1","description":"ICD-JDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 4.12-7.0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2201","description":"Lens sphere bifocal 4.12-7.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD0","description":"ICD-GDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6528","description":"Gradient compression garment_ bra_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDA1","description":"ICD-CFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73600","description":"X-ray exam of ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 12 COM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0216U","description":"NEURO INH ATAXIA DNA 12 COM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2999","description":"Lower extremity orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXC1","description":"ICD-OLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC0","description":"ICD-DGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUA1","description":"ICD-FGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61150","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC1","description":"ICD-OFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Performance Met: The Residual Change Score Is Equal To Or Greater Than 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2152","description":"Performance Met: The Residual Change Score Is Equal To Or Greater Than 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including CT guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10009","description":"Fine needle aspiration biopsy_ including CT guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ burosumab-twza_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0584","description":"Injection_ burosumab-twza_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26530","description":"Revise knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB0","description":"ICD-IFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE0","description":"ICD-OJEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67882","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2016F","description":"Asthma risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue base vol reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41530","description":"Tongue base vol reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB1","description":"ICD-FCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD240","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No antipla/p2y12 ord_ rs nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9611","description":"No antipla/p2y12 ord_ rs nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA1","description":"ICD-BGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0667","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","description":"HCPCS-G0667","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD0","description":"ICD-OFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revita_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4180","description":"Revita_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC145","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient use of hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9693","description":"Patient use of hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling catheter special","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4340","description":"Indwelling catheter special","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE1","description":"ICD-NCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITE0","description":"ICD-KITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9770","description":"Vitrectomy_ mechanical_ pars plana approach_ with subretinal injection of pharmacologic/biologic agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin splt grft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15100","description":"Skin splt grft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0867T","description":"Transperineal laser ablation of benign prostatic hyperplasia_ including imaging guidance; prostate volume greater or equal to 50 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L8720","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8720","description":"HCPCS-L8720","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q2058","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","description":"HCPCS-Q2058","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBC1","description":"ICD-CIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/o inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93892","description":"Tcd emboli detect w/o inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED0","description":"ICD-GAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus caus bac inx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9364","description":"Sinus caus bac inx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay for calprotectin fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83993","description":"Assay for calprotectin fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1801","description":"HCPCS-A1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC0","description":"ICD-FCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81464","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYC1","description":"ICD-GAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE226","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB0","description":"ICD-KCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB1","description":"ICD-IIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE1","description":"ICD-OCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b vac series prev recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4157F","description":"Hep b vac series prev recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC1","description":"ICD-OBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84100","description":"Assay of phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD0","description":"ICD-LAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC1","description":"ICD-CFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10007","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEF0","description":"ICD-CEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMA0","description":"ICD-GBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC0","description":"ICD-EHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQF1","description":"ICD-HDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCID0","description":"ICD-KCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1031T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1031T","description":"CPT-1031T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE0","description":"ICD-GEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC0","description":"ICD-OJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC1","description":"ICD-LCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRE0","description":"ICD-CCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17274","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYF0","description":"ICD-HAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8C","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHC1","description":"ICD-ECHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF0","description":"ICD-OFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9245","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9245","description":"CDT-D9245","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27605","description":"Incision of achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatobiliary system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78226","description":"Hepatobiliary system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB1","description":"ICD-OFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE0","description":"ICD-NLPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4356","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","description":"HCPCS-Q4356","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIA1","description":"ICD-NKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMD1","description":"ICD-ODMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMF0","description":"ICD-NHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOE0","description":"ICD-DFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0D","description":"Low Rehab_ ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA0","description":"ICD-BAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB1","description":"ICD-EEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20005","description":"Incision and drainage of soft tissue abscess_ subfascial (ie_ involves the soft tissue below the deep fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF1","description":"ICD-JFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95927","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCB1","description":"ICD-BGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD1","description":"ICD-JCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28740","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lift elev heel/sole cor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3320","description":"Shoe lift elev heel/sole cor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gemtuzumab ozogamicin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9300","description":"Gemtuzumab ozogamicin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7571","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7571","description":"HCPCS-C7571","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC0","description":"ICD-FCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB12","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB0","description":"ICD-MCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75946","description":"Intravascular ultrasound (non-coronary vessel)_ radiological supervision and interpretation; each additional non-coronary vessel (list separately in addition to c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HER2/neu negative or undocumented/unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9825","description":"HER2/neu negative or undocumented/unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACE0","description":"ICD-MACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCD0","description":"ICD-OCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCF1","description":"ICD-IFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Throat x-ray & fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70370","description":"Throat x-ray & fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMD0","description":"ICD-ECMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUD1","description":"ICD-KIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"U1nonsealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2364","description":"U1nonsealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drsg <=16 sq in w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6209","description":"Foam drsg <=16 sq in w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC0","description":"ICD-FEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF0","description":"ICD-NIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSF0","description":"ICD-OCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE0","description":"ICD-NILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC1","description":"ICD-FCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCF0","description":"ICD-EBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0798T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB0","description":"ICD-CGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av fuse uppr arm basilic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36819","description":"Av fuse uppr arm basilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE1","description":"ICD-BCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy balloon <30mm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43220","description":"Esophagoscopy balloon <30mm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15934","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB210","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC40","description":"Ultra High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF0","description":"ICD-NLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66991","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC1","description":"ICD-ABUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC160","description":"Special Care Low _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJC0","description":"ICD-NAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC106","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJE0","description":"ICD-NAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQC0","description":"ICD-CEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24362","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC1","description":"ICD-OCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDF1","description":"ICD-IHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0247","description":"Intravenous infusion_ sotrovimab_ includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA1","description":"ICD-CEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC0","description":"ICD-GGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63307","description":"Remov vert idrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC1","description":"ICD-KEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286U","description":"Cep72 (Centrosomal Protein_ 72-Kda)_ Nudt15 (Nudix Hydrolase 15) And Tpmt (Thiopurine S-Methyltransferase) (Eg_ Drug Metabolism) Gene Analysis_ Common Variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB31","description":"ICD-2EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right ventricular recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93603","description":"Right ventricular recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28665","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA0","description":"ICD-PJRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86551","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ticarcillin disod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0040","description":"Injection_ ticarcillin disod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC1","description":"ICD-GEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC0","description":"ICD-JIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJC0","description":"ICD-NFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of scrotum abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55100","description":"Drainage of scrotum abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0644","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0644","description":"HCPCS-J0644","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC1","description":"ICD-NABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF1","description":"ICD-ICUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1946","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1946","description":"HCPCS-J1946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEF0","description":"ICD-OIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28208","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC33","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKD0","description":"ICD-GEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33927","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA1","description":"ICD-CHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD1","description":"ICD-EBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9999","description":"Chemotherapy drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD0","description":"ICD-NGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA0","description":"ICD-IBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD0","description":"ICD-ICUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9729","description":"Patient unable to complete the FOTO hip intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex for nonspeech dev rx add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92618","description":"Ex for nonspeech dev rx add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0493T","description":"Near-infrared spectroscopy studies of lower extremity wounds (eg_ for oxyhemoglobin measurement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01180","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","description":"CPT-01180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mesentery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44850","description":"Repair of mesentery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC1","description":"ICD-OEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99152","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEB1","description":"ICD-KIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBE0","description":"ICD-AGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXB0","description":"ICD-NAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWF0","description":"ICD-CFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF1","description":"ICD-GECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal cortex & medulla img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78075","description":"Adrenal cortex & medulla img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD1","description":"ICD-ACAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED1","description":"ICD-NBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27230","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCF1","description":"ICD-MJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC0","description":"ICD-CEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95711","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3514F","description":"Hep c scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal biophys profil w/o nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76819","description":"Fetal biophys profil w/o nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC1","description":"ICD-OBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0521","description":"Management of new patient-caregiver dyad with dementia_ high complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB0","description":"ICD-KIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB0","description":"ICD-KDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXC0","description":"ICD-CGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE1","description":"ICD-BHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMB0","description":"ICD-ODMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1125","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tacrolimus injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7525","description":"Tacrolimus injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE0","description":"ICD-ECDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43020","description":"Incision of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam/biopsy of vulva w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56821","description":"Exam/biopsy of vulva w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKD1","description":"ICD-NBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural c/t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64479","description":"Inj foramen epidural c/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","description":"CPT-00400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYE1","description":"ICD-DDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release spinal cord lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63200","description":"Release spinal cord lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DB21","description":"ICD-1DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte histamine release","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86343","description":"Leukocyte histamine release","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMD1","description":"ICD-IFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGF1","description":"ICD-KBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA1","description":"ICD-NAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58943","description":"Removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87182","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","description":"CPT-87182","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB0","description":"ICD-MEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE0","description":"ICD-KHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGD1","description":"ICD-CGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE0","description":"ICD-NFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB1","description":"ICD-OIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel thomas extend to b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3470","description":"Shoe heel thomas extend to b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDED1","description":"ICD-MDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX02","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Standing frame sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0638","description":"Standing frame sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSA1","description":"ICD-CBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWD1","description":"ICD-PGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLA0","description":"ICD-NLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bile tract surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47999","description":"Bile tract surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF0","description":"ICD-NJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1748","description":"Injection_ infliximab-dyyb (Zymfentra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF1","description":"ICD-ACDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC1","description":"ICD-NIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDND1","description":"ICD-GDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268T","description":"Implt/rpl crtd sns dev gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITE0","description":"ICD-AITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1106T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1106T","description":"CPT-1106T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted procedure colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45399","description":"Unlisted procedure colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF1","description":"ICD-AEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell cnt 200-499 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3495F","description":"Cd4+cell cnt 200-499 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD0","description":"ICD-BAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7501","description":"Percutaneous breast biopsies using stereotactic guidance_ with placement of breast localization device(s) (eg_ clip_ metallic pellet)_ when performed_ and imaging of the biops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD0","description":"ICD-JGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92642","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","description":"CPT-92642","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAA0","description":"ICD-MBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artificial cornea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8609","description":"Artificial cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUC0","description":"ICD-CAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEA0","description":"ICD-BBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34101","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cbc without platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0307","description":"Cbc without platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD1","description":"ICD-BFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35903","description":"Excision graft extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plan care lipid control docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556F","description":"Plan care lipid control docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0685U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685U","description":"CPT-0685U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF1","description":"ICD-FHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1228","description":"Patient_ who has a reactive hcv antibody test_ and has a follow up hcv viral test that detected hcv viremia_ has hcv treatment initiated within 3 months of the reactive hcv an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dementia measures group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8902","description":"Dementia measures group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t3 n0 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9091","description":"Onc dx rectal t3 n0 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB1","description":"ICD-AGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD0","description":"ICD-HFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC0","description":"ICD-OHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC1","description":"ICD-OHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ear cartilage graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21235","description":"Ear cartilage graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA1","description":"ICD-KIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED1","description":"ICD-OEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECC1","description":"ICD-FECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arbutamine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0395","description":"Arbutamine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apomorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0364","description":"Apomorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proton treatment complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77525","description":"Proton treatment complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Superimposed prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5954","description":"Superimposed prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNB0","description":"ICD-KDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2044","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","description":"HCPCS-A2044","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDC0","description":"ICD-AFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29035","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA0","description":"ICD-KFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES220","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scap thorac prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6570","description":"Scap thorac prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ binaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5249","description":"Hearing aid_ binaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE1","description":"ICD-OGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optimizing Chronic Disease Management Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0056","description":"Optimizing Chronic Disease Management Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUE0","description":"ICD-ICUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec med comp dev_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1505","description":"Elec med comp dev_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF1","description":"ICD-CEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exoskel hip ultra-light mate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5795","description":"Exoskel hip ultra-light mate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFED1","description":"ICD-CFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Voriconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80285","description":"Voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leads any type vad_ rep only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0487","description":"Leads any type vad_ rep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluocinol acet intravit imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7313","description":"Fluocinol acet intravit imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC1","description":"ICD-PKYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE0","description":"ICD-CAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417T","description":"Prgrmg eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Car-car bp grft/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33891","description":"Car-car bp grft/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99309","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1261","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB0","description":"ICD-KHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD0","description":"ICD-CGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code 13-16 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP16","description":"Auto test panel pricing code 13-16 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA1","description":"ICD-EDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8A","description":"Low Rehab_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01992","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","description":"CPT-01992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPD0","description":"ICD-KIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2C","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA1","description":"ICD-JIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE0","description":"ICD-PDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKA0","description":"ICD-KFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOD1","description":"ICD-DIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWB0","description":"ICD-OAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01400","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","description":"CPT-01400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hypothermia ill neonate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99184","description":"Hypothermia ill neonate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLB1","description":"ICD-EGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCF1","description":"ICD-GBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583T","description":"Tympanostomy (Requiring Insertion Of Ventilating Tube)_ Using An Automated Tube Delivery System_ Iontophoresis Local Anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB12","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE1","description":"ICD-LGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body pos d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8983","description":"Body pos d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/implant finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26536","description":"Revise/implant finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYE0","description":"ICD-KDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAD1","description":"ICD-JAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID1","description":"ICD-AAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME0","description":"ICD-AHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96133","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite drsg >16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6204","description":"Composite drsg >16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2A","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE1","description":"ICD-BHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFE1","description":"ICD-NJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81403","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD1","description":"ICD-CAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93319","description":"3D Echocardiographic Imaging And Postprocessing During Transesophageal Echocardiography_ Or During Transthoracic Echocardiography For Congenital Cardiac Anomalies_ For The Ass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF1","description":"ICD-BAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64598","description":"Revision or removal of neurostimulator electrode array_ peripheral nerve_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0C","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBD1","description":"ICD-GIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21267","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC0","description":"ICD-BATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF1","description":"ICD-ECHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB220","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDE0","description":"ICD-AEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYD0","description":"ICD-LIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Buttock fasciotomy w/dbrdmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27057","description":"Buttock fasciotomy w/dbrdmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGE1","description":"ICD-GDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB0","description":"ICD-NKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly or PuraPly AM_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4172","description":"PuraPly or PuraPly AM_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBB1","description":"ICD-AHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB1","description":"ICD-EEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF0","description":"ICD-KBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF1","description":"ICD-BHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHC1","description":"ICD-KBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tafasitamab-cxix_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9070","description":"Injection_ tafasitamab-cxix_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWD0","description":"ICD-PDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4383","description":"Urinary rubber pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58674","description":"Laparoscopy_ surgical_ ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ motixafortide_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2277","description":"Injection_ motixafortide_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF0","description":"ICD-OJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe wedge sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3340","description":"Shoe wedge sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD110","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC0","description":"ICD-JGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of windpipe airway","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31502","description":"Change of windpipe airway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE1","description":"ICD-GAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLA0","description":"ICD-BCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLE0","description":"ICD-GHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC0","description":"ICD-NHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23800","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMC0","description":"ICD-JFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCF0","description":"ICD-GFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054U","description":"Prescription drug monitoring_ 14 or more classes of drugs and substances_ definitive tandem mass spectrometry with chromatography_ capillary blood_ quantitative report with th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision secondary cataract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66820","description":"Incision secondary cataract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUD1","description":"ICD-ICUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9697","description":"Injection_ carboxydextran-coated superparamagnetic iron oxide_ per study dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC1","description":"ICD-AACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXD0","description":"ICD-KDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vasc graft into carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25430","description":"Vasc graft into carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dark field examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87166","description":"Dark field examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99244","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC1","description":"ICD-HEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA1","description":"ICD-BGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD1","description":"ICD-ICMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX35","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ranibizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2778","description":"Ranibizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHC1","description":"ICD-BGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9998","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","description":"HCPCS-Q9998","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD0","description":"ICD-LERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLC1","description":"ICD-AFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE0","description":"ICD-BGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol carb > 50%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4180","description":"Parenteral sol carb > 50%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF1","description":"ICD-NDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC0","description":"ICD-EHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB0","description":"ICD-JDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYD0","description":"ICD-DGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9033","description":"Injection_ fosnetupitant 235 mg and palonosetron 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC0","description":"ICD-IBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8C","description":"High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXE1","description":"ICD-OKXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47361","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTE0","description":"ICD-MLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE1","description":"ICD-KANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA22","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33365","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4021","description":"Cast sup sht arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE244","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise cerv artific disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22861","description":"Revise cerv artific disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspergillus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86606","description":"Aspergillus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYB0","description":"ICD-ODYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA0","description":"ICD-OKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF1","description":"ICD-OAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA0","description":"ICD-FHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEF0","description":"ICD-ACEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD0","description":"ICD-CHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVF0","description":"ICD-GAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE0","description":"ICD-FCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15834","description":"Excise excessive skin hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6035","description":"Gold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD0","description":"ICD-FELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMC0","description":"ICD-ADMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIE1","description":"ICD-MJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC0","description":"ICD-JAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD0","description":"ICD-OHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWE0","description":"ICD-PCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB1","description":"ICD-OAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin depression screen not d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8432","description":"Clin depression screen not d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Path consult introp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88329","description":"Path consult introp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC1","description":"ICD-JFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoro exam of g/colon tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49465","description":"Fluoro exam of g/colon tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant maintenance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6080","description":"Implant maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB131","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA1","description":"ICD-PLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC1","description":"ICD-KAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHA0","description":"ICD-BCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8999","description":"Orthodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB1","description":"ICD-FEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB0","description":"ICD-OBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lungs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75743","description":"Artery x-rays lungs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE1","description":"ICD-NDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAE1","description":"ICD-OLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io radiation tx management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77469","description":"Io radiation tx management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF1","description":"ICD-GHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8B","description":"High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD1","description":"ICD-KEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD0","description":"ICD-ODLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interspinous implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1821","description":"Interspinous implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniotic membrane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2790","description":"Amniotic membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQB0","description":"ICD-HEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF1","description":"ICD-GGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid repair/modifying","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5014","description":"Hearing aid repair/modifying","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD0","description":"ICD-PFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0672T","description":"Endovaginal Cryogen-Cooled_ Monopolar Radiofrequency Remodeling Of The Tissues Surrounding The Female Bladder Neck And Proximal Urethra For Urinary Incontinence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTC1","description":"ICD-MGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC1","description":"ICD-FFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVF1","description":"ICD-OHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJF1","description":"ICD-FEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90473","description":"Immune admin oral/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB1","description":"ICD-BGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy gastrostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43653","description":"Laparoscopy gastrostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93317","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary cath anchor device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4333","description":"Urinary cath anchor device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE1","description":"ICD-NJIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27630","description":"Removal of tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS EA COMP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0215U","description":"RARE DS XOM DNA ALYS EA COMP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUB0","description":"ICD-IFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for wrist x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25246","description":"Injection for wrist x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICE0","description":"ICD-BICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA1","description":"ICD-BAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1131","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKD1","description":"ICD-NFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB225","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDME0","description":"ICD-JDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIME0","description":"ICD-MIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAE0","description":"ICD-CBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLA1","description":"ICD-FBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLE1","description":"ICD-EGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33859","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Disease Other Than Dissection (Eg_ Aneurysm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD1","description":"ICD-OKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative assay drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80299","description":"Quantitative assay drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82541","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; qualitative_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9025","description":"Plasma_ cryoprecipitate reduced_ pathogen reduced_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hypertonic saline sol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7131","description":"Hypertonic saline sol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCME0","description":"ICD-KCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVA1","description":"ICD-FBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA1","description":"ICD-JAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bacterium antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86609","description":"Bacterium antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoabdominal graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33877","description":"Thoracoabdominal graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDF1","description":"ICD-OEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc of neg or man pos tb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9360","description":"No doc of neg or man pos tb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB0","description":"ICD-OKNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01966","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","description":"CPT-01966","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUC0","description":"ICD-MEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx rad extra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25607","description":"Treat fx rad extra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB1","description":"ICD-NGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB1","description":"ICD-OGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8006","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8006","description":"HCPCS-C8006","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATA0","description":"ICD-IATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57200","description":"Repair of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB1","description":"ICD-BIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA03","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of mercury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83825","description":"Assay of mercury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA0","description":"ICD-FHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD1","description":"ICD-EHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC1","description":"ICD-GABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB1","description":"ICD-FHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0149","description":"Heavy duty wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGD0","description":"ICD-KEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27198","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","description":"HCPCS-J9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1702","description":"HCPCS-B1702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUF0","description":"ICD-ODUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA1","description":"ICD-AFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Root canal therapy 3 canals","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3330","description":"Root canal therapy 3 canals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screen depression performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3725F","description":"Screen depression performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC0","description":"ICD-GEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPC1","description":"ICD-JAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50436","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBE1","description":"ICD-MHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise abdomen-venous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49426","description":"Revise abdomen-venous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28F","description":"Special Care High _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEF0","description":"ICD-OHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUA0","description":"ICD-EAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPE1","description":"ICD-JCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC1","description":"ICD-KHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31574","description":"Laryngoscopy_ flexible; with injection(s) for augmentation (eg_ percutaneous_ transoral)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68841","description":"Insertion Of Drug-Eluting Implant_ Including Punctal Dilation When Performed_ Into Lacrimal Canaliculus_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75651","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC0","description":"ICD-PEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA160","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15877","description":"Suction lipectomy trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impreg gauze no h20/sal/yard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6266","description":"Impreg gauze no h20/sal/yard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE213","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0090U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15C","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjustable angle footplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0040","description":"Adjustable angle footplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27499","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust cmplt mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5411","description":"Dentures adjust cmplt mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUE1","description":"ICD-BFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv <10mg daily predniso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4193F","description":"Pt rcv <10mg daily predniso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext at dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9069","description":"Onc dx sclc/nsclc ext at dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ alemtuzumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0202","description":"Injection_ alemtuzumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE1","description":"ICD-KAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIC1","description":"ICD-EHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB1","description":"ICD-HCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF1","description":"ICD-GIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJC1","description":"ICD-OCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66920","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc rspse chmotx rx motility cntrst tomography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083U","description":"Onc rspse chmotx rx motility cntrst tomography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC1","description":"ICD-BIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF0","description":"ICD-EIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA1","description":"ICD-GACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA0","description":"ICD-GEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCC1","description":"ICD-NBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB0","description":"ICD-GESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air elevator for heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0370","description":"Air elevator for heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0589","description":"Injection_ daxibotulinumtoxina-lanm_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18C","description":"Special Care Low _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl oral cushion combo mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7028","description":"Repl oral cushion combo mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDC1","description":"ICD-IDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD1","description":"ICD-JFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75889","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect abd tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22905","description":"Rad resect abd tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJF0","description":"ICD-BHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQC0","description":"ICD-HGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9795","description":"Stereotactic body radiation therapy_ treatment delivery_ per fraction to 1 or more lesions_ including image guidance and real-time positron emissions-based delivery adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF1","description":"ICD-EBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICA1","description":"ICD-NICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mech remov tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36595","description":"Mech remov tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE0","description":"ICD-IHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supp maint employ_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2025","description":"Supp maint employ_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97162","description":"Physical therapy evaluation: moderate complexity_ requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81417","description":"Exome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26455","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31080","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD1","description":"ICD-BADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF0","description":"ICD-ODCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA1","description":"ICD-MCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF0","description":"ICD-LFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQB0","description":"ICD-HGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD0","description":"ICD-OHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLC1","description":"ICD-OKLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp pop-tibl-prl-other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35671","description":"Art byp pop-tibl-prl-other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hammertoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28286","description":"Repair of hammertoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWC0","description":"ICD-HGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33929","description":"Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64901","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1B","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology Cardiac Specialist Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4002","description":"Electrophysiology Cardiac Specialist Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal seg width over","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2219","description":"Lens bifocal seg width over","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA1","description":"ICD-JEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE0","description":"ICD-CANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27386","description":"Repair/graft of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA0","description":"ICD-OLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA0","description":"ICD-OFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92519","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Cervical (Cvemp) And Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intranasal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30118","description":"Removal of intranasal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes oxford","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3219","description":"Orthopedic mens shoes oxford","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sperm cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55520","description":"Removal of sperm cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD1","description":"ICD-DDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/o pat by phys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99367","description":"Team conf w/o pat by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE0","description":"ICD-CAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA1","description":"ICD-EDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWB1","description":"ICD-KCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0163","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","description":"HCPCS-J0163","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wnd prep f/n/hf/g addl cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15005","description":"Wnd prep f/n/hf/g addl cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE0","description":"ICD-DCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBF1","description":"ICD-CEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99238","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB0","description":"ICD-EHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLF0","description":"ICD-MBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13B","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE0","description":"ICD-AFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj cervical plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64413","description":"N block inj cervical plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA0","description":"ICD-CDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","description":"HCPCS-A2036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable corrugated tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7010","description":"Disposable corrugated tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vc lesion w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31545","description":"Remove vc lesion w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHE0","description":"ICD-JDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoluminal bx urtr rnl plvs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50606","description":"Endoluminal bx urtr rnl plvs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray for pancreas endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74329","description":"X-ray for pancreas endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC1","description":"ICD-CCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA0","description":"ICD-JIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB113","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBE0","description":"ICD-ABBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0994T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","description":"CPT-0994T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis auto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81001","description":"Urinalysis auto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC1","description":"ICD-EHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD0","description":"ICD-PIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC0","description":"ICD-OBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA0","description":"ICD-KDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor lung single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32855","description":"Prepare donor lung single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOB0","description":"ICD-DIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flex thermoplastic collar mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0130","description":"Flex thermoplastic collar mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Offset/lat rocker arm w/ela","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2632","description":"Offset/lat rocker arm w/ela","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","description":"HCPCS-M1472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24802","description":"Fusion/graft of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBE1","description":"ICD-BHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0837T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; interpretation and report (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVE1","description":"ICD-NJVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bamlanivimab and etesevimab_ 2100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0245","description":"Injection_ bamlanivimab and etesevimab_ 2100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNE0","description":"ICD-OCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft hepatorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35535","description":"Art byp grft hepatorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shldr disar prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6550","description":"Shldr disar prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko elas w/ condyle pads & jo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1820","description":"Ko elas w/ condyle pads & jo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10A","description":"Special Care High _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases o2 sat only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82810","description":"Blood gases o2 sat only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33418","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63182","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE0","description":"ICD-OEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46080","description":"Incision of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB0","description":"ICD-CFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0737","description":"Injection_ clindamycin phosphate (baxter)_ not therapeutically equivalent to j0736_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35612","description":"Art byp subclav-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0102U","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer)_ genomic sequence analysis panel utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF1","description":"ICD-KGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient occurred any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9720","description":"Hospice services for patient occurred any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vert bitewings-sev to eight","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0277","description":"Vert bitewings-sev to eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC246","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB250","description":"Special Care Low _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB0","description":"ICD-OCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flecainide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80181","description":"Flecainide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA0","description":"ICD-KDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise head/neck of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27179","description":"Revise head/neck of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shorten/lengthen thighs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27468","description":"Shorten/lengthen thighs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE0","description":"ICD-BAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB0","description":"ICD-JEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF1","description":"ICD-JFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYC0","description":"ICD-ODYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE1","description":"ICD-FHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD0","description":"ICD-OLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUE1","description":"ICD-MFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPD0","description":"ICD-BAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB1","description":"ICD-JDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Waterjet prostate abltj cmpl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421T","description":"Waterjet prostate abltj cmpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD1","description":"ICD-FFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERA0","description":"ICD-GERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE0","description":"ICD-OHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8657","description":"Fun stat score le pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC0","description":"ICD-OANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADE1","description":"ICD-OADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4030","description":"Pulmonology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMB0","description":"ICD-GFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18F","description":"Special Care Low _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHA1","description":"ICD-AIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB15","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay growth hormone (hgh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83003","description":"Assay growth hormone (hgh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHE0","description":"ICD-KHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI w/stress img","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75559","description":"Cardiac MRI w/stress img","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration femoral artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35721","description":"Exploration femoral artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent tobacco status is not tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9792","description":"Most recent tobacco status is not tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22899","description":"Spine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orchiopexy (fowler-stephens)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54650","description":"Orchiopexy (fowler-stephens)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWD1","description":"ICD-KEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4024","description":"Pediatrics Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAE0","description":"ICD-KDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB0","description":"ICD-MFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKB0","description":"ICD-GAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMD0","description":"ICD-FDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg awake and drowsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95816","description":"Eeg awake and drowsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB0","description":"ICD-JHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWF0","description":"ICD-LHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB1","description":"ICD-BEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHND1","description":"ICD-GHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF0","description":"ICD-OFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIA0","description":"ICD-BHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE1","description":"ICD-KALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA1","description":"ICD-CGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC0","description":"ICD-MBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0035U","description":"Neurology (prior disease)_ cerebrospinal fluid_ detection of prion protein by quaking-induced conf conversion_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9074","description":"Injection_ lumasiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA0","description":"ICD-BGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26742","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC1","description":"ICD-EAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero & or pyeloscope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52351","description":"Cystouretero & or pyeloscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE0","description":"ICD-CGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml blast phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9125","description":"Onc dx cml blast phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0005","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA1","description":"ICD-EBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVE0","description":"ICD-KIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJF1","description":"ICD-OFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA1","description":"ICD-ADIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE231","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB0","description":"ICD-NABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methyl aminolevulinate_ top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7309","description":"Methyl aminolevulinate_ top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD0","description":"ICD-OBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bleeding control","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91651","description":"Anesth bleeding control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC0","description":"ICD-ODWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE1","description":"ICD-CGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUD0","description":"ICD-OKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA0","description":"ICD-MGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBA1","description":"ICD-NIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA0","description":"ICD-KDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38226","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","description":"CPT-38226","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd biopsy single/multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43239","description":"Egd biopsy single/multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ent procedure/service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92700","description":"Ent procedure/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD0","description":"ICD-KIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Band stabilization - per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2976","description":"Band stabilization - per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGB1","description":"ICD-CGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE0","description":"ICD-OBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78015","description":"Thyroid met imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24495","description":"Decompression of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC0","description":"ICD-FFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA0","description":"ICD-JIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA1","description":"ICD-DFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHA0","description":"ICD-OBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES330","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIE0","description":"ICD-CBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDD1","description":"ICD-GIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47537","description":"Removal biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA0","description":"ICD-CHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ethchlorvynol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6050","description":"Ethchlorvynol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDF0","description":"ICD-GHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Morphine 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0093","description":"Morphine 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splint digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8450","description":"Splint digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIA0","description":"ICD-BIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBC1","description":"ICD-GBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC0","description":"ICD-KGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOC1","description":"ICD-GDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE0","description":"ICD-BHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYE1","description":"ICD-HBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurawrap nerve protector_cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9353","description":"Neurawrap nerve protector_cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA1","description":"ICD-JBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEF0","description":"ICD-JEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIID0","description":"ICD-OIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB1","description":"ICD-LGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD0","description":"ICD-NBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSB1","description":"ICD-KHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDC0","description":"ICD-BEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef incomplete/modular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4155","description":"Ef incomplete/modular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE0","description":"ICD-NIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB117","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD0","description":"ICD-IBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symes type medial opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5636","description":"Symes type medial opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20900","description":"Removal of bone for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88165","description":"Cytopath tbs c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1046T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1046T","description":"CPT-1046T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55831","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMC0","description":"ICD-MFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7683","description":"Triamcinolone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2B","description":"Ultra High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADB0","description":"ICD-AADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recement space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1550","description":"Recement space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE1","description":"ICD-KIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD1","description":"ICD-AGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPC0","description":"ICD-GDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post vert arthrplst 1 lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202T","description":"Post vert arthrplst 1 lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB0","description":"ICD-KDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNE0","description":"ICD-GGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA1","description":"ICD-NBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB0","description":"ICD-OHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA0","description":"ICD-ABTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53230","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89356","description":"Thawing cryopresrved oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC0","description":"ICD-BHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Windowing of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29730","description":"Windowing of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRE0","description":"ICD-OCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum dep 5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27339","description":"Exc thigh/knee tum dep 5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILB1","description":"ICD-GILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of cleft lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10251","description":"Anesth repair of cleft lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED0","description":"ICD-FCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCA0","description":"ICD-BBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50280","description":"Removal of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disp home glucose monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9275","description":"Disp home glucose monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn not first line amox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9314","description":"Norsn not first line amox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC1","description":"ICD-FETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE1","description":"ICD-KIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITD1","description":"ICD-GITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB03","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aoe comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9466","description":"Aoe comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB1","description":"ICD-JCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1160","description":"Wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC1","description":"ICD-BDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC06","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF0","description":"ICD-BCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUD1","description":"ICD-BBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1403","description":"HCPCS-A1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3470","description":"Hyaluronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33946","description":"Ecmo/ecls initiation venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC221","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX31","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9175","description":"HCPCS-C9175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABED0","description":"ICD-ABED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE104","description":"Special Care High _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial plast molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5560","description":"Prep ak ischial plast molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF0","description":"ICD-MFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28E","description":"Clinically Complex _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF0","description":"ICD-NDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB0","description":"ICD-MAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2004","description":"HCPCS-A2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGID1","description":"ICD-AGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLE0","description":"ICD-JCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1249","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3A","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGA0","description":"ICD-FGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD0","description":"ICD-IBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cymetra injectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4112","description":"Cymetra injectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone sinus implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1090","description":"Mometasone sinus implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND1","description":"ICD-GAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infliximab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80230","description":"Infliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traction stand free standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0850","description":"Traction stand free standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urology surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53899","description":"Urology surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJD0","description":"ICD-BHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray special views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71035","description":"Chest x-ray special views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0493U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","description":"CPT-0493U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB0","description":"ICD-PIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC1","description":"ICD-FBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial foot exam pt lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0245","description":"Initial foot exam pt lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I & d vaginal hematoma pp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57022","description":"I & d vaginal hematoma pp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17284","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA1","description":"ICD-IICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB50","description":"Very High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Feces culture aerobic bact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87045","description":"Feces culture aerobic bact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2100","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA0","description":"ICD-OLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5A","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC1","description":"ICD-OCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB0","description":"ICD-IDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC1","description":"ICD-OEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0676T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC1","description":"ICD-KCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoprostenol dilutant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0155","description":"Epoprostenol dilutant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF1","description":"ICD-JEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for hip x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27095","description":"Injection for hip x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29044","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUB1","description":"ICD-CIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF0","description":"ICD-NCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd aspirin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4563F","description":"Pt recvd aspirin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair narrowing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0969","description":"Wheelchair narrowing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRB1","description":"ICD-GDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound cleanser any type/size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6260","description":"Wound cleanser any type/size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD0","description":"ICD-CGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB0","description":"ICD-BIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD0","description":"ICD-FFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFA0","description":"ICD-KDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC1","description":"ICD-KETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQB0","description":"ICD-DHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c ab test confirm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86804","description":"Hep c ab test confirm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntiol category 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1005","description":"Ntiol category 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apligraf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4101","description":"Apligraf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA1","description":"ICD-FACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE0","description":"ICD-BAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC125","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61521","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE1","description":"ICD-PDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF1","description":"ICD-GEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rho d immune globulin 50 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2788","description":"Rho d immune globulin 50 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLF1","description":"ICD-AGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE1","description":"ICD-KHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE1","description":"ICD-KCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary stress test/simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94620","description":"Pulmonary stress test/simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE1","description":"ICD-FEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSA0","description":"ICD-PKSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA0","description":"ICD-KGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC21","description":"ICD-3GC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKF1","description":"ICD-NDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB21","description":"ICD-1IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0605U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","description":"CPT-0605U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26497","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA1","description":"ICD-GAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid imaging w/blood flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78014","description":"Thyroid imaging w/blood flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF1","description":"ICD-NHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC0","description":"ICD-MHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD0","description":"ICD-EFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEB0","description":"ICD-CAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHD1","description":"ICD-EGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHF0","description":"ICD-CHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serv part of phase i trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9988","description":"Serv part of phase i trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRB1","description":"ICD-LGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB26","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASA1","description":"ICD-PASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter for hysterography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58340","description":"Catheter for hysterography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALD1","description":"ICD-JALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJE1","description":"ICD-NHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF1","description":"ICD-KBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMF1","description":"ICD-CAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0404","description":"HCPCS-C0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE1","description":"ICD-BCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC0","description":"ICD-GCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF0","description":"ICD-KIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD1","description":"ICD-NEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2C","description":"High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE1","description":"ICD-NJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIB1","description":"ICD-FEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SkinTE_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4200","description":"SkinTE_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB0","description":"ICD-OJAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAF0","description":"ICD-NDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD1","description":"ICD-PBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thera&Couns Svcs (Counseling Svcs)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0093","description":"Thera&Couns Svcs (Counseling Svcs)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD1","description":"ICD-DFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA0","description":"ICD-LCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCC0","description":"ICD-EHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF0","description":"ICD-ICTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92613","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRD1","description":"ICD-DGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWD0","description":"ICD-PAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE0","description":"ICD-FIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCD1","description":"ICD-OKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flu vac pandem prsrv free im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90666","description":"Flu vac pandem prsrv free im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27703","description":"Reconstruction ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/insert implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65103","description":"Remove eye/insert implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9601","description":"Flortaucipir F 18 injection_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87495","description":"Cytomeg dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA1","description":"ICD-IIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0323U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ central nervous system pathogen_ metagenomic next-generation sequencing_ cerebrospinal fluid (CSF)_ identification of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMD0","description":"ICD-IHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIA0","description":"ICD-NLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45500","description":"Repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable underpads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4554","description":"Disposable underpads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurodesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32650","description":"Thoracoscopy w/pleurodesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg strap h style each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0039","description":"Leg strap h style each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVA1","description":"ICD-FIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech volume modulation system_ any type_ including all components and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E3000","description":"Speech volume modulation system_ any type_ including all components and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE0","description":"ICD-DIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD0","description":"ICD-NKJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2225","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore neck vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35800","description":"Explore neck vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA12","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (focinvez)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1434","description":"Injection_ fosaprepitant (focinvez)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFD0","description":"ICD-NJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC240","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin fungi culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87101","description":"Skin fungi culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27698","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC1","description":"ICD-NEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYA0","description":"ICD-GHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF1","description":"ICD-KAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/subs interv 15-30mn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0396","description":"Alcohol/subs interv 15-30mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62115","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA1","description":"ICD-PFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2865","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","description":"HCPCS-J2865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Yellow fever vaccine subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90717","description":"Yellow fever vaccine subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31610","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMC0","description":"ICD-AFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io rad tx deliver by elctrns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77425","description":"Io rad tx deliver by elctrns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA0","description":"ICD-FHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF0","description":"ICD-CGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB0","description":"ICD-FHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE1","description":"ICD-NAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB30","description":"Very High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone replce graft each add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4264","description":"Bone replce graft each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gait training therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97116","description":"Gait training therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on sm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4525","description":"Adult size pull-on sm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB0","description":"ICD-OHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colon motility 6 hr study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91117","description":"Colon motility 6 hr study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD213","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF0","description":"ICD-CGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB0","description":"ICD-IITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB0","description":"ICD-OENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eo elas w/metal jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3710","description":"Eo elas w/metal jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD1","description":"ICD-FFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9174","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9174","description":"HCPCS-C9174","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7561","description":"Debridement_ bone (includes epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed); first 20 sq cm or less with manual preparation and insertion of drug-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDE0","description":"ICD-OCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXB1","description":"ICD-JEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF0","description":"ICD-CHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE1","description":"ICD-MDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD0","description":"ICD-LHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAE0","description":"ICD-EAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOD0","description":"ICD-CDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42505","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for brain wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61458","description":"Incise skull for brain wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7529","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELE0","description":"ICD-OELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung perfusion differential","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78597","description":"Lung perfusion differential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF1","description":"ICD-JEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11641","description":"Exc f/e/e/n/l mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF0","description":"ICD-JINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCD1","description":"ICD-EDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82492","description":"Chromatography_ quantitative_ column (eg_ gas liquid or hplc); multiple analytes_ single stationary and mobile phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCA0","description":"ICD-EBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc rectal tumor endoscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184T","description":"Exc rectal tumor endoscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Written discharge instr prvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4014F","description":"Written discharge instr prvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF1","description":"ICD-FEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA1","description":"ICD-IETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb thx presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8696","description":"Antithromb thx presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA0","description":"ICD-OLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOD0","description":"ICD-LGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4410","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","description":"HCPCS-Q4410","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF0","description":"ICD-MIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feed supp pump per d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4035","description":"Enteral feed supp pump per d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGF0","description":"ICD-OBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D8671","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D8671","description":"CDT-D8671","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla ii typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81383","description":"Hla ii typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28H","description":"Clinically Complex _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perp bk ptb thermopls direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5520","description":"Perp bk ptb thermopls direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy uv-a or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96913","description":"Photochemotherapy uv-a or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA1","description":"ICD-NCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant drainage device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66183","description":"Insert ant drainage device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50694","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA1","description":"ICD-OHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Satisfy survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0917","description":"Satisfy survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c seat lift mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0985","description":"W/c seat lift mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC1","description":"ICD-GCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF0","description":"ICD-ICLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHA1","description":"ICD-KHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF0","description":"ICD-BIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKF1","description":"ICD-OLKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC0","description":"ICD-GIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54120","description":"Partial removal of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFF1","description":"ICD-BFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC0","description":"ICD-MAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD0","description":"ICD-PCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA1","description":"ICD-KGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor intestine/artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44721","description":"Prep donor intestine/artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ppsv23 vacc 2 yrs+ subq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90732","description":"Ppsv23 vacc 2 yrs+ subq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBF0","description":"ICD-CCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRC0","description":"ICD-LBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB216","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF0","description":"ICD-KINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVB0","description":"ICD-KAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diab manage trn per indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0108","description":"Diab manage trn per indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOF0","description":"ICD-KDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC1","description":"ICD-OASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBC0","description":"ICD-NJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electro hearng aid tst both","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92595","description":"Electro hearng aid tst both","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEE0","description":"ICD-JHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC1","description":"ICD-CDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF0","description":"ICD-PEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB0","description":"ICD-EHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-visit patient screening","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9912","description":"Pre-visit patient screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOA0","description":"ICD-PBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEE0","description":"ICD-NCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0746T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC0","description":"ICD-LHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA0","description":"ICD-KHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9856","description":"Patient was not admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE220","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCC0","description":"ICD-JDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE141","description":"Clinically Complex _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGC0","description":"ICD-JAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIE0","description":"ICD-NKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB0","description":"ICD-NDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC0","description":"ICD-MGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF0","description":"ICD-BBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGME0","description":"ICD-BGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA1","description":"ICD-OAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28A","description":"Special Care Low _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYF0","description":"ICD-KCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1114","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADB1","description":"ICD-MADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD0","description":"ICD-KFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA224","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer dome & mouthpiece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7016","description":"Nebulizer dome & mouthpiece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUE1","description":"ICD-KBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF0","description":"ICD-GFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor stent ather s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9602","description":"Perc d-e cor stent ather s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES230","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna vrl ld surfaces perm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2161","description":"Amalgam 4 or > surfaces perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum dep 1.5cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28041","description":"Exc foot/toe tum dep 1.5cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB0","description":"ICD-MBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSA1","description":"ICD-DCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWD0","description":"ICD-HDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF0","description":"ICD-IIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC0","description":"ICD-FAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTC1","description":"ICD-OGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF0","description":"ICD-NFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIB1","description":"ICD-OHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD0","description":"ICD-NJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22548","description":"Neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87497","description":"Cytomeg dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35452","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHME1","description":"ICD-OHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD1","description":"ICD-LBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38222","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo sing fre stirr thi/calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2000","description":"Kafo sing fre stirr thi/calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC1","description":"ICD-MLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD1","description":"ICD-NEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolong serv w/o contact add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99359","description":"Prolong serv w/o contact add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF1","description":"ICD-MFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid exam one ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92590","description":"Hearing aid exam one ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAID0","description":"ICD-AAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6780","description":"Crown 3/4 high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0327U","description":"Fetal aneuploidy (trisomy 13_ 18_ and 21)_ DNA sequence analysis of selected regions using maternal plasma_ algorithm reported as a risk score for each trisomy_ includes sex r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand-held pefr meter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4614","description":"Hand-held pefr meter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27601","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1213","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9067","description":"Gallium ga-68_ dotatoc_ diagnostic_ 0.01 mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC20","description":"High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC1","description":"ICD-MEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTD1","description":"ICD-ICTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No 30 day f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9404","description":"No 30 day f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF1","description":"ICD-CAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYF0","description":"ICD-GHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNB0","description":"ICD-OJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional neuromuscularstim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0764","description":"Functional neuromuscularstim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE0","description":"ICD-OGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC0","description":"ICD-IDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1359","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB0","description":"ICD-PHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF0","description":"ICD-KCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD1","description":"ICD-FBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA1","description":"ICD-OISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB0A","description":"Very High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8937","description":"Computer-aided detection_ including computer algorithm analysis of breast MRI image data for lesion detection/characterization_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp duct stent placement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43274","description":"Ercp duct stent placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBF1","description":"ICD-JIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463U","description":"Oncology (cervix)_ mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16_ 18_ 31_ 33_ 45_ 52_ 58)_ by real-time nu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC0","description":"ICD-OFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC0","description":"ICD-KGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0705","description":"Transfer device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE0","description":"ICD-FETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX03","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1333","description":"Acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB1","description":"ICD-CCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE1","description":"ICD-LDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE0","description":"ICD-NFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLD1","description":"ICD-MLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std mult pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0885","description":"Pwc gp4 std mult pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5C","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antinomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86602","description":"Antinomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUE0","description":"ICD-CEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock single ply upper l","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8485","description":"Pros sock single ply upper l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13B","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC0","description":"ICD-CDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46611","description":"Anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRE1","description":"ICD-HGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQA1","description":"ICD-CAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF0","description":"ICD-OALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKB1","description":"ICD-OIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE1","description":"ICD-KHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE1","description":"ICD-GIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVE1","description":"ICD-FEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOB1","description":"ICD-GGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc to have fall in asc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8910","description":"Pt doc to have fall in asc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9994","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME0","description":"ICD-AEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros info op rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9304","description":"Pros info op rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA1","description":"ICD-CGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUE0","description":"ICD-NAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBF1","description":"ICD-CFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC0","description":"ICD-CGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMA1","description":"ICD-JDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50561","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0650","description":"Injection_ levothyroxine sodium_ not otherwise specified_ 10 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA31","description":"ICD-3JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB1","description":"ICD-NIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA1","description":"ICD-FGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0716T","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE0","description":"ICD-KGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 25MCG/0.25ML IM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91311","description":"SARSCOV2 VAC 25MCG/0.25ML IM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNA1","description":"ICD-KHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pyrophosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9538","description":"Tc99m pyrophosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNE0","description":"ICD-BBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0355U","description":"APOL1 (apolipoprotein L1) (eg_ chronic kidney disease)_ risk variants (G1_ G2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med record copy per page","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9982","description":"Med record copy per page","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFA0","description":"ICD-GAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29131","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB1","description":"ICD-FBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUB0","description":"ICD-GGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0670U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0670U","description":"CPT-0670U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD1","description":"ICD-NEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUC0","description":"ICD-CCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQE1","description":"ICD-CAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJE1","description":"ICD-OLJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJB1","description":"ICD-CFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ using oral fluid_ reported as a comparison to an estimated steady-state range_ per date of service inclu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMA1","description":"ICD-NCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE0","description":"ICD-LGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune rheumatoid arthr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81490","description":"Autoimmune rheumatoid arthr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA146","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB0","description":"ICD-LBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE0","description":"ICD-NDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Max MRI image capture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0385","description":"Max MRI image capture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Couns potent glauc impct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4174F","description":"Couns potent glauc impct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA0","description":"ICD-FBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2103","description":"Non-adjunctive_ non-implanted continuous glucose monitor or receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped complete intact nut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4158","description":"Ef ped complete intact nut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery w/tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33505","description":"Repair artery w/tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD0","description":"ICD-JFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE0","description":"ICD-OLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD241","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36216","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB0","description":"ICD-CAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAB1","description":"ICD-AIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach care kit for new trach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4625","description":"Trach care kit for new trach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHC1","description":"ICD-CGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31276","description":"Nasal/sinus endoscopy_ surgical_ with frontal sinus exploration_ including removal of tissue from frontal sinus_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0629U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","description":"CPT-0629U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quick disconn hook adapter o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6628","description":"Quick disconn hook adapter o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQF1","description":"ICD-GBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB0","description":"ICD-OCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0129U","description":"Anesthesia for intracranial procedures; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bls-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0429","description":"Bls-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFA1","description":"ICD-NBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF0","description":"ICD-MBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0723T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained without diagnostic magnetic r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF1","description":"ICD-FEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4228","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4228","description":"HCPCS-A4228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0127U","description":"Anesthesia for procedures on facial bones or skull; radical surgery (includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nivolumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9299","description":"Injection_ nivolumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLF0","description":"ICD-ACLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical opening of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42955","description":"Surgical opening of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35563","description":"Art byp grft ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWC1","description":"ICD-OHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61651","description":"Evasc prlng admn rx agnt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB1","description":"ICD-OJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSA1","description":"ICD-LGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUB1","description":"ICD-CEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ed svc ckd grp per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0421","description":"Ed svc ckd grp per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD1","description":"ICD-LGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF1","description":"ICD-PFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bypass graft/av fist patency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35686","description":"Bypass graft/av fist patency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80339","description":"Antiepileptics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE1","description":"ICD-KFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLD0","description":"ICD-MGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE1","description":"ICD-CHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ibandronate sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1740","description":"Ibandronate sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOF1","description":"ICD-DFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGE1","description":"ICD-FAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA0","description":"ICD-OEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46735","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB0","description":"ICD-LBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD146","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE0","description":"ICD-PLOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC0","description":"ICD-NKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWA1","description":"ICD-LFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC0","description":"ICD-CDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36120","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 74-100 gm pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4197","description":"Parenteral sol 74-100 gm pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPE1","description":"ICD-KAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 12-17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99394","description":"Prev visit est age 12-17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEA0","description":"ICD-MLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD0","description":"ICD-GAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTD0","description":"ICD-GCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9728","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44372","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-non-el","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0629","description":"Seat lift for pt furn-non-el","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB1","description":"ICD-BEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKF0","description":"ICD-CCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF0","description":"ICD-NHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6060","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC0","description":"ICD-ECCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8B","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE125","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43754","description":"Dx gastr intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF1","description":"ICD-BAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5099","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","description":"HCPCS-Q5099","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAED1","description":"ICD-NAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHD1","description":"ICD-EAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD1","description":"ICD-LCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADB1","description":"ICD-NADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMC1","description":"ICD-ICMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF1","description":"ICD-OKJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC1","description":"ICD-BICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral busulfan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8510","description":"Oral busulfan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ intravas ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1753","description":"Cath_ intravas ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE1","description":"ICD-NLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suprv interfacilty transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99485","description":"Suprv interfacilty transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB0","description":"ICD-ICTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIB0","description":"ICD-JBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIC1","description":"ICD-FDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE0","description":"ICD-MEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB1","description":"ICD-CHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stnd wt pwr whlchr w control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0011","description":"Stnd wt pwr whlchr w control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE1","description":"ICD-CBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEE0","description":"ICD-IBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPB0","description":"ICD-BDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME0","description":"ICD-JEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65760","description":"Revision of cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABC1","description":"ICD-JABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD1","description":"ICD-HHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTC1","description":"ICD-EHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA0","description":"ICD-DIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD0","description":"ICD-CETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHE1","description":"ICD-CFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE0","description":"ICD-CDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of abdominal wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49900","description":"Repair of abdominal wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE1","description":"ICD-OFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76390","description":"Mr spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0462T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with pregnancy during adjuvant treatment course","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2205","description":"Patients with pregnancy during adjuvant treatment course","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37244","description":"Vasc embolize/occlude bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTF0","description":"ICD-IBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10060","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD1","description":"ICD-PEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kerecis omega3 marigen shield_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2019","description":"Kerecis omega3 marigen shield_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX15","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD1","description":"ICD-PGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC1","description":"ICD-JHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compl gift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4013","description":"Compl gift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECE0","description":"ICD-JECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0151A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAME1","description":"ICD-GAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0984T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","description":"CPT-0984T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTB1","description":"ICD-MHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB1","description":"ICD-KCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE1","description":"ICD-OFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYB1","description":"ICD-HAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC1","description":"ICD-JGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF1","description":"ICD-BHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF1","description":"ICD-JABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4010","description":"Cast sup sht arm adult fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE1","description":"ICD-ODNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ot re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97004","description":"Ot re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDD0","description":"ICD-EGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp guide wire dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43196","description":"Esophagoscp guide wire dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGME1","description":"ICD-NGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA0","description":"ICD-NGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frame typ socket shoulder di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6689","description":"Frame typ socket shoulder di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE1","description":"ICD-AHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSC0","description":"ICD-PBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27665","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF0","description":"ICD-BDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6529","description":"Gradient compression garment_ bra_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB11","description":"ICD-2EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB1","description":"ICD-FGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA11","description":"ICD-3FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3372F","description":"AJCC Breast Cancer Stage I: T1mic_ T1a or T1b (tumor size <= 1 cm) documented (ONC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA114","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special supplies phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99070","description":"Special supplies phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBD0","description":"ICD-AHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB1","description":"ICD-MHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD1","description":"ICD-HDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF0","description":"ICD-OBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2390","description":"Solid drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA0","description":"ICD-GCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID0","description":"ICD-CEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB12D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repeat control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30906","description":"Repeat control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrodiag polyneuro 6 mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3751F","description":"Electrodiag polyneuro 6 mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC1","description":"ICD-BAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Perfusion Echo Ischm/Viability Assmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0439T","description":"Myocardial Perfusion Echo Ischm/Viability Assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD1","description":"ICD-OBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD1","description":"ICD-JCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRB1","description":"ICD-PFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYF1","description":"ICD-PFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m mebrofenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9537","description":"Tc99m mebrofenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJA1","description":"ICD-FBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF1","description":"ICD-BCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA1","description":"ICD-GCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD121","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22B","description":"Clinically Complex _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1169","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g._ prior anaphylaxis due to the influenza vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUA1","description":"ICD-JIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abscess drainage under x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75989","description":"Abscess drainage under x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5A","description":"Default_ /PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA0","description":"ICD-CFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCF1","description":"ICD-BBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF1","description":"ICD-KGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto/uretero stricture tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52344","description":"Cysto/uretero stricture tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF0","description":"ICD-ODBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dxa no results doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8400","description":"Pt w/dxa no results doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9272","description":"Injection_ dostarlimab-gxly_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE0","description":"ICD-HDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMF1","description":"ICD-KHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYF0","description":"ICD-ODYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA1","description":"ICD-OJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC0","description":"ICD-BAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC21","description":"ICD-3EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDF0","description":"ICD-MBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD0","description":"ICD-GDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","description":"HCPCS-Q0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX42","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB1","description":"ICD-KDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope procedure liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47379","description":"Laparoscope procedure liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27880","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not disch home by day #2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8838","description":"Not disch home by day #2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelet antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86022","description":"Platelet antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF1","description":"ICD-HFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC0","description":"ICD-GBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBF1","description":"ICD-OCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00520","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","description":"CPT-00520","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBA0","description":"ICD-CGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC0","description":"ICD-MJLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lwr ext dynamic prosth pylon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5985","description":"Lwr ext dynamic prosth pylon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQC1","description":"ICD-GHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Over-bed table","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0274","description":"Over-bed table","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28360","description":"Reconstruct cleft foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCE1","description":"ICD-KBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB0","description":"ICD-AHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aud brainstem implt programg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92640","description":"Aud brainstem implt programg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow inter loc elbow forarm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6250","description":"Elbow inter loc elbow forarm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comm psy sup tx pgm per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0037","description":"Comm psy sup tx pgm per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD1","description":"ICD-GDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC1","description":"ICD-CCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND0","description":"ICD-CHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDF1","description":"ICD-MGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCE1","description":"ICD-IDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE1","description":"ICD-ABLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB1","description":"ICD-FAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous islet celltrans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0341","description":"Percutaneous islet celltrans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA0","description":"ICD-AETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert electrodes for eeg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95830","description":"Insert electrodes for eeg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF0","description":"ICD-NDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","description":"HCPCS-E1804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay phosphatidylglycerol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84081","description":"Assay phosphatidylglycerol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVE0","description":"ICD-KCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE145","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF0","description":"ICD-EBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w/doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93306","description":"Tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fetal fibronectin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82731","description":"Assay of fetal fibronectin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo tibial fracture rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2116","description":"Afo tibial fracture rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50135","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA1","description":"ICD-IAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF0","description":"ICD-FGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric suction pump hme mdl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2000","description":"Gastric suction pump hme mdl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65280","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28445","description":"Treat ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC1","description":"ICD-KIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27860","description":"Fixation of ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2089","description":"Most Recent Hemoglobin A1C (Hba1C) Level 7.0 To 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB236","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert vad artery access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33990","description":"Insert vad artery access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","description":"HCPCS-J3291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE1","description":"ICD-JEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb not doc rns not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8974","description":"Hgb not doc rns not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXC0","description":"ICD-GCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis training incompl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90993","description":"Dialysis training incompl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF1","description":"ICD-BEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5720","description":"Dentures rebase part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA0","description":"ICD-JIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult daycare services 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5100","description":"Adult daycare services 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE1","description":"ICD-PGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309U","description":"Cardiology (cardiovascular disease)_ analysis of 4 proteins (NT-proBNP_ osteopontin_ tissue inhibitor of metalloproteinase-1 [TIMP-1]_ and kidney injury molecule-1 [KIM-1])_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42600","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMA1","description":"ICD-KGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB1","description":"ICD-BFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Butorphanol tartrate_ nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0012","description":"Butorphanol tartrate_ nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGF1","description":"ICD-OJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA1","description":"ICD-EFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE0","description":"ICD-ICCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Humidif extens supple w ippb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0550","description":"Humidif extens supple w ippb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWB1","description":"ICD-GGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA1","description":"ICD-PDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC1","description":"ICD-OEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD0","description":"ICD-OGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41828","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHD0","description":"ICD-AHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen imp urinary 2.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8603","description":"Collagen imp urinary 2.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB0","description":"ICD-OIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29885","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VAC 3 MCG TRS-SUCR","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91308","description":"SARSCOV2 VAC 3 MCG TRS-SUCR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plerixafor injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2562","description":"Plerixafor injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHB0","description":"ICD-AGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42415","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18E","description":"Clinically Complex _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20A","description":"Clinically Complex _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81286","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tbo-filgrastim_ 5 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1446","description":"Injection_ tbo-filgrastim_ 5 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC1","description":"ICD-FFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1373","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","description":"HCPCS-M1373","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3B","description":"Default_ /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLE1","description":"ICD-NJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27602","description":"Decompression of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXE1","description":"ICD-BIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUF0","description":"ICD-NBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEA0","description":"ICD-EBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1091T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1091T","description":"CPT-1091T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYB0","description":"ICD-KFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guardant360 CDX_ Guardant Health Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0242U","description":"Guardant360 CDX_ Guardant Health Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE22B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB0","description":"ICD-AAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA36","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4B","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2132","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Period O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNA0","description":"ICD-NDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYD0","description":"ICD-LDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB0","description":"ICD-GCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE251","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE0","description":"ICD-EHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9046","description":"Injection_ bortezomib_ (dr. reddy_s)_ not therapeutically equivalent to j9041_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF1","description":"ICD-KHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25650","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGND0","description":"ICD-FGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe lifts tapered to one-ha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3332","description":"Shoe lifts tapered to one-ha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX41","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BA21","description":"ICD-3BA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90720","description":"Diphtheria_ tetanus toxoids_ and whole cell pertussis vaccine and hemophilus influenza b vaccine (dtp-hib)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF0","description":"ICD-JIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC0","description":"ICD-GFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81213","description":"BRCA1_ BRCA2 (breast cancer 1 and 2) (eg_ hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1417","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","description":"HCPCS-M1417","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA11","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beclomethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7622","description":"Beclomethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1802","description":"HCPCS-B1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE1","description":"ICD-JEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE1","description":"ICD-BEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACE1","description":"ICD-EACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Single pivot hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6605","description":"Single pivot hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27475","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer care checklist used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0583F","description":"Transfer care checklist used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE1","description":"ICD-HHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA0","description":"ICD-GEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace trilateral socket br","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4010","description":"Replace trilateral socket br","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXB1","description":"ICD-FBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61737","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Multiple Trajectories For","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA11","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB53","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAB0","description":"ICD-EAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA0","description":"ICD-KCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99381","description":"Init pm e/m new pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB1","description":"ICD-GBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61543","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJA0","description":"ICD-CAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj perflutren lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9957","description":"Inj perflutren lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dry pressure pad for mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0199","description":"Dry pressure pad for mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA130","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29820","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILC1","description":"ICD-JILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER QUAN IMAGING","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207U","description":"NEURO ALZHEIMER QUAN IMAGING","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIE1","description":"ICD-GFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF0","description":"ICD-NJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC0","description":"ICD-HBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75580","description":"Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC0","description":"ICD-KHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w/o barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5072","description":"Urinary pouch w/o barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo_ colon_ retro imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1749","description":"Endo_ colon_ retro imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCD1","description":"ICD-FFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0693T","description":"Comprehensive Full Body Computer-Based Markerless 3D Kinematic And Kinetic Motion Analysis And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nos vitamin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84591","description":"Assay of nos vitamin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noncovered ambulance mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0888","description":"Noncovered ambulance mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0103","description":"HCPCS-C0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIB0","description":"ICD-JEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA0","description":"ICD-FCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin-oxygen affinity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82820","description":"Hemoglobin-oxygen affinity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEA0","description":"ICD-IFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE1","description":"ICD-DAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF1","description":"ICD-OBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76019","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","description":"CPT-76019","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB0","description":"ICD-AGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23616","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC1","description":"ICD-CCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic custom molded shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5501","description":"Diabetic custom molded shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7538","description":"Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for left ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert ureteral support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50605","description":"Insert ureteral support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMD0","description":"ICD-OCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone sodium succinate_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2919","description":"Injection_ methylprednisolone sodium succinate_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77048","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA1","description":"ICD-KDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF1","description":"ICD-NBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ileostomy/jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44310","description":"Ileostomy/jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40451","description":"Anesth surgery of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDB1","description":"ICD-CGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAA1","description":"ICD-NJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE0","description":"ICD-ABCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD0","description":"ICD-GEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA56","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD1","description":"ICD-ABTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCID0","description":"ICD-FCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7402","description":"Mometasone furoate sinus implant_ (sinuva)_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma scrn hgh risk direc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0117","description":"Glaucoma scrn hgh risk direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD0","description":"ICD-CEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEB0","description":"ICD-EBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUA1","description":"ICD-FFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA1","description":"ICD-NBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair fem hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49557","description":"Rerepair fem hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of manganese","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83785","description":"Assay of manganese","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDED0","description":"ICD-EDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA1","description":"ICD-NDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC1","description":"ICD-OFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - soft appliance_ full arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9945","description":"Occlusal guard - soft appliance_ full arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2930","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD1","description":"ICD-AIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA0","description":"ICD-NEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFF1","description":"ICD-NBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKB1","description":"ICD-NKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tcd emboli detect w/inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93893","description":"Tcd emboli detect w/inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guide cathet fluid drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10030","description":"Guide cathet fluid drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC0","description":"ICD-KBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enclosed ped crib hosp grade","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0300","description":"Enclosed ped crib hosp grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC0","description":"ICD-IGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE1","description":"ICD-EEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHE0","description":"ICD-MKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFF1","description":"ICD-JCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye mvmt alys w/o calbrj i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0615T","description":"Eye mvmt alys w/o calbrj i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVC1","description":"ICD-NJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOC0","description":"ICD-ODOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0102","description":"CDT-D0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE1","description":"ICD-OGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA106","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 2 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92316","description":"Rx cntact lens aphakia 2 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE0","description":"ICD-FDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXF0","description":"ICD-BAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE1","description":"ICD-AGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer skin pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15650","description":"Transfer skin pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial mastectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19301","description":"Partial mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE1","description":"ICD-CHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX11","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB0","description":"ICD-JBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTF0","description":"ICD-ACTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58925","description":"Removal of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACD0","description":"ICD-KACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4027","description":"Cast sup hip spica ped plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA230","description":"Clinically Complex _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSF0","description":"ICD-KCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 1-4 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99382","description":"Init pm e/m new pat 1-4 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1742","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1742","description":"HCPCS-C1742","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD0","description":"ICD-BCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF0","description":"ICD-KDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC05","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nerve/shorten bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64876","description":"Repair nerve/shorten bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinusitis comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9464","description":"Sinusitis comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA0","description":"ICD-IBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD0","description":"ICD-BEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76706","description":"Ultrasound_ abdominal aorta_ real time with image documentation_ screening study for abdominal aortic aneurysm (AAA)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC1","description":"ICD-OJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2063","description":"Qualified Nonphysician Qualified Healthcare Professional Assessment Service_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 21 Or More Mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB0","description":"ICD-GEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXD0","description":"ICD-GEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNA1","description":"ICD-NGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF0","description":"ICD-NAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443T","description":"R-T Spctrl Alys Prst8 Tiss Fluorescenc Spctrscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA0","description":"ICD-JEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68440","description":"Incise tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECB0","description":"ICD-NECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB1","description":"ICD-CHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC1","description":"ICD-JCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90637","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 30 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKA0","description":"ICD-BAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB0","description":"ICD-OGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete aa_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4303","description":"Complete aa_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC45","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic anrysm5.5-5.9cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9003F","description":"Aortic anrysm5.5-5.9cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91312","description":"SARSCOV2 VACCINE BIVALENT 30 MCG/0.3 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC1","description":"ICD-MJBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCA1","description":"ICD-KCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB0","description":"ICD-EABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB0","description":"ICD-DHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPF1","description":"ICD-FBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBA0","description":"ICD-FGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37180","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUB1","description":"ICD-OCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11760","description":"Repair of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCC1","description":"ICD-ECCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD1","description":"ICD-JFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool tub_ walk-in_ portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1301","description":"Whirlpool tub_ walk-in_ portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq tcat intratrl septl sht","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0613T","description":"Perq tcat intratrl septl sht","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC1","description":"ICD-JDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj iv push","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96374","description":"Ther/proph/diag inj iv push","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA0","description":"ICD-GEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEC0","description":"ICD-IBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF1","description":"ICD-DCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture bacterial urine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P7001","description":"Culture bacterial urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee disarticulat leather so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5640","description":"Knee disarticulat leather so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD1","description":"ICD-OHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air & bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0209T","description":"Audiometry air & bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTD0","description":"ICD-FCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plastic pediatric size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2035","description":"Kafo plastic pediatric size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC1","description":"ICD-JIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHC1","description":"ICD-BAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC0","description":"ICD-LBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA1","description":"ICD-PCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26352","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fimbrioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58760","description":"Fimbrioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWC1","description":"ICD-HBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB1","description":"ICD-FFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF1","description":"ICD-AFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1247","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiviral ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9245","description":"Antiviral ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD1","description":"ICD-OCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNB0","description":"ICD-BCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF1","description":"ICD-OKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCD1","description":"ICD-CDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump opt inst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0478","description":"Drug test presump opt inst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nonunion carpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25431","description":"Repair nonunion carpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam feces for meat fibers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89160","description":"Exam feces for meat fibers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAC1","description":"ICD-BEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35151","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cid ext controller repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8628","description":"Cid ext controller repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKA1","description":"ICD-GFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDA1","description":"ICD-ADDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell >=15% (hiv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3498F","description":"Cd4+ cell >=15% (hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUA0","description":"ICD-JEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation physics consult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77370","description":"Radiation physics consult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBA0","description":"ICD-AGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF0","description":"ICD-BAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tub stool or bench","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0245","description":"Tub stool or bench","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETC0","description":"ICD-EETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGA0","description":"ICD-OIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC54","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLA0","description":"ICD-IDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Overdenture partial max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5864","description":"Overdenture partial max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37254","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","description":"CPT-37254","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKC1","description":"ICD-FHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA0","description":"ICD-OIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA0","description":"ICD-GGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA1","description":"ICD-ECTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA0","description":"ICD-BIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE0","description":"ICD-NDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alveolus open reduction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7671","description":"Alveolus open reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA0","description":"ICD-KCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attendant Care Services_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1793","description":"Attendant Care Services_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHE0","description":"ICD-OFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF1","description":"ICD-KIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB1","description":"ICD-GFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD0","description":"ICD-FEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A5102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","description":"HCPCS-A5102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB0","description":"ICD-OAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC1","description":"ICD-DCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal smear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65430","description":"Corneal smear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC51","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48102","description":"Needle biopsy pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBD1","description":"ICD-OGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6063","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMA0","description":"ICD-KAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of rbc galactokinase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82759","description":"Assay of rbc galactokinase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD0","description":"ICD-KAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB1","description":"ICD-GBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69725","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA1","description":"ICD-JHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11C","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59135","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVF0","description":"ICD-OGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2300","description":"Arthroscopy_ shoulder_ surgi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal maint procedures","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4910","description":"Periodontal maint procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01996","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","description":"CPT-01996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID0","description":"ICD-KDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIC0","description":"ICD-NAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVC0","description":"ICD-KCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinal male jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0325","description":"Urinal male jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tcran magn stim redetemine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90869","description":"Tcran magn stim redetemine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC1","description":"ICD-CEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXD0","description":"ICD-GIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD1","description":"ICD-NAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA1","description":"ICD-DDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0262T","description":"Implantation of catheter-delivered prosthetic pulmonary valve_ endovascular approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0502U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","description":"CPT-0502U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special teletx port plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77321","description":"Special teletx port plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSE1","description":"ICD-DDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rolapitant_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2797","description":"Injection_ rolapitant_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlorothiazide sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1205","description":"Chlorothiazide sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB236","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF0","description":"ICD-CBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUA1","description":"ICD-MAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23450","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED1","description":"ICD-EBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interro eval cardiac modulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0418T","description":"Interro eval cardiac modulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAA1","description":"ICD-FDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD1","description":"ICD-OGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMA1","description":"ICD-KDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visit to determ ldct elig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0296","description":"Visit to determ ldct elig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD1","description":"ICD-MGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC215","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD1","description":"ICD-PDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0561T","description":"Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bed pan fracture","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0276","description":"Bed pan fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILF1","description":"ICD-IILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 hd mult pow s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0886","description":"Pwc gp4 hd mult pow s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF1","description":"ICD-BFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB1","description":"ICD-NBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33959","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF0","description":"ICD-EALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD13B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD0","description":"ICD-ICDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig footwear evaluatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8416","description":"Pt inelig footwear evaluatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMA0","description":"ICD-FBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWA1","description":"ICD-PIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC0","description":"ICD-GFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB21","description":"High Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF0","description":"ICD-PDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heat lamp without stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0200","description":"Heat lamp without stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVC0","description":"ICD-NIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADED0","description":"ICD-ADED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJD0","description":"ICD-CHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66700","description":"Destruction ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Tedizolid Phosphate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9446","description":"Injection_ Tedizolid Phosphate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2188","description":"Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Curette/treat cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65436","description":"Curette/treat cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF1","description":"ICD-GANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB1","description":"ICD-FAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC0","description":"ICD-FHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0560","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","description":"HCPCS-G0560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6233","description":"Hydrogel dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rabies ig heat treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90376","description":"Rabies ig heat treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB1","description":"ICD-CBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE1","description":"ICD-PDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF0","description":"ICD-NIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine pch w ex wear bar conv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4393","description":"Urine pch w ex wear bar conv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sargramostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2820","description":"Sargramostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXC0","description":"ICD-NJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth testis suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93051","description":"Anesth testis suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGD0","description":"ICD-KIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA155","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC0","description":"ICD-OJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWE1","description":"ICD-LIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC104","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQF0","description":"ICD-OBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC0","description":"ICD-GDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd shck absrbr for hd man wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1017","description":"Hd shck absrbr for hd man wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC0","description":"ICD-BGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLB0","description":"ICD-MLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB1","description":"ICD-MDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0291","description":"Hosp bed fx ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRE1","description":"ICD-OGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA1","description":"ICD-GAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73130","description":"X-ray exam of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26705","description":"Treat knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27538","description":"Treat knee fracture(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0900T","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF)_ derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB1","description":"ICD-FGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mdd in remission","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3092F","description":"Mdd in remission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28455","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Central dexa results docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3095F","description":"Central dexa results docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRA0","description":"ICD-KFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUD0","description":"ICD-AAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0682T","description":"Removal Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC1","description":"ICD-NCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLB0","description":"ICD-OLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMD0","description":"ICD-FHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37264","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","description":"CPT-37264","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in lt/non-skilled nf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5003","description":"Hospice in lt/non-skilled nf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOF0","description":"ICD-GFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87116","description":"Mycobacteria culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSE1","description":"ICD-CGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excursion amplifier lever ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6642","description":"Excursion amplifier lever ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB0","description":"ICD-HCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB0","description":"ICD-ICHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment Career Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1732","description":"Employment Career Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF0","description":"ICD-AEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Packing strips_ non-impreg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6407","description":"Packing strips_ non-impreg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD1","description":"ICD-OIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Larynscop remve cart + scop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31561","description":"Larynscop remve cart + scop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flu imm no admin doc rea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8483","description":"Flu imm no admin doc rea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB1","description":"ICD-BHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9767","description":"Revascularization_ endovascular_ open or percutaneous_ any vessel(s); with intravascular lithotripsy and transluminal s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB1","description":"ICD-NJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE1","description":"ICD-HIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0923T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","description":"CPT-0923T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB1","description":"ICD-EADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFC0","description":"ICD-NBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE236","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Progressive lens per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2781","description":"Progressive lens per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA0","description":"ICD-OBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPD0","description":"ICD-NGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD0","description":"ICD-CBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost s/d ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7402","description":"Add ue prost s/d ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE1","description":"ICD-NHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25101","description":"Explore/treat wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDF1","description":"ICD-GIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJF1","description":"ICD-CBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9039","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF1","description":"ICD-EBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal sinus therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30210","description":"Nasal sinus therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA111","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise penis/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54328","description":"Revise penis/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1202","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1202","description":"HCPCS-C1202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6461","description":"Synthetic resorbable wound dressing_ sterile_ pad size more than 16 sq in but less than or equal to 48 sq in_ without adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair iris & ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66680","description":"Repair iris & ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD0","description":"ICD-KBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5820","description":"Denture interm part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA26","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACA0","description":"ICD-GACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC0","description":"ICD-OHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth collar bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45451","description":"Anesth collar bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28055","description":"Neurectomy foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF0","description":"ICD-CEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx orbit w/manipulj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21401","description":"Closed tx orbit w/manipulj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC0","description":"ICD-GESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1004","description":"Clinical Decision Support Mechanism National Decision Support Company_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of somatostatin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84307","description":"Assay of somatostatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_ autosys_ rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0148","description":"Scr c/v cyto_ autosys_ rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC0","description":"ICD-LCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power wheelchair noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0898","description":"Power wheelchair noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC1","description":"ICD-AGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bed accessory brd/tbl/supprt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0315","description":"Bed accessory brd/tbl/supprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD101","description":"Special Care Low _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quinupristin/dalfopristin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2770","description":"Quinupristin/dalfopristin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2139","description":"Back Pain Measured By The Visual Analog Scale (Vas) Pain At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Back Pain Measured By The Visual Analog Scale (V","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topical prep rx aoe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4130F","description":"Topical prep rx aoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81459","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_ copy number variants_ microsatellite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49656","description":"Lap inc hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD1","description":"ICD-KDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAE1","description":"ICD-MCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orthosis trilat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1720","description":"Legg perthes orthosis trilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-86581","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","description":"CPT-86581","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD1","description":"ICD-HIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGD1","description":"ICD-JCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1038","description":"Patients with a diagnosis of lumbar spine region fracture at the time of the procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX11","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Centrifuge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1500","description":"Centrifuge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB0","description":"ICD-JGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HER2-targeted therapies administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9828","description":"HER2-targeted therapies administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHC0","description":"ICD-KAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSC0","description":"ICD-KGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXE0","description":"ICD-OHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC241","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL50","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibiot rxd/given","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4120F","description":"Antibiot rxd/given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA106","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma volume single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78110","description":"Plasma volume single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA1","description":"ICD-FEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB0","description":"ICD-OFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Static or dynami afo pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4397","description":"Static or dynami afo pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJF0","description":"ICD-FAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEB1","description":"ICD-BAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methyldopate hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0210","description":"Methyldopate hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58700","description":"Removal of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef blenderized foods","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4149","description":"Ef blenderized foods","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0651U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0651U","description":"CPT-0651U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54135","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUC0","description":"ICD-FBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA1","description":"ICD-ODHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24201","description":"Removal of arm foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMF0","description":"ICD-AHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvesting of donor multivis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2055","description":"Harvesting of donor multivis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration popliteal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35741","description":"Exploration popliteal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1013","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD1","description":"ICD-OGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA1","description":"ICD-GBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE160","description":"Reduced Physical Function _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIC0","description":"ICD-EGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27472","description":"Repair/graft of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE1","description":"ICD-OEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25C","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl cardiac modulj pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412T","description":"Rmvl cardiac modulj pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61641","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHND1","description":"ICD-JHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJB1","description":"ICD-NCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remov/replc ur sphinctr comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53448","description":"Remov/replc ur sphinctr comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply spine prosth device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22851","description":"Apply spine prosth device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52310","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peritoneal dialysis clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1634","description":"Peritoneal dialysis clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB1","description":"ICD-BFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDC1","description":"ICD-BIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC1","description":"ICD-OIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7515","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9295","description":"Injection_ necitumumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1271","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","description":"HCPCS-J1271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB0","description":"ICD-JIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE0","description":"ICD-KFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ viltolarsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9071","description":"Injection_ viltolarsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0788","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0788","description":"HCPCS-E0788","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin polyc mch sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5816","description":"Endo knee-shin polyc mch sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0803","description":"HCPCS-C0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB1","description":"ICD-JCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9176","description":"HCPCS-C9176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB1","description":"ICD-GBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC1","description":"ICD-OBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compl zift case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4014","description":"Compl zift case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy & revise urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52275","description":"Cystoscopy & revise urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dextroamphetamine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0160","description":"Dextroamphetamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND0","description":"ICD-FIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF0","description":"ICD-OAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx dprsd malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21360","description":"Opn tx dprsd malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID0","description":"ICD-MKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tendon & muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23405","description":"Incision of tendon & muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9796","description":"Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g._ porcine small intestine submocosa[SIS])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nb resuscitation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99465","description":"Nb resuscitation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC1","description":"ICD-KBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJC0","description":"ICD-CBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta phys/qhp ea 30d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0606T","description":"Rem oct rta phys/qhp ea 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCF0","description":"ICD-CCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15936","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE0","description":"ICD-ICEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHB1","description":"ICD-IGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23473","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND0","description":"ICD-KIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB0","description":"ICD-IHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Job Finding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1735","description":"Employment - Job Finding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 4mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0464","description":"Tlso 4mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE120","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5109","description":"Injection_ infliximab-qbtx_ biosimilar_ (Ixifi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth inpt pharm mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0459","description":"Telehealth inpt pharm mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUA1","description":"ICD-NIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo pos solid ank plastic mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1960","description":"Afo pos solid ank plastic mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81333","description":"TGFBI (transforming growth factor beta-induced) (eg_ corneal dystrophy) gene analysis_ common variants (eg_ R124H_ R124C_ R124L_ R555W_ R555Q)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD0","description":"ICD-FBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1pc ost pch drain hgh output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4435","description":"1pc ost pch drain hgh output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE0","description":"ICD-GEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSB1","description":"ICD-PJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Large disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4541","description":"Large disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA1","description":"ICD-AAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy w/us needle bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43232","description":"Esophagoscopy w/us needle bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0A","description":"Default_ /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC1","description":"ICD-ECBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAB1","description":"ICD-OHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMF1","description":"ICD-MFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9485","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88005","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collect & appl blood product","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7921","description":"Collect & appl blood product","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sugars single qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84376","description":"Sugars single qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFE1","description":"ICD-GIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJF0","description":"ICD-OKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKA1","description":"ICD-FDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex for speech device rx 1hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92607","description":"Ex for speech device rx 1hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEB1","description":"ICD-GBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE0","description":"ICD-MFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA1","description":"ICD-AIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg >16<=48 w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6235","description":"Hydrocolld drg >16<=48 w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC230","description":"Reduced Physical Function _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE1","description":"ICD-DAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58562","description":"Hysteroscopy remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB02","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWA0","description":"ICD-CGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLA0","description":"ICD-NJLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB1","description":"ICD-CDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC20","description":"Ultra High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA02","description":"High Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ genital region_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6570","description":"Gradient compression garment_ genital region_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE1","description":"ICD-ABUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF0","description":"ICD-IFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423U","description":"Psychiatry (eg_ depression_ anxiety)_ genomic analysis panel_ including variant analysis of 26 genes_ buccal swab_ report including metabolizer status and risk of drug toxicit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34833","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by abdominal or retroperitoneal inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOB1","description":"ICD-OLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAE0","description":"ICD-MJAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD1","description":"ICD-KILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEA0","description":"ICD-OLEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0810T","description":"Subretinal injection of a pharmacologic agent_ including vitrectomy and 1 or more retinotomies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93264","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days_ including at least weekly downloads of pulmonary artery pressure recordings_ interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSC0","description":"ICD-CGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMA0","description":"ICD-OEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIE1","description":"ICD-BCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDE1","description":"ICD-BHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex type 1 test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86695","description":"Herpes simplex type 1 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58575","description":"Laparoscopy_ surgical_ total hysterectomy for resection of malignancy (tumor debulking)_ with omentectomy including salpingo-oophorectomy_ unilateral or bilateral_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Angioscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35400","description":"Angioscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSB0","description":"ICD-PCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC1","description":"ICD-NJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD1","description":"ICD-KELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDC1","description":"ICD-AHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLF1","description":"ICD-NFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUE0","description":"ICD-IDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82330","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo intralesional up to 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96405","description":"Chemo intralesional up to 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWA1","description":"ICD-CAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE1","description":"ICD-NGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0C","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD0","description":"ICD-OJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11643","description":"Exc f/e/e/n/l mal+mrg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA1","description":"ICD-FFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4226","description":"Supplies For Maintenance Of Insulin Infusion Pump With Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing_ Per Week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung perfusion imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78580","description":"Lung perfusion imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD1","description":"ICD-OETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE1","description":"ICD-KETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grade 2 or above diarrhea and/or grade 2 or above colitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1181","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01770","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","description":"CPT-01770","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA1","description":"ICD-OLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC1","description":"ICD-MIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9822","description":"Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2799","description":"Injection_ risperidone (uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7011","description":"Corrugated tubing_ non-disposable_ used with large volume nebulizer_ 10 feet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD0","description":"ICD-NHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC16","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC05","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC10","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF1","description":"ICD-FDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Granulocytes_ pheresis unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9050","description":"Granulocytes_ pheresis unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cellular therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0075","description":"Cellular therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thxp apheresis w/hdl delip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342T","description":"Thxp apheresis w/hdl delip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat recline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1003","description":"Pwr seat recline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81419","description":"Epilepsy Genomic Sequence Analysis Panel_ Must Include Analyses For Aldh7A1_ Cacna1A_ Cdkl5_ Chd2_ Gabrg2_ Grin2A_ Kcnq2_ Mecp2_ Pcdh19_ Polg_ Prrt2_ Scn1A_ Scn1B_ Scn2A_ Scn8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE1","description":"ICD-IGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9749","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXF1","description":"ICD-OAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin k","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84597","description":"Assay of vitamin k","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1B","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILA0","description":"ICD-OILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Succinycholine chloride inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0330","description":"Succinycholine chloride inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMF1","description":"ICD-EGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPC1","description":"ICD-NBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA0","description":"ICD-CDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen tent excl croup/ped t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0455","description":"Oxygen tent excl croup/ped t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2361","description":"HCPCS-J2361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0704","description":"HCPCS-B0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 350-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9963","description":"Hocm 350-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NuDYN SL or NuDYN SLW_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4286","description":"NuDYN SL or NuDYN SLW_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IN GNOTYP CD44 EXONS 2 3 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191U","description":"IN GNOTYP CD44 EXONS 2 3 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF0","description":"ICD-MICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJF0","description":"ICD-NCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate conc sol add 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4766","description":"Dialysate conc sol add 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOA0","description":"ICD-DFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Omegaven_ 10 Grams Lipids","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4187","description":"Omegaven_ 10 Grams Lipids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB0","description":"ICD-KENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB0","description":"ICD-OELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE0","description":"ICD-OAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid specific gravity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84315","description":"Body fluid specific gravity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport lodgng escrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0200","description":"Noner transport lodgng escrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD0","description":"ICD-LDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD0","description":"ICD-HIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA1","description":"ICD-MBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25C","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00541","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","description":"CPT-00541","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD1","description":"ICD-NLJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOF0","description":"ICD-HEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC1","description":"ICD-OCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2138","description":"Back Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB1","description":"ICD-AEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above elbow prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6500","description":"Above elbow prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate upper arm & implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24931","description":"Amputate upper arm & implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJB0","description":"ICD-JHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Environmental manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90882","description":"Environmental manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC05","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD112","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87480","description":"Candida dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCE1","description":"ICD-KDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDB0","description":"ICD-GHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF1","description":"ICD-EDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0201","description":"HCPCS-A0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF0","description":"ICD-NDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35266","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE1","description":"ICD-AHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC1","description":"ICD-GGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68328","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBE0","description":"ICD-AFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0603","description":"HCPCS-A0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB260","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF1","description":"ICD-CDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID1","description":"ICD-MHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHD0","description":"ICD-MJHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 2 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95131","description":"Immntx 2 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAA0","description":"ICD-MDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5142","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","description":"HCPCS-Q5142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGE0","description":"ICD-FGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLD0","description":"ICD-BHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2786","description":"Injection_ reslizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKD0","description":"ICD-OHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCC0","description":"ICD-IDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (sandoz)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9074","description":"Injection_ cyclophosphamide (sandoz)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUD0","description":"ICD-EBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB0","description":"ICD-DARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlude fallopian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58615","description":"Occlude fallopian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0644T","description":"Transcatheter removal or debulking of intracardiac mass (eg_ vegetations_ thrombus) via suction (eg_ vacuum_ aspiration) device_ percutaneous approach_ w/ intraoperative reinf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF1","description":"ICD-KHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKC0","description":"ICD-OGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0398U","description":"Gastroenterology (Barrett esophagus)_ P16_ RUNX3_ HPP1_ and FBN1 DNA methylation analysis using PCR_ formalin-fixed paraffin-embedded (FFPE) tissue_ algorithm reported as risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnosticmammographydigital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0206","description":"Diagnosticmammographydigital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE0","description":"ICD-BCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF1","description":"ICD-NIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLD1","description":"ICD-GFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32671","description":"Thoracoscopy pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency anesthesia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99140","description":"Emergency anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGC0","description":"ICD-FFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA160","description":"Reduced Physical Function _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIE0","description":"ICD-JGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA1","description":"ICD-AHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIB0","description":"ICD-OCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC0","description":"ICD-ICEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUC1","description":"ICD-KHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTF1","description":"ICD-EHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1223","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aortofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35647","description":"Art byp aortofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE1","description":"ICD-CHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0593","description":"Injection_ lanadelumab-flyo_ 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician_ not for use when drug is self-administered)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert brain-fluid device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61215","description":"Insert brain-fluid device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHB1","description":"ICD-BHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91322","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 50 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53235","description":"Removal of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kyphosis pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1020","description":"Kyphosis pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTC1","description":"ICD-ABTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC1","description":"ICD-JAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASB1","description":"ICD-PASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE0","description":"ICD-DIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endocrine surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60699","description":"Endocrine surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smoking cessation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9453","description":"Smoking cessation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IB31","description":"ICD-1IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB0","description":"ICD-NAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB224","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82570","description":"Assay of urine creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC1","description":"ICD-GEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","description":"CPT-37272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTE1","description":"ICD-EGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD1","description":"ICD-LEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGA1","description":"ICD-OBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF1","description":"ICD-IFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCB1","description":"ICD-MJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2980","description":"Crown repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD0","description":"ICD-OCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC250","description":"Special Care Low _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rx ace or arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8935","description":"Rx ace or arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE1","description":"ICD-OIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADC0","description":"ICD-NADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8999","description":"Motor speech current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right heart cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93451","description":"Right heart cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1735","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1735","description":"HCPCS-C1735","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTC1","description":"ICD-FBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA125","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC0","description":"ICD-FIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB32","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHB0","description":"ICD-IIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inebilizumab-cdon_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1823","description":"Injection_ inebilizumab-cdon_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2206","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSE1","description":"ICD-PJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE1","description":"ICD-ICTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE1","description":"ICD-OAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE1","description":"ICD-NCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal scaling 1-3teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4342","description":"Periodontal scaling 1-3teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs ext/flex a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3730","description":"Forearm/arm cuffs ext/flex a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA0","description":"ICD-JEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Tocilizumab for COVID-19 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0249","description":"Injection Tocilizumab for COVID-19 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27536","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI compatible system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0859","description":"MRI compatible system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB0","description":"ICD-KAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKE1","description":"ICD-GHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JB31","description":"ICD-2JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation and curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58120","description":"Dilation and curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD0","description":"ICD-GBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMD0","description":"ICD-EBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA17","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB231","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis rad/ul","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3982","description":"Upper ext fx orthosis rad/ul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMC1","description":"ICD-OEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD1","description":"ICD-CFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKC0","description":"ICD-GFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22867","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m labeled rbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9560","description":"Tc99m labeled rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUA0","description":"ICD-IEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA0","description":"ICD-AGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB0","description":"ICD-NDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0627U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","description":"CPT-0627U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE1","description":"ICD-EDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTA1","description":"ICD-CDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF0","description":"ICD-MLBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialyzer_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4690","description":"Dialyzer_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA1","description":"ICD-OCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22114","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCE1","description":"ICD-IBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA0","description":"ICD-OHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43191","description":"Esophagoscopy rigid trnso dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck follup rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9554","description":"CT/MRI chest/neck follup rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA INFLUENZA A/B EACH","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87400","description":"IAAD IA INFLUENZA A/B EACH","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pouch w faucet/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4428","description":"Urine ost pouch w faucet/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rig fram pelvic pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0469","description":"Tlso rig fram pelvic pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC0","description":"ICD-AAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA21","description":"ICD-3GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99437","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDD1","description":"ICD-MDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF0","description":"ICD-OHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD0","description":"ICD-FGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69635","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE0","description":"ICD-OCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21280","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wnd tx 2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63016","description":"Remove spine lamina >2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMC0","description":"ICD-IAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC0","description":"ICD-IBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397U","description":"Oncology (non-small cell lung cancer)_ cell-free DNA from plasma_ targeted sequence analysis of at least 109 genes_ including sequence variants_ substitutions_ insertions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD0","description":"ICD-EACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advancing Care For Heart Disease Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0055","description":"Advancing Care For Heart Disease Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skel musc relaxant 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80370","description":"Skel musc relaxant 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice_ inpatient hospital","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5005","description":"Hospice_ inpatient hospital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66999","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCE1","description":"ICD-JDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB1","description":"ICD-DAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC0","description":"ICD-KANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Embryo hatching","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89253","description":"Embryo hatching","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFB0","description":"ICD-JGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC21","description":"ICD-3AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro windpipe wire/tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31730","description":"Intro windpipe wire/tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE0","description":"ICD-NGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEF0","description":"ICD-JCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA0","description":"ICD-KGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC0","description":"ICD-OLNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE0","description":"ICD-GDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for needle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77012","description":"Ct scan for needle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRF1","description":"ICD-LBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 1ST DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF1","description":"ICD-EHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8575","description":"Postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB1","description":"ICD-CHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill/fem/fem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35533","description":"Art byp grft axill/fem/fem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF0","description":"ICD-MILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4046F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52441","description":"Cystourethro w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIF1","description":"ICD-GGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4029","description":"Preventive Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC1","description":"ICD-OKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj cmo not pres rsn not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8929","description":"Adj cmo not pres rsn not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo poly hip_ pneu/hyd/rot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5961","description":"Endo poly hip_ pneu/hyd/rot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0886T","description":"Sigmoidoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE1","description":"ICD-AFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWE0","description":"ICD-KDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Growth stimulation gene 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83006","description":"Growth stimulation gene 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart muscle imaging (pet)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78459","description":"Heart muscle imaging (pet)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Formoterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7640","description":"Formoterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE144","description":"Clinically Complex _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDED1","description":"ICD-GDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj cutting of a muscle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7856","description":"Tmj cutting of a muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77076","description":"X-rays bone survey infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7567","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7567","description":"HCPCS-C7567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft pros&vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35681","description":"Composite byp grft pros&vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHA1","description":"ICD-MLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHC1","description":"ICD-NCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD1","description":"ICD-MFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29840","description":"Wrist arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB1","description":"ICD-NDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIE1","description":"ICD-MHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGF1","description":"ICD-FBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHD0","description":"ICD-EHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 12 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP12","description":"Auto.test pane pricing code_ 12 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEC0","description":"ICD-EEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25151","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl >=3srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6611","description":"Onlay cst hgh nbl mtl >=3srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; each additional 30 minutes of technician time (List separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYA0","description":"ICD-OGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD0","description":"ICD-NJLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA0","description":"ICD-OFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are breastfeeding","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9779","description":"Patients who are breastfeeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg coma or sleep only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95822","description":"Eeg coma or sleep only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF1","description":"ICD-JAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUD0","description":"ICD-JAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD1","description":"ICD-GCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLD0","description":"ICD-JDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE116","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMD0","description":"ICD-KFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB1","description":"ICD-PKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Joint device (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1776","description":"Joint device (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUB1","description":"ICD-FFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC13","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD150","description":"Special Care High _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group health education","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99078","description":"Group health education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINF0","description":"ICD-NINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99315","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB1","description":"ICD-LIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inner skull vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61702","description":"Inner skull vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD1","description":"ICD-NBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0304","description":"CDT-D0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroid activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84442","description":"Assay of thyroid activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA0","description":"ICD-GENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC1","description":"ICD-CBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD1","description":"ICD-GGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA0","description":"ICD-OBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB01","description":"High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF0","description":"ICD-GELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAME1","description":"ICD-AAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB1","description":"ICD-GGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFC1","description":"ICD-CAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGF0","description":"ICD-FAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE0","description":"ICD-JAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0983","description":"Add pwr joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUA0","description":"ICD-MCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYD0","description":"ICD-LCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27466","description":"Lengthening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18B","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID0","description":"ICD-FHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB1","description":"ICD-GIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJA1","description":"ICD-KEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut fixed dent max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6114","description":"Implnt/abut fixed dent max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg <4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64892","description":"Nerve graft arm/leg <4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flu vacc iiv3 no preserv id","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90654","description":"Flu vacc iiv3 no preserv id","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA0","description":"ICD-NKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMD0","description":"ICD-FBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy live donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44133","description":"Enterectomy live donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temporary tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4262","description":"Temporary tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii (porcine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7191","description":"Factor viii (porcine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB31","description":"ICD-4EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE0","description":"ICD-JDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0342U","description":"Oncology (pancreatic cancer)_ multiplex immunoassay of C5_ C4_ cystatin C_ factor B_ osteoprotegerin (OPG)_ gelsolin_ IGFBP3_ CA125 and multiplex electrochemiluminescent imm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRA1","description":"ICD-GGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","description":"HCPCS-J0462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sbrt management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77435","description":"Sbrt management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m tetrofosmin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9502","description":"Tc99m tetrofosmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC0","description":"ICD-DIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB1","description":"ICD-NELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBB1","description":"ICD-CDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63055","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFC0","description":"ICD-OKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA0","description":"ICD-JFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB0","description":"ICD-CIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC0","description":"ICD-JHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67105","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE0","description":"ICD-MELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETE0","description":"ICD-EETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx med space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32606","description":"Thoracoscopy w/bx med space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast soft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2132","description":"Kafo femoral fx cast soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDE0","description":"ICD-EEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRE0","description":"ICD-LIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD0","description":"ICD-OFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Helminth antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86682","description":"Helminth antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA1","description":"ICD-GFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA0","description":"ICD-CEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUD0","description":"ICD-GCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7045","description":"Pediatric electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTE0","description":"ICD-MCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF1","description":"ICD-FANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA1","description":"ICD-CADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0904T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","description":"CPT-0904T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWF0","description":"ICD-CGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILB0","description":"ICD-AILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE0","description":"ICD-KEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27345","description":"Removal of knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ca screen;flexi sigmoidscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0104","description":"Ca screen;flexi sigmoidscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC0","description":"ICD-LFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA0","description":"ICD-ODAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED0","description":"ICD-MBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2117","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22B","description":"Special Care High _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD0","description":"ICD-OBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE0","description":"ICD-KEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance response/treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0998","description":"Ambulance response/treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23B","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8G","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn; barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0122","description":"Colon ca scrn; barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00790","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","description":"CPT-00790","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9342","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","description":"HCPCS-J9342","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0684","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","description":"HCPCS-G0684","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTF1","description":"ICD-BGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contour cranial bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21181","description":"Contour cranial bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJD1","description":"ICD-KAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD1","description":"ICD-PJYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB235","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24498","description":"Reinforce humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCA1","description":"ICD-MGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin pheno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82104","description":"Alpha-1-antitrypsin pheno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC1","description":"ICD-JELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stimulants synthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80371","description":"Stimulants synthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMC1","description":"ICD-CAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1304","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supp for self-adm injections","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4211","description":"Supp for self-adm injections","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX40","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABF1","description":"ICD-GABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE1","description":"ICD-OHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug screenin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0003","description":"Alcohol and/or drug screenin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride skin musc at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11011","description":"Debride skin musc at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCD1","description":"ICD-KBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2840","description":"Injection_ sebelipase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE1","description":"ICD-GGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPF1","description":"ICD-KGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE1","description":"ICD-NFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA0","description":"ICD-FHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF1","description":"ICD-FAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE1","description":"ICD-BBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD1","description":"ICD-PBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML24","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF1","description":"ICD-GGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESC1","description":"ICD-GESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD0","description":"ICD-EGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC0","description":"ICD-GFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0947","description":"Fracture frame attachmnts pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE124","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEC0","description":"ICD-BBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0743","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","description":"HCPCS-E0743","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onco (ovar) five proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81503","description":"Onco (ovar) five proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea scrnd no-mild dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3450F","description":"Dyspnea scrnd no-mild dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1350","description":"Patients who had a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical enc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB1","description":"ICD-EIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/snare","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44394","description":"Colonoscopy w/snare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUC0","description":"ICD-GIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIA0","description":"ICD-JCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1408","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","description":"HCPCS-M1408","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to palliative care services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1017","description":"Patient admitted to palliative care services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC0","description":"ICD-FBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF1","description":"ICD-NCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Galactose transferase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82776","description":"Galactose transferase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMD0","description":"ICD-JCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF0","description":"ICD-FEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE0","description":"ICD-JFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/2-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34802","description":"Endovas aaa repr w/2-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2220","description":"Solid propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIB0","description":"ICD-NAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE1","description":"ICD-MEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81220","description":"Cftr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69200","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB1","description":"ICD-NGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE0","description":"ICD-FGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC0","description":"ICD-OAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"40-75y w/type 1/2 w/ldl-c rs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9676","description":"40-75y w/type 1/2 w/ldl-c rs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB0","description":"ICD-NCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGF1","description":"ICD-GEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXC0","description":"ICD-KHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RHD&RHCE GNTYP RHD1-10&RHCE5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198U","description":"RHD&RHCE GNTYP RHD1-10&RHCE5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE1","description":"ICD-OEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIE0","description":"ICD-KCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC1","description":"ICD-EGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC204","description":"Reduced Physical Function _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF1","description":"ICD-BATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB0","description":"ICD-ODSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound warming wound cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6000","description":"Wound warming wound cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration behind upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31040","description":"Exploration behind upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0505","description":"Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment_ history obtained from pati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX16","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD1","description":"ICD-NKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90471","description":"Immunization admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE141","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE150","description":"Special Care Low _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj motion knee jnt lerman t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2186","description":"Adj motion knee jnt lerman t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med list docd in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1159F","description":"Med list docd in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0922T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","description":"CPT-0922T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31085","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD0","description":"ICD-FEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34451","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_non-prog_ perm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1891","description":"Infusion pump_non-prog_ perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAC1","description":"ICD-MAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFE0","description":"ICD-BCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C-reactive protein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86140","description":"C-reactive protein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFB1","description":"ICD-KDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA0","description":"ICD-IFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face les sbq 2 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21012","description":"Exc face les sbq 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB1","description":"ICD-PEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHA1","description":"ICD-EEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE1","description":"ICD-CCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE1","description":"ICD-KDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC1","description":"ICD-BCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD1","description":"ICD-BCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF0","description":"ICD-GAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"deep sedation/general anesthesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9223","description":"deep sedation/general anesthesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1710","description":"Moderna Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0804T","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA0","description":"ICD-NCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD1","description":"ICD-CEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4B","description":"Default_ /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMD0","description":"ICD-JFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of palm tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26170","description":"Removal of palm tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii vw ristoctn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85245","description":"Clot factor viii vw ristoctn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWB0","description":"ICD-OKWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE0","description":"ICD-NBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evasc prlng admn rx agnt 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61650","description":"Evasc prlng admn rx agnt 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC1","description":"ICD-MKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lithium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80178","description":"Assay of lithium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNF1","description":"ICD-FCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF1","description":"ICD-NLFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF1","description":"ICD-MKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB0","description":"ICD-EELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSE0","description":"ICD-PCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB0","description":"ICD-BAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5514","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQA0","description":"ICD-CCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01173","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","description":"CPT-01173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE1","description":"ICD-BBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIE0","description":"ICD-CHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc deglycerolized","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9039","description":"Rbc deglycerolized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE0","description":"ICD-AFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of somatomedin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84305","description":"Assay of somatomedin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC1","description":"ICD-GAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1453","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","description":"HCPCS-M1453","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID0","description":"ICD-NGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEB0","description":"ICD-IAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJF0","description":"ICD-KCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF1","description":"ICD-JCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHA1","description":"ICD-BBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLC1","description":"ICD-EBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35702","description":"Exploration Not Followed By Surgical Repair_ Artery; Upper Extremity (Eg_ Axillary_ Brachial_ Radial_ Ulnar)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPD1","description":"ICD-GDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symes ankle w/o (sach) foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5703","description":"Symes ankle w/o (sach) foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE1","description":"ICD-KHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXC1","description":"ICD-GAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBD0","description":"ICD-NFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC0","description":"ICD-PDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB0","description":"ICD-CEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8X","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBE0","description":"ICD-GHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD0","description":"ICD-LDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWC0","description":"ICD-PBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE0","description":"ICD-EEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High dose rate_electronic bracytherapy_ per fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182T","description":"High dose rate_electronic bracytherapy_ per fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42330","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC1","description":"ICD-OCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA0","description":"ICD-JGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD1","description":"ICD-GBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixed bilat space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1515","description":"Fixed bilat space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Missed appointment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9986","description":"Missed appointment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRE1","description":"ICD-KHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB1","description":"ICD-CETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB0","description":"ICD-JCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLF0","description":"ICD-GCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9054","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","description":"HCPCS-J9054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERB0","description":"ICD-DERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27252","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53275","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTB1","description":"ICD-BHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14B","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical collar molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0170","description":"Cervical collar molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11603","description":"Exc tr-ext mal+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIC1","description":"ICD-OKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB106","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L hrt art/grft angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93459","description":"L hrt art/grft angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0A","description":"Medium Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC0","description":"ICD-ODUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA45","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39545","description":"Revision of diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND1","description":"ICD-OBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert idrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63304","description":"Remove vert idrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLB1","description":"ICD-BFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB1","description":"ICD-NJPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","description":"HCPCS-J7172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB1","description":"ICD-CDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINB0","description":"ICD-BINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocation pocket pacemaker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33222","description":"Relocation pocket pacemaker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDD0","description":"ICD-KCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC1","description":"ICD-CBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB1","description":"ICD-GDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTE1","description":"ICD-IBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD0","description":"ICD-BIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC1","description":"ICD-OGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKB1","description":"ICD-NBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm cmplt maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5810","description":"Denture interm cmplt maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald unspecified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5274","description":"Ald unspecified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC254","description":"Clinically Complex _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE1","description":"ICD-JDXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE0","description":"ICD-FDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLD1","description":"ICD-BCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0640T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist/elbow bowden cbl dir f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6582","description":"Wrist/elbow bowden cbl dir f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX22","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUD1","description":"ICD-ECUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC0","description":"ICD-BCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIA0","description":"ICD-NBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE1","description":"ICD-KGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNE1","description":"ICD-GBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC0","description":"ICD-HFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cebpa gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81218","description":"Cebpa gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62258","description":"Replace brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tenolysis triceps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24332","description":"Tenolysis triceps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQB0","description":"ICD-CIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD1","description":"ICD-MLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conn tiss_ non-human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1763","description":"Conn tiss_ non-human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC0","description":"ICD-CHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF1","description":"ICD-GAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEC1","description":"ICD-OBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1027","description":"Oral device/appliance used to reduce upper airway collapsibility_ without fixed mechanical hinge_ custom fabricated_ includes fitting and adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD1","description":"ICD-EADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental unspec restorative pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2999","description":"Dental unspec restorative pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF1","description":"ICD-MGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC0","description":"ICD-BDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0902","description":"HCPCS-B0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam of head and neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76536","description":"Us exam of head and neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43633","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65780","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61537","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRB0","description":"ICD-LIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD1","description":"ICD-ADDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE221","description":"Special Care Low _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC0","description":"ICD-NFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE0","description":"ICD-OJFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66179","description":"Aqueous shunt eye w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJD1","description":"ICD-JCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56152","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA0","description":"ICD-JCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA0","description":"ICD-MLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63053","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meg spontaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95965","description":"Meg spontaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67914","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE0","description":"ICD-NANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reopen fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58345","description":"Reopen fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA1","description":"ICD-DARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78262","description":"Gastroesophageal reflux exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRB0","description":"ICD-GIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWE0","description":"ICD-KIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRE0","description":"ICD-OJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGF1","description":"ICD-NCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA1","description":"ICD-CEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF0","description":"ICD-LDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKME0","description":"ICD-MKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB1","description":"ICD-JCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8H","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLA1","description":"ICD-IFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5214","description":"Hearing aid_ contralateral routing system_ binaural_ ITC/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no follow imag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9555","description":"Doc med reas no follow imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy resect bullae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32655","description":"Thoracoscopy resect bullae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIA1","description":"ICD-IBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC1","description":"ICD-OKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Great toe-hand transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26551","description":"Great toe-hand transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOD1","description":"ICD-CFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0618","description":"Hospital Special Treatment Room Support Component (Hstrsc) Administration Of Chemotherapy Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBA1","description":"ICD-ACBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMF0","description":"ICD-EAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis access study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90940","description":"Hemodialysis access study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX31","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dent anesthesia w/o surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9210","description":"Dent anesthesia w/o surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEED1","description":"ICD-AEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87591","description":"N.gonorrhoeae dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPD1","description":"ICD-CBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD0","description":"ICD-JAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD1","description":"ICD-MEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD0","description":"ICD-LASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE1","description":"ICD-NKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87557","description":"M.tuberculo dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOB1","description":"ICD-HCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE0","description":"ICD-BCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC1","description":"ICD-NJNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1127","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQE1","description":"ICD-OIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crwn pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2930","description":"Prefab stnlss steel crwn pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD0","description":"ICD-KHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2049","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2049","description":"HCPCS-A2049","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB0","description":"ICD-OANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2218","description":"Lens aniseikonic bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23660","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cad cxr remote","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0175T","description":"Cad cxr remote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp lithotripsy calculi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43265","description":"Ercp lithotripsy calculi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRB1","description":"ICD-PLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clean rem part denture mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9935","description":"Clean rem part denture mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89291","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Receiver/transmitter_ neuro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1816","description":"Receiver/transmitter_ neuro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDF0","description":"ICD-JEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amp reqd w/in 48h ieler proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9641","description":"Amp reqd w/in 48h ieler proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB1","description":"ICD-GEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA11","description":"ICD-3HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPC1","description":"ICD-KCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWC1","description":"ICD-CGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKC1","description":"ICD-GAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITE0","description":"ICD-JITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB0","description":"ICD-FDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26591","description":"Repair muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59140","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5274","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA1","description":"ICD-IEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair multi-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54408","description":"Repair multi-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWB0","description":"ICD-OBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB0","description":"ICD-GGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin & tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15839","description":"Excise excess skin & tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment chinstrp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6502","description":"Compres burngarment chinstrp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBD0","description":"ICD-BGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43108","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF1","description":"ICD-AIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA1","description":"ICD-MFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB0","description":"ICD-EHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo prox th","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4100","description":"Repl leath cuff kafo prox th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inflammatory bowel dis mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8899","description":"Inflammatory bowel dis mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"V-band gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43842","description":"V-band gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1001","description":"HCPCS-B1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45540","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF1","description":"ICD-OEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISA0","description":"ICD-GISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8724","description":"Pt_ pn_ hist grade not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILF1","description":"ICD-MILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Etidronate disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1436","description":"Etidronate disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0310","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admini on the same date of service_ 5 to 15 minutes time Medicaid only.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF1","description":"ICD-MCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0534","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","description":"HCPCS-G0534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Octreotide injection_ depot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2353","description":"Octreotide injection_ depot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB0","description":"ICD-PHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVA0","description":"ICD-BCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68801","description":"Dilate tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47712","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD0","description":"ICD-GEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0859T","description":"Noncontact near-infrared spectroscopy (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation)_ other than for screening for peripheral arteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUA0","description":"ICD-GAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of finger splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29130","description":"Application of finger splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANF0","description":"ICD-JANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLF1","description":"ICD-ICLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC1","description":"ICD-NFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0441T","description":"Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB0","description":"ICD-MEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain biopsy w/ct/mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61751","description":"Brain biopsy w/ct/mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATF0","description":"ICD-BATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB114","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA0","description":"ICD-FAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69642","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC224","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC1","description":"ICD-MHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJF0","description":"ICD-NEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVB0","description":"ICD-OGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor lobectomy (lung)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2061","description":"Donor lobectomy (lung)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB0","description":"ICD-KFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9923","description":"Safety concerns screen provided and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69646","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6520","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fev <40% predicted value","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3040F","description":"Fev <40% predicted value","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC1","description":"ICD-CFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFB1","description":"ICD-BIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB1","description":"ICD-CHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD1","description":"ICD-CICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no preop assmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9616","description":"Doc rsn no preop assmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGED1","description":"ICD-GGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE0","description":"ICD-CHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB1","description":"ICD-IDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photodynmc tx 30 min add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96570","description":"Photodynmc tx 30 min add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amitriptyline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6030","description":"Amitriptyline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9946","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at one year (9 to 15 months) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSD0","description":"ICD-OCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIF1","description":"ICD-OAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF0","description":"ICD-OGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microdissection manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88381","description":"Microdissection manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5128","description":"Injection_ ranibizumab-eqrn (cimerli)_ biosimilar_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE0","description":"ICD-OHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nos quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0110T","description":"Nos quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8696","description":"Repair Of Orthodontic Appliance - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA224","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE151","description":"Clinically Complex _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DO GNOTYP ART4 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0184U","description":"DO GNOTYP ART4 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total lung lavage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32997","description":"Total lung lavage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYA0","description":"ICD-DGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGE0","description":"ICD-JCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014M","description":"Liver disease_ analysis of 3 biomarkers (hyaluronic acid [ha]_ procollagen iii amino terminal peptide [piiinp]_ tissue inhibitor of metalloproteinase 1 [timp-1])_ using immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAB1","description":"ICD-IBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise thigh tendon & fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27305","description":"Incise thigh tendon & fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD0","description":"ICD-GAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA1","description":"ICD-MHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53661","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech threshold audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92555","description":"Speech threshold audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDF0","description":"ICD-KIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine hydro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0020","description":"Injection_ bupivicaine hydro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA1","description":"ICD-JFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC1","description":"ICD-AGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD1","description":"ICD-LCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE101","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB1","description":"ICD-PDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0103","description":"HCPCS-A0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67840","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srn clin dep doc no f/u pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8940","description":"Srn clin dep doc no f/u pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF1","description":"ICD-KGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA0","description":"ICD-LESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cataract surgery complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66982","description":"Cataract surgery complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTE1","description":"ICD-IFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNE1","description":"ICD-BGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD1","description":"ICD-EFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2B","description":"Medium Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD1","description":"ICD-MFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX10","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF0","description":"ICD-IITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental bitewing single film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0270","description":"Dental bitewing single film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAE0","description":"ICD-MEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral antiplatelet therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4011F","description":"Oral antiplatelet therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEA0","description":"ICD-MHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vision svcs frames purchases","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2020","description":"Vision svcs frames purchases","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE1","description":"ICD-EFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQB1","description":"ICD-KIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB0","description":"ICD-ODRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHB1","description":"ICD-OGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9411","description":"No admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMC1","description":"ICD-CBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB1","description":"ICD-GCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGA1","description":"ICD-BCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNA1","description":"ICD-GFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0207","description":"Traumatic brain injury with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF1","description":"ICD-ODQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat ht <17 or >=21 ltwt wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0056","description":"Seat ht <17 or >=21 ltwt wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reverse osmosis h2o puri sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1610","description":"Reverse osmosis h2o puri sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC1","description":"ICD-CAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA0","description":"ICD-EGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXE0","description":"ICD-CCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD0","description":"ICD-NCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma volume multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78111","description":"Plasma volume multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME0","description":"ICD-CHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENE0","description":"ICD-BENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUC1","description":"ICD-GDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB0","description":"ICD-CBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGE0","description":"ICD-KHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF1","description":"ICD-FBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk waist belt webbing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5688","description":"Bk waist belt webbing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99453","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; set-up and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD0","description":"ICD-OLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx oral admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79005","description":"Nuclear rx oral admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36908","description":"Transcatheter placement of intravascular stent(s)_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Verteporfin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3396","description":"Verteporfin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8E","description":"High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC0","description":"ICD-KDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA1","description":"ICD-DCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME1","description":"ICD-IAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGC1","description":"ICD-KFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat each add spine fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22328","description":"Treat each add spine fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES250","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE0","description":"ICD-IAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE0","description":"ICD-NBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC260","description":"Special Care High _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB1","description":"ICD-BGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67311","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 10-15dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0303","description":"Pre-op service lvrs 10-15dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWB1","description":"ICD-PAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bath tub wall rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0241","description":"Bath tub wall rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE140","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETC1","description":"ICD-BETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak/ft power asst incl motors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5969","description":"Ak/ft power asst incl motors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures immediat maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5130","description":"Dentures immediat maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"G6pc gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81250","description":"G6pc gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB0","description":"ICD-JBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD0","description":"ICD-NAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"removal of implant body not requiring bone removal or flap elevation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6105","description":"removal of implant body not requiring bone removal or flap elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD1","description":"ICD-OAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0228T","description":"Njx tfrml eprl w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF1","description":"ICD-ICCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHB0","description":"ICD-AHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETE1","description":"ICD-AETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0741T","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software_ data collection_ transmission_ and storage_ each 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rep part denture cast frame","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5620","description":"Rep part denture cast frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD1","description":"ICD-GCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vessel injection procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36299","description":"Vessel injection procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37296","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","description":"CPT-37296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC0","description":"ICD-NKIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOA1","description":"ICD-GAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNB1","description":"ICD-KBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB1","description":"ICD-CIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF0","description":"ICD-OLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0104","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0104","description":"HCPCS-C0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF0","description":"ICD-FDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid monaural in ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5050","description":"Hearing aid monaural in ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE1","description":"ICD-NFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTF1","description":"ICD-NGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC1","description":"ICD-LEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4C","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1071T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1071T","description":"CPT-1071T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0527","description":"Management of established patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0413T","description":"Rmvl car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of thigh muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27385","description":"Repair of thigh muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUA1","description":"ICD-OAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA0","description":"ICD-NKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Camisole post-mast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8460","description":"Camisole post-mast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB0","description":"ICD-OIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCF0","description":"ICD-MHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabazitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9043","description":"Cabazitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBD0","description":"ICD-CHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF0","description":"ICD-OBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHED1","description":"ICD-EHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy upr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15878","description":"Suction lipectomy upr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Statin med pres at disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8816","description":"Statin med pres at disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cerv artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22864","description":"Remove cerv artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0825","description":"Pwc gp 2 hd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair paravag defect vag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57285","description":"Repair paravag defect vag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00540","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","description":"CPT-00540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458U","description":"Oncology (breast cancer)_ S100A8 and S100A9_ by enzyme-linked immunosorbent assay (ELISA)_ tear fluid with age_ algorithm reported as a risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD0","description":"ICD-BFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF0","description":"ICD-MAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAF1","description":"ICD-FCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC1","description":"ICD-MBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAC0","description":"ICD-IAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACB0","description":"ICD-NACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE146","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brake for wheeled walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0159","description":"Brake for wheeled walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMA1","description":"ICD-JBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","description":"CPT-00402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC201","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier powder per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4371","description":"Skin barrier powder per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD236","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB234","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA0","description":"ICD-CGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKE0","description":"ICD-CBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert uro/ves nck sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53445","description":"Insert uro/ves nck sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA0","description":"ICD-OJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flexion/extension wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6620","description":"Flexion/extension wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE0","description":"ICD-KAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD1","description":"ICD-GCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA1","description":"ICD-BHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB0","description":"ICD-JENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE105","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAB1","description":"ICD-OFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Presbyopia-correct function","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2788","description":"Presbyopia-correct function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysin acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85475","description":"Hemolysin acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF1","description":"ICD-ACUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1603","description":"HCPCS-B1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOF0","description":"ICD-CAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64657","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","description":"CPT-64657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relieve pressure on nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64722","description":"Relieve pressure on nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surg on vag/urethral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94251","description":"Anesth surg on vag/urethral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34714","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by groin incision_ unilateral (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA1","description":"ICD-OIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create new tubal opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58770","description":"Create new tubal opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0660T","description":"Implantation of anterior segment intraocular nonbiodegradable drug-eluting system_ internal approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5983","description":"Radiation applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27727","description":"Repair of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sales tax","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9999","description":"Sales tax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME0","description":"ICD-MFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comm psy face-face per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0036","description":"Comm psy face-face per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i phenotype qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86830","description":"Hla class i phenotype qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0502","description":"HCPCS-B0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXC1","description":"ICD-KEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA0","description":"ICD-KHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31805","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE1","description":"ICD-NGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4560","description":"Neuromuscular electrical stimulator (nmes)_ disposable_ replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKED0","description":"ICD-MKED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust ankle ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1815","description":"Adjust ankle ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21480","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj codeine phosphate /30 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0745","description":"Inj codeine phosphate /30 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE1","description":"ICD-CGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33321","description":"Repair major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF0","description":"ICD-FIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16378","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16378","description":"CPT-16378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA0","description":"ICD-EIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supports brokerage_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2051","description":"Supports brokerage_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE131","description":"Special Care Low _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6056","description":"Prefabricated abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0806","description":"Replacement of lower extremity joint with Motor <22.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRB1","description":"ICD-GHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug hotline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0030","description":"Alcohol and/or drug hotline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACD1","description":"ICD-EACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED0","description":"ICD-NIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0715T","description":"Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF1","description":"ICD-JCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC0","description":"ICD-ADUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE0","description":"ICD-OANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA0","description":"ICD-CGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC11","description":"ICD-3EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA0","description":"ICD-JBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01935","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","description":"CPT-01935","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Casting/strapping procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29799","description":"Casting/strapping procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDF1","description":"ICD-KEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reticulated platelet assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85055","description":"Reticulated platelet assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQC1","description":"ICD-HCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transect artery sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61611","description":"Transect artery sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of hip cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29305","description":"Application of hip cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTA1","description":"ICD-EGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABA0","description":"ICD-GABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC1","description":"ICD-CAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD0","description":"ICD-OFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95836","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter_ including recording_ with interpretation and written report_ up to 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38525","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABB0","description":"ICD-OABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE1","description":"ICD-EDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD0","description":"ICD-KHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0595U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","description":"CPT-0595U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHF1","description":"ICD-MBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQE1","description":"ICD-PAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVF1","description":"ICD-CAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0548","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","description":"HCPCS-G0548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB1","description":"ICD-JCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD1","description":"ICD-CFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB0","description":"ICD-CHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breath hydrogen/methane test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91065","description":"Breath hydrogen/methane test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD231","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB1","description":"ICD-FDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct lower extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73700","description":"Ct lower extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE0","description":"ICD-GDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5C","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC0","description":"ICD-BHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laiv4 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90672","description":"Laiv4 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mst rcnt hbb < 10g/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8973","description":"Mst rcnt hbb < 10g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9129","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9129","description":"CDT-D9129","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA32","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Organic acid single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83921","description":"Organic acid single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chore services per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5120","description":"Chore services per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33688","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC0","description":"ICD-GAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC41","description":"Very High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/joint(s) custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3806","description":"Whfo w/joint(s) custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy retro balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43213","description":"Esophagoscopy retro balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA1","description":"ICD-PIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom shoes depth inlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3230","description":"Custom shoes depth inlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSD0","description":"ICD-PLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test urine for lactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83633","description":"Test urine for lactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF1","description":"ICD-GDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC0","description":"ICD-HCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","description":"CPT-01474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90935","description":"Hemodialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43291","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with removal of intragastric bariatric balloon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5155","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","description":"HCPCS-Q5155","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop ea cast chg & realign","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6386","description":"Postop ea cast chg & realign","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVA0","description":"ICD-KDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98010","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","description":"CPT-98010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB0","description":"ICD-DDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit postnatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99501","description":"Home visit postnatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA1","description":"ICD-FEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extended culture of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89272","description":"Extended culture of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC1","description":"ICD-FFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIB0","description":"ICD-FAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJE1","description":"ICD-CBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADC0","description":"ICD-KADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96161","description":"Administration of caregiver-focused health risk assessment instrument (eg_ depression inventory) for the benefit of the patient_ with scoring and documentation_ per standardiz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atten goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9166","description":"Atten goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal cord puncture prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59012","description":"Fetal cord puncture prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE0","description":"ICD-FFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE1","description":"ICD-EIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arsenic trioxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9017","description":"Arsenic trioxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRA0","description":"ICD-LFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry air only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208T","description":"Audiometry air only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semi-precision abutment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6191","description":"Semi-precision abutment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27391","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBE0","description":"ICD-NCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cephalin floculation test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2028","description":"Cephalin floculation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB0","description":"ICD-METB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPB1","description":"ICD-JBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMB1","description":"ICD-NCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWD0","description":"ICD-LGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1402","description":"HCPCS-C1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6505","description":"Cmprsburngarment glove-elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF1","description":"ICD-KBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAC0","description":"ICD-EDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-cov proc_ clinical trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0294","description":"Non-cov proc_ clinical trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX15","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21138","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mohs 1 stage h/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17311","description":"Mohs 1 stage h/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj meniscectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7850","description":"Tmj meniscectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA117","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXA1","description":"ICD-BDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALB1","description":"ICD-FALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF0","description":"ICD-IAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61151","description":"Pierce skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11770","description":"Remove pilonidal cyst simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAE0","description":"ICD-CDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64902","description":"Nerve graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69662","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME1","description":"ICD-IBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81328","description":"SLCO1B1 (solute carrier organic anion transporter family_ member 1B1) (eg_ adverse drug reaction)_ gene analysis_ common variant(s) (eg_ *5)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB0","description":"ICD-OAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC0","description":"ICD-IDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens pmma bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2502","description":"Contact lens pmma bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB0","description":"ICD-JALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD0","description":"ICD-PGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDA1","description":"ICD-ICDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33788","description":"Revision of pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uvl sys panel 4 ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0692","description":"Uvl sys panel 4 ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14C","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBA0","description":"ICD-IGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRA1","description":"ICD-CHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Durable medical equipment mi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1399","description":"Durable medical equipment mi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE230","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of percutaneous biliary drainage catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47525","description":"Change of percutaneous biliary drainage catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAF1","description":"ICD-NCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ank-foot sys dors-plant flex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5973","description":"Ank-foot sys dors-plant flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBF0","description":"ICD-NJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE1","description":"ICD-OIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt inpat init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94002","description":"Vent mgmt inpat init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0050U","description":"Targeted genomic sequence analysis panel_ acute myelogenous leukemia_ DNA analysis_ 194 genes_ interrogation for sequence variants_ copy number variants or rearrangements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncoprotein dcp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83951","description":"Oncoprotein dcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME0","description":"ICD-EDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB1","description":"ICD-CGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of jaw muscle/bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21296","description":"Revision of jaw muscle/bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTA0","description":"ICD-OKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC0","description":"ICD-NDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92235","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","description":"HCPCS-J0607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLF0","description":"ICD-JFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB11","description":"ICD-1BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA0","description":"ICD-BCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPB0","description":"ICD-CIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA1","description":"ICD-KHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC1","description":"ICD-MDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ptfalls assess-docd ge2>/yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1100F","description":"Ptfalls assess-docd ge2>/yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc advncd dis comfort 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1152F","description":"Doc advncd dis comfort 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantable access syst perc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4301","description":"Implantable access syst perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2290","description":"HCPCS-J2290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAC1","description":"ICD-EBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTE1","description":"ICD-JHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg <= 16 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0744","description":"Absorp drg <= 16 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1014T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","description":"CPT-1014T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE1","description":"ICD-OKWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21139","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC1","description":"ICD-ACLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKD0","description":"ICD-NAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36245","description":"Ins cath abd/l-ext art 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0722T","description":"Quantitative computed tomography (CT) tissue characterization_ including interpretation and report_ obtained with concurrent CT examination of any structure contained in the c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE1","description":"ICD-IHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYC1","description":"ICD-PEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA131","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heparin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85520","description":"Heparin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 20.1-30.0","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12056","description":"Intmd rpr face/mm 20.1-30.0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC0","description":"ICD-GGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIC0","description":"ICD-OCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nutrition class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9452","description":"Nutrition class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKC1","description":"ICD-CDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad resect hand tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26118","description":"Rad resect hand tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456U","description":"Autoimmune (rheumatoid arthritis)_ next-generation sequencing (NGS)_ gene expression testing of 19 genes_ whole blood_ with analysis of anti-cyclic citrullinated peptides (CCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUE1","description":"ICD-CAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB0","description":"ICD-BDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF1","description":"ICD-IFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC0","description":"ICD-EGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2060","description":"Hospital Special Treatment Room Support Component (Hstrsc) Incomplete Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJE1","description":"ICD-FHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAA0","description":"ICD-FIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scrn hcv infec not recd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9386","description":"Scrn hcv infec not recd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor three anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81510","description":"Ftl cgen abnor three anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prior history of known cvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1256","description":"Prior history of known cvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQD0","description":"ICD-HEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0665","description":"Injection_ bupivicaine_ not otherwise specified_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD205","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNF1","description":"ICD-FDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor serv ivf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4025","description":"Donor serv ivf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins lt atrl press monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293T","description":"Ins lt atrl press monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo radical prostatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55866","description":"Laparo radical prostatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB1","description":"ICD-KCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF1","description":"ICD-CCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE0","description":"ICD-FCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise oral mucosa for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40818","description":"Excise oral mucosa for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC0","description":"ICD-IDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transdermal gfr measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0602T","description":"Transdermal gfr measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQA1","description":"ICD-DHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCD0","description":"ICD-KFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0701T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB124","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLE1","description":"ICD-EDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAD1","description":"ICD-CCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibula bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20955","description":"Fibula bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97018","description":"Paraffin bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow med ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24346","description":"Reconstruct elbow med ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC1","description":"ICD-GEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJA0","description":"ICD-GIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA1","description":"ICD-HCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0255","description":"Hospital bed var ht w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-electronic spirometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9284","description":"Non-electronic spirometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXC1","description":"ICD-BGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD211","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIC1","description":"ICD-MEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45308","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME0","description":"ICD-EAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE0","description":"ICD-GIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKC0","description":"ICD-NJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGE1","description":"ICD-JHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD0","description":"ICD-KEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC0","description":"ICD-CGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE0","description":"ICD-CDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibody testing for a public health related pathogen_ including coronavirus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0605","description":"Antibody testing for a public health related pathogen_ including coronavirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC1","description":"ICD-NLCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43101","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQC0","description":"ICD-OIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBC1","description":"ICD-EGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3 comp foot exam completed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9226","description":"3 comp foot exam completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography dx w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74262","description":"Ct colonography dx w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB0","description":"ICD-AFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFE1","description":"ICD-KCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rapid desensitization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95180","description":"Rapid desensitization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA1","description":"ICD-AEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete wheel lock assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2206","description":"Complete wheel lock assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD1","description":"ICD-OEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Y90 ibritumomab_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9543","description":"Y90 ibritumomab_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelet survival","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78191","description":"Platelet survival","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath stent cca w/eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37215","description":"Transcath stent cca w/eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB1","description":"ICD-GAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJA1","description":"ICD-OIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intens behave ther cardio dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0446","description":"Intens behave ther cardio dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd diagnostic brush wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43235","description":"Egd diagnostic brush wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace foot drop spint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4394","description":"Replace foot drop spint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2109","description":"Spherocylinder 4.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD0","description":"ICD-GCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBC0","description":"ICD-ODBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMF1","description":"ICD-KFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA53","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB0","description":"ICD-AATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA12","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA0","description":"ICD-GCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99 tilmanocept diag 0.5mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9520","description":"Tc99 tilmanocept diag 0.5mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD1","description":"ICD-IFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA0","description":"ICD-OAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF0","description":"ICD-KIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 3MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0081A","description":"ADM SARSCV2 3MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33030","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPF0","description":"ICD-FFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate oral 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8610","description":"Methotrexate oral 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSF1","description":"ICD-PLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF0","description":"ICD-FELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMC0","description":"ICD-JBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.pneumon dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87582","description":"M.pneumon dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGD1","description":"ICD-BFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA15B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUF1","description":"ICD-FDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDF0","description":"ICD-AGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69727","description":"Removal_ Osseointegrated Implant_ Skull; With Magnetic Transcutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunodiffusion ouchterlony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86331","description":"Immunodiffusion ouchterlony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skilled Nursing Facility Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4033","description":"Skilled Nursing Facility Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil prevoc waiver per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2015","description":"Habil prevoc waiver per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB1","description":"ICD-OAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND0","description":"ICD-GIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olaratumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9285","description":"Injection_ olaratumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9389","description":"Unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74455","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEF1","description":"ICD-CIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE0","description":"ICD-OBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad sleeve heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8423","description":"Custom grad sleeve heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE1","description":"ICD-GBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain w/ h noble m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2750","description":"Crown porcelain w/ h noble m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cath care noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5497","description":"Hit cath care noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB1","description":"ICD-PEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ above knee_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6585","description":"Gradient pressure wrap with adjustable straps_ above knee_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHA1","description":"ICD-MIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9460","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF0","description":"ICD-NGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA1","description":"ICD-AHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj olanzapine 2.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0166","description":"Inj olanzapine 2.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28605","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp5 ped sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0890","description":"Pwc gp5 ped sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiograph head w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70546","description":"Mr angiograph head w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59820","description":"Care of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE1","description":"ICD-DASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29040","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDF1","description":"ICD-OLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHA1","description":"ICD-IDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2121","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES301","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA1","description":"ICD-CCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove intracorporeal device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33980","description":"Remove intracorporeal device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov part bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7230","description":"Impact tooth remov part bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0318U","description":"Pediatrics (congenital epigenetic disorders)_ whole genome methylation analysis by microarray for 50 or more genes_ blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA0","description":"ICD-HBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther xcl hrvst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264T","description":"Im b1 mrw cel ther xcl hrvst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct head/brain w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70450","description":"Ct head/brain w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC1","description":"ICD-BHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVC1","description":"ICD-FEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No card tamp e/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9409","description":"No card tamp e/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93226","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD1","description":"ICD-FIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35211","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF0","description":"ICD-OAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Barium swallow test not req","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3200F","description":"Barium swallow test not req","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWF0","description":"ICD-OIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infliximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1745","description":"Infliximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0698T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEB1","description":"ICD-NAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25B","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288U","description":"Oncology (Lung)_ Mrna_ Quantitative Pcr Analysis Of 11 Genes (Bag1_ Brca1_ Cdc6_ Cdk2Ap1_ Erbb3_ Fut3_ Il11_ Lck_ Rnd3_ Sh3Bgr_ Wnt3A) And 3 Reference Genes (Esd_ Tbp_ Yap1)_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr/aicd combination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1899","description":"Lead_ pmkr/aicd combination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ovrsght xtrcorp liv asst pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405T","description":"Ovrsght xtrcorp liv asst pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lo sag ri an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0642","description":"Lo sag ri an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD0","description":"ICD-OJVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUF0","description":"ICD-MDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA0","description":"ICD-PDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC215","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB0","description":"ICD-JFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAD0","description":"ICD-KIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDB0","description":"ICD-GBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOD1","description":"ICD-DGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE1","description":"ICD-NBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dimecaprol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0470","description":"Dimecaprol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF0","description":"ICD-GHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1073","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","description":"HCPCS-J1073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD1","description":"ICD-GAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB0","description":"ICD-EFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD1","description":"ICD-CFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl nasal pillow comb mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7029","description":"Repl nasal pillow comb mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0607","description":"Repl batt for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33391","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; complex (eg_ leaflet extension_ leaflet resection_ leaflet reconstruction_ or annuloplasty)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0673U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673U","description":"CPT-0673U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECE0","description":"ICD-OECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB0","description":"ICD-OBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67210","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDE0","description":"ICD-GEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9494","description":"INJECTION_ OCRELIZUMAB_ 1 MG (OCREVUS)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METE1","description":"ICD-METE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA1","description":"ICD-NHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF0","description":"ICD-EHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2107","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE1","description":"ICD-FIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE1","description":"ICD-DBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC1","description":"ICD-NANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCD1","description":"ICD-NDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB1","description":"ICD-GHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJB0","description":"ICD-FCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26205","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1499","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","description":"HCPCS-M1499","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF0","description":"ICD-CDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp carotid-vertebral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35642","description":"Art byp carotid-vertebral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB0","description":"ICD-ADHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES221","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35703","description":"Exploration Not Followed By Surgical Repair_ Artery; Lower Extremity (Eg_ Common Femoral_ Deep Femoral_ Superficial Femoral_ Popliteal_ Tibial_ Peroneal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE1","description":"ICD-OAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAD1","description":"ICD-CBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBME1","description":"ICD-CBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC1","description":"ICD-MFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm transmitter ald","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5288","description":"Ald fm/dm transmitter ald","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC1","description":"ICD-NBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AB11","description":"ICD-3AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relieve bladder contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52640","description":"Relieve bladder contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHE0","description":"ICD-JBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB0","description":"ICD-NHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA0","description":"ICD-AEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID0","description":"ICD-FBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVC0","description":"ICD-FBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED1","description":"ICD-ODED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGB0","description":"ICD-OJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81186","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube cuffed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7521","description":"Trach/laryn tube cuffed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77058","description":"Magnetic resonance imaging_ breast_ without and/or with contrast material(s); unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF1","description":"ICD-OCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2071","description":"Medication Assisted Treatment_ Buprenorphine (Implant Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE155","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPC1","description":"ICD-BAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00902","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","description":"CPT-00902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE0","description":"ICD-KBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB0","description":"ICD-KCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF1","description":"ICD-GDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXD0","description":"ICD-GHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures mand part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5212","description":"Dentures mand part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epiglottis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31420","description":"Removal of epiglottis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDE1","description":"ICD-NEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1101","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjustment of custom sleep apnea appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9948","description":"Adjustment of custom sleep apnea appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABD0","description":"ICD-JABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFC0","description":"ICD-OAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81190","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No xray/ct/ et al ordd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3320F","description":"No xray/ct/ et al ordd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC0","description":"ICD-OFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0999T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","description":"CPT-0999T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21B","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA1","description":"ICD-KIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKA0","description":"ICD-NCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRF0","description":"ICD-KCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revsc opn/prq tib/pero stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37234","description":"Revsc opn/prq tib/pero stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41827","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-waterproof tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4450","description":"Non-waterproof tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED0","description":"ICD-NCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC204","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0620U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","description":"CPT-0620U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27712","description":"Realignment of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC10B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lysis of labial lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56441","description":"Lysis of labial lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pegaptanib sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2503","description":"Pegaptanib sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28G","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD0","description":"ICD-HAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic shoe w/roller/rockr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5503","description":"Diabetic shoe w/roller/rockr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECA1","description":"ICD-IECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYC1","description":"ICD-LCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUD0","description":"ICD-CFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWF1","description":"ICD-DHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Joint survey single view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77077","description":"Joint survey single view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC0","description":"ICD-NAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVB1","description":"ICD-BIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung extrapleural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32445","description":"Removal of lung extrapleural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQF1","description":"ICD-GCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD0","description":"ICD-MGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTD0","description":"ICD-CBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clotting assay whole blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85396","description":"Clotting assay whole blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth facility fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3014","description":"Telehealth facility fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets leukocytes reduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9031","description":"Platelets leukocytes reduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharm rx agent noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9699","description":"Radiopharm rx agent noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA0","description":"ICD-OHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLE0","description":"ICD-OGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOF0","description":"ICD-GEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB0","description":"ICD-GFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCME1","description":"ICD-MCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOE0","description":"ICD-OIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66172","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAE0","description":"ICD-CHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50234","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440T","description":"Abltj Perc Cryoabltj Img Gdn Uxtr/Perph Nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion 13/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22804","description":"Post fusion 13/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Youth size pull-on","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4534","description":"Youth size pull-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch ex wear convex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4390","description":"Drainable pch ex wear convex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2221","description":"Solid caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Npm1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81310","description":"Npm1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96381","description":"Administration of respiratory syncytial virus_ monoclonal antibody_ seasonal dose by intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25909","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87593","description":"Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (e.g._ monkeypox virus_ cowpox virus_ vaccinia virus)_ amplified probe technique_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDD1","description":"ICD-EEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKC0","description":"ICD-CBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB1","description":"ICD-NGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXA1","description":"ICD-OGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53665","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year sperm/semen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89343","description":"Storage/year sperm/semen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA21","description":"ICD-4IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTE0","description":"ICD-CBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE1","description":"ICD-BITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYD0","description":"ICD-LGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87428","description":"IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB21","description":"ICD-3JB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOA0","description":"ICD-OGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD1","description":"ICD-HAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF0","description":"ICD-BCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD1","description":"ICD-HFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNC0","description":"ICD-OJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1149","description":"Patient unable to complete the neck fs prom at initial evaluation and/or discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility_ and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of head brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20661","description":"Application of head brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB0","description":"ICD-OCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMA0","description":"ICD-BBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Melanomaajcc stage 0 or ia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3322F","description":"Melanomaajcc stage 0 or ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init pm e/m new pat 65+ yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99387","description":"Init pm e/m new pat 65+ yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8F","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-25448","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","description":"CPT-25448","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1707","description":"Janssen (Johnson & Johnson) COVID-19 vaccine administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0186","description":"Air pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD1","description":"ICD-IIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0243U","description":"PIGF Preeclampsia Screen_ PerkinElmer Genetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC21C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0928T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","description":"CPT-0928T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIC0","description":"ICD-IHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37259","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","description":"CPT-37259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical foods for noninborn errors of metabolism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9432","description":"Medical foods for noninborn errors of metabolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVC0","description":"ICD-KAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD0","description":"ICD-CCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND0","description":"ICD-KBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Erythro lactobionate /500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1364","description":"Erythro lactobionate /500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA1","description":"ICD-KBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport air","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0140","description":"Nonemergency transport air","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA0","description":"ICD-KHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA21","description":"ICD-2EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMC0","description":"ICD-KCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE24A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHF0","description":"ICD-ECHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB0","description":"ICD-CCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44381","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVF1","description":"ICD-BCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUA0","description":"ICD-NHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA0","description":"ICD-IGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracorp shockwv tx hi enrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101T","description":"Extracorp shockwv tx hi enrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID1","description":"ICD-AFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA1","description":"ICD-EHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITC0","description":"ICD-KITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYD1","description":"ICD-DHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC1","description":"ICD-NCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID0","description":"ICD-EFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUB0","description":"ICD-IBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAC0","description":"ICD-JHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA25","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0771T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA1","description":"ICD-KIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE1","description":"ICD-NDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7d/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2207","description":"Lens sphcy bifocal 4.25-7d/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKA1","description":"ICD-NLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB1","description":"ICD-PDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ PRAME and LINC00518_ superficial collection using adhesive patch(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0089U","description":"Oncology (melanoma)_ gene expression profiling by RTqPCR_ PRAME and LINC00518_ superficial collection using adhesive patch(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC216","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xcm biologic tiss matrix 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4142","description":"Xcm biologic tiss matrix 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx mult myeloma stg2 hig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9129","description":"Onc dx mult myeloma stg2 hig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB1","description":"ICD-OEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBE0","description":"ICD-BGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD254","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5862","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atten d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9167","description":"Atten d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1027","description":"The Number Of Adult Patient-Months In The Denominator Who Were On Maintenance Hemodialysis Under The Care Of The Same Practitioner Or Group Partner As Of The Last Hemodialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBB0","description":"ICD-NCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC1","description":"ICD-JDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iloprost non-comp unit dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4074","description":"Iloprost non-comp unit dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1947","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1947","description":"HCPCS-J1947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral speech device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92597","description":"Oral speech device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHC0","description":"ICD-AEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25028","description":"Drainage of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHE1","description":"ICD-JHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0903","description":"For diabetics only_ multiple density insert_ made by direct carving with CAM technology from a rectified CAD model created from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Death occurring during the index acute care hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9814","description":"Death occurring during the index acute care hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA0","description":"ICD-OCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25924","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26517","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0311","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service_ 16-30 minutes time Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screen pap by tech w md supv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3000","description":"Screen pap by tech w md supv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE1","description":"ICD-IIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0599U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","description":"CPT-0599U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOA1","description":"ICD-LHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD0","description":"ICD-GDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWE1","description":"ICD-DDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB0","description":"ICD-EEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Had smoke b/4 anes day surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9645","description":"Had smoke b/4 anes day surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA0","description":"ICD-OADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIB0","description":"ICD-MDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterostomal therapy by a re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9474","description":"Enterostomal therapy by a re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urethral insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4336","description":"Urethral insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED0","description":"ICD-CEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRC0","description":"ICD-PGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macul exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2019F","description":"Dilated macul exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21182","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB154","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRB1","description":"ICD-OJRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED0","description":"ICD-GIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASB0","description":"ICD-DASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36585","description":"Replace picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC0","description":"ICD-PJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk waist belt padded and lin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5690","description":"Bk waist belt padded and lin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11B","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB1","description":"ICD-PLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF0","description":"ICD-BEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWB0","description":"ICD-LFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lsh w/t/o ut 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58542","description":"Lsh w/t/o ut 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOB1","description":"ICD-DBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD1","description":"ICD-DIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE0","description":"ICD-NAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC1","description":"ICD-AFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobramycin non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7682","description":"Tobramycin non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEC0","description":"ICD-MIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest femoropopliteal vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35572","description":"Harvest femoropopliteal vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0822T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; clinical staff under the direction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB0","description":"ICD-GANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8E","description":"High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8D","description":"Low Rehab_ ADL Index 0-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC0","description":"ICD-OGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKC0","description":"ICD-KCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWA0","description":"ICD-LAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC1","description":"ICD-GBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","description":"CPT-01930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAED1","description":"ICD-CAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOB1","description":"ICD-PCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLD0","description":"ICD-GCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","description":"HCPCS-J0166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGF0","description":"ICD-KCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB1","description":"ICD-KIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB1","description":"ICD-PBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC1","description":"ICD-NLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4017","description":"Cast sup lng arm splint plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC240","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull & explore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61253","description":"Pierce skull & explore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE0","description":"ICD-KIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB0","description":"ICD-IHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1144","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot 4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4408","description":"Ext wear ost skn barr >4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50081","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE1","description":"ICD-AHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered air flotation bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0193","description":"Powered air flotation bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortorenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35560","description":"Art byp grft aortorenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx px nfrosgrm &/urtrgrm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50430","description":"Njx px nfrosgrm &/urtrgrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone algrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20930","description":"Sp bone algrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD1","description":"ICD-FDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore sinus remove polyps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31032","description":"Explore sinus remove polyps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA1","description":"ICD-BFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF1","description":"ICD-GAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50546","description":"Laparoscopic nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA1","description":"ICD-HHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reposition intraocular lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66825","description":"Reposition intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENF1","description":"ICD-FENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPE1","description":"ICD-OLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi den insert direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5512","description":"Multi den insert direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE1","description":"ICD-JDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLF1","description":"ICD-BCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE1","description":"ICD-MITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUD0","description":"ICD-JEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smear complex stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87209","description":"Smear complex stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF0","description":"ICD-OETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HER2/neu positive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9830","description":"HER2/neu positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUE1","description":"ICD-MAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHC1","description":"ICD-AGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4412","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","description":"HCPCS-Q4412","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92997","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF0","description":"ICD-FITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ custom_ medium weight_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6579","description":"Gradient compression glove_ custom_ medium weight_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF1","description":"ICD-CDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb quant transcutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88738","description":"Hgb quant transcutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDF0","description":"ICD-JBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB03","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Redo compl cardiac anomaly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33622","description":"Redo compl cardiac anomaly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0254U","description":"Reproductive Medicine (Preimplantation Genetic Assessment)_ Analysis Of 24 Chromosomes Using Embryonic Dna Genomic Sequence Analysis For Aneuploidy_ And A Mitochondrial Dna Sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0205","description":"HCPCS-B0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX05","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0244U","description":"Oncotype MAP Pan-Cancer Tissue Test_ Paradigm Diagnostics_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUA0","description":"ICD-EDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF0","description":"ICD-GDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0483U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","description":"CPT-0483U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9973","description":"Extrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscopy_ with or without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39400","description":"Mediastinoscopy_ with or without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37242","description":"Vasc embolize/occlude artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treated water per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4714","description":"Treated water per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5D","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86805","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQB0","description":"ICD-LFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB1","description":"ICD-AGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs cranial lesion simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61796","description":"Srs cranial lesion simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE1","description":"ICD-PLYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLA0","description":"ICD-NKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKID1","description":"ICD-MKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee lift loop drop lock rin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2492","description":"Knee lift loop drop lock rin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC46","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behav chng smoking > 10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99407","description":"Behav chng smoking > 10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVB1","description":"ICD-KDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC0","description":"ICD-FENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8633","description":"Pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/replace penis prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54410","description":"Remove/replace penis prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0966T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","description":"CPT-0966T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28I","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC1","description":"ICD-HHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFE1","description":"ICD-GEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLC0","description":"ICD-EFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE1","description":"ICD-EHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLE0","description":"ICD-OHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaccina ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90393","description":"Vaccina ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABB0","description":"ICD-JABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech lang goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9175","description":"Speech lang goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt simple w/o comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77520","description":"Proton trmt simple w/o comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC1","description":"ICD-GHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHF0","description":"ICD-NEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA1","description":"ICD-CBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJD0","description":"ICD-KCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA1","description":"ICD-OGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD131","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx gastro intub w/asp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43753","description":"Tx gastro intub w/asp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self care goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8988","description":"Self care goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal application device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7034","description":"Nasal application device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF1","description":"ICD-CFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin buttck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15835","description":"Excise excessive skin buttck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90876","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-htn/htn_ no f/u_ not gvn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8952","description":"Pre-htn/htn_ no f/u_ not gvn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep trk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15002","description":"Wound prep trk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98940","description":"Chiropract manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0306U","description":"Oncology (minimal residual disease [MRD])_ next-generation targeted sequencing analysis_ cell-free DNA_ initial (baseline) assessment to determine a patient specific panel for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho frejka cov only pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1610","description":"Ho frejka cov only pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACB1","description":"ICD-OACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF0","description":"ICD-CGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDE1","description":"ICD-KBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31576","description":"Laryngoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Azathioprine parenteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7501","description":"Azathioprine parenteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEA1","description":"ICD-NGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB1","description":"ICD-CGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/irrigate tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68840","description":"Explore/irrigate tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDA1","description":"ICD-AFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0578U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","description":"CPT-0578U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHF1","description":"ICD-GDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; one view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73500","description":"Radiologic examination_ hip_ unilateral; one view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening tests dm done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3754F","description":"Screening tests dm done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE1","description":"ICD-ICAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD0","description":"ICD-FFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Membrane graft or membrane wrap_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4205","description":"Membrane graft or membrane wrap_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28022","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKD0","description":"ICD-GAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percut bx lung/mediastinum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32405","description":"Percut bx lung/mediastinum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC0","description":"ICD-KGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWF1","description":"ICD-PBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove kidney open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50220","description":"Remove kidney open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC1","description":"ICD-NLVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEF1","description":"ICD-MHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA06","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF1","description":"ICD-ICIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME0","description":"ICD-NKME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doppler color flow add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93325","description":"Doppler color flow add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRE0","description":"ICD-PCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOF1","description":"ICD-LIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC1","description":"ICD-NBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA52","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev_ sport/rec/work att","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6704","description":"Term dev_ sport/rec/work att","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63741","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulm function test by gas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94727","description":"Pulm function test by gas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2103","description":"Seven Standard Field Stereoscopic Photos With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0804","description":"HCPCS-C0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE1","description":"ICD-NDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parathyroid planar imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78070","description":"Parathyroid planar imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXB1","description":"ICD-NCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0839T","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (List separately in addition to code for primary proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE1","description":"ICD-EDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUA0","description":"ICD-MHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56751","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c rna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87520","description":"Hepatitis c rna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE0","description":"ICD-MHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Water pressure pad for mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0198","description":"Water pressure pad for mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare embryo for transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89255","description":"Prepare embryo for transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOA1","description":"ICD-OJOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA10","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60240","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Macul result phy/qhp mng dm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5010F","description":"Macul result phy/qhp mng dm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11303","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear medicine therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79999","description":"Nuclear medicine therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7956","description":"guided tissue regeneration_ edentulous area - resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASB1","description":"ICD-CASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF0","description":"ICD-EDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable canister for pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7000","description":"Disposable canister for pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9260","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXB1","description":"ICD-FFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHD0","description":"ICD-NGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKB0","description":"ICD-FHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84144","description":"Assay of progesterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA0","description":"ICD-MLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA1","description":"ICD-OKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE0","description":"ICD-BGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUD0","description":"ICD-OBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB1","description":"ICD-KGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1930","description":"Afo plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","description":"CPT-64567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair corporeal tear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54437","description":"Repair corporeal tear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture typing added method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87158","description":"Culture typing added method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4019","description":"Cast sup lng arm splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture groin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35132","description":"Repair artery rupture groin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE1","description":"ICD-JCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC0","description":"ICD-KHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35311","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deli/install chrg hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1600","description":"Deli/install chrg hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE0","description":"ICD-LIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAC0","description":"ICD-MDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0476T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording_ data scanning_ with raw electronic signal transfer of data and storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulm fx w/in 12 mon b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3038F","description":"Pulm fx w/in 12 mon b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90694","description":"Influenza Virus Vaccine_ Quadrivalent (Aiiv4)_ Inactivated_ Adjuvanted_ Preservative Free_ 0.5 Ml Dosage_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other specified case mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9012","description":"Other specified case mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc acc_ lith-based battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2397","description":"Pwc acc_ lith-based battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam pelvic limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76857","description":"Us exam pelvic limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF0","description":"ICD-AITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAC0","description":"ICD-IGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cromolyn sodium comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7632","description":"Cromolyn sodium comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKC1","description":"ICD-JGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21172","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0354U","description":"Human papilloma virus (HPV)_ high-risk types (ie_ 16_ 18_ 31_ 33_ 45_ 52 and 58) qualitative mRNA expression of E6/E7 by quantitative polymerase chain reaction (qPCR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9758","description":"Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrial Shunt Or Placebo Control_ Including Right Heart Catheterization_ Trans-Esophag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81352","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Targeted Sequence Analysis (Eg_ 4 Oncology)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIF1","description":"ICD-CFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMF0","description":"ICD-MGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB33","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMD0","description":"ICD-MEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC1","description":"ICD-MHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy w/rf delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0288T","description":"Anoscopy w/rf delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFC0","description":"ICD-FIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOA1","description":"ICD-GIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37299","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","description":"CPT-37299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortobi-iliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35538","description":"Art byp grft aortobi-iliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJC1","description":"ICD-NCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0525","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","description":"HCPCS-J0525","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smear fluorescent/acid stai","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87206","description":"Smear fluorescent/acid stai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0682U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682U","description":"CPT-0682U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMD0","description":"ICD-ADMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90669","description":"Pneumococcal conjugate vaccine_ polyvalent_ for children under 5 years_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC1","description":"ICD-PCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0589U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","description":"CPT-0589U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0505U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","description":"CPT-0505U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37140","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA1","description":"ICD-KGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE1","description":"ICD-NFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA0","description":"ICD-DGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQA1","description":"ICD-HDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins tun ip cath for dial opn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49421","description":"Ins tun ip cath for dial opn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATD0","description":"ICD-CATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE1","description":"ICD-OKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF1","description":"ICD-PAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA1","description":"ICD-KCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0536","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","description":"HCPCS-G0536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0154U","description":"Oncology (urothelial cancer)_ RNA_ analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie_ p.R248C [c.742C>T]_ p.S249C [c.746C>G]_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dmd dup/delet analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81161","description":"Dmd dup/delet analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE0","description":"ICD-FBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUA1","description":"ICD-IFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA0","description":"ICD-KEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRD0","description":"ICD-GIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUD0","description":"ICD-NBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF0","description":"ICD-JIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWF1","description":"ICD-DAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PSYC GEN ALYS PANEL 14 GENES","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0173U","description":"PSYC GEN ALYS PANEL 14 GENES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9983","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES325","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC0","description":"ICD-OLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQC0","description":"ICD-KGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE1","description":"ICD-FHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA1","description":"ICD-EIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB105","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA0","description":"ICD-CHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA0","description":"ICD-GCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5962","description":"Below knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUF1","description":"ICD-MBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISC0","description":"ICD-CISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66630","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urethra abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53040","description":"Drainage of urethra abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28140","description":"Removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGD1","description":"ICD-GGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKF0","description":"ICD-FIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC1","description":"ICD-ECLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Moving Expenses)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7333","description":"Community Transition Svcs (Moving Expenses)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33858","description":"Ascending Aorta Graft_ With Cardiopulmonary Bypass_ Includes Valve Suspension_ When Performed; For Aortic Dissection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369T","description":"Adaptive behavior treatment with protocol modification administered by physician or other qualified health care professional with one patient; each additional 30 minutes of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25035","description":"Treat forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of creatinine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82565","description":"Assay of creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise mandible lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21040","description":"Excise mandible lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD0","description":"ICD-MKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEE1","description":"ICD-IAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD135","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA0","description":"ICD-CCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toc tool incl elem not used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9658","description":"Toc tool incl elem not used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef adult fluids and electro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4102","description":"Ef adult fluids and electro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC105","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABB0","description":"ICD-KABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB32","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBA1","description":"ICD-JFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gum tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41830","description":"Removal of gum tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAD0","description":"ICD-KAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA0","description":"ICD-BCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB0","description":"ICD-GEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467U","description":"Oncology (bladder)_ DNA_ next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy_ urine_ algorithms reported as minimal residual disease (MRD) status positive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF0","description":"ICD-OCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIID0","description":"ICD-CIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE206","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEA1","description":"ICD-GEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62190","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20600","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of iliopsoas muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27111","description":"Transfer of iliopsoas muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC0","description":"ICD-GAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHID1","description":"ICD-FHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1C","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMF0","description":"ICD-FBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA0","description":"ICD-NIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHE1","description":"ICD-EGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC104","description":"Special Care High _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPC0","description":"ICD-NDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF0","description":"ICD-ABCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21348","description":"Opn tx nasomax fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMC0","description":"ICD-KEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial cervical orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0112","description":"Cranial cervical orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE0","description":"ICD-JDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGD1","description":"ICD-KBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF0","description":"ICD-KBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1032T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1032T","description":"CPT-1032T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD0","description":"ICD-IGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTC0","description":"ICD-ECTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment jacket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6509","description":"Compres burn garment jacket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES326","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98975","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Initial Set-Up And Patient Education On Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA31","description":"ICD-3KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asth not controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9434","description":"Asth not controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC1","description":"ICD-OKCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGD0","description":"ICD-OAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHND0","description":"ICD-FHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUB0","description":"ICD-MCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBC0","description":"ICD-GCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1295","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto in fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88174","description":"Cytopath c/v auto in fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8856","description":"Ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70542","description":"MRI orbit/face/neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB1","description":"ICD-CDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRD1","description":"ICD-GFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bpci home visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9187","description":"Bpci home visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF1","description":"ICD-GDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPC1","description":"ICD-KEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99242","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levetiracetam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1953","description":"Levetiracetam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA1","description":"ICD-GBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniowrap2_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4221","description":"Amniowrap2_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB1","description":"ICD-BAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVC1","description":"ICD-JFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC1","description":"ICD-KGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0643U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0643U","description":"CPT-0643U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply srs headframe add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61800","description":"Apply srs headframe add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE0","description":"ICD-JCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBE1","description":"ICD-JGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15738","description":"Muscle-skin graft leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC0","description":"ICD-FCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEB0","description":"ICD-NHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQC0","description":"ICD-LCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD0","description":"ICD-BAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATA0","description":"ICD-EATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97155","description":"Adaptive behavior treatment with protocol modification_ administered by physician or other qualified health care professional_ which may include simultaneous direction of tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63197","description":"Incise spine&cord 2 trx thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0C","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMB1","description":"ICD-OJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dinutuximab_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1246","description":"Injection_ dinutuximab_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36473","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; first vein treated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening pregabalin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80366","description":"Drug screening pregabalin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for tobacco use_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9905","description":"Patient not screened for tobacco use_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair ing hernia blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49521","description":"Rerepair ing hernia blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF0","description":"ICD-OLXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65130","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWB0","description":"ICD-CAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43632","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL20","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Segmental pneumatic chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0657","description":"Segmental pneumatic chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9441","description":"Asthma education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB1","description":"ICD-OADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1015","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPF0","description":"ICD-KIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDD1","description":"ICD-FEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence garment anytype","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4520","description":"Incontinence garment anytype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD1","description":"ICD-FHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB0","description":"ICD-KBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB0","description":"ICD-FFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28H","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE0","description":"ICD-AHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6086","description":"Implant Supported Crown - Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26755","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJA1","description":"ICD-JAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA226","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB0","description":"ICD-GIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med trng & support per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0034","description":"Med trng & support per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53660","description":"Dilation of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX52","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE1","description":"ICD-KGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0503","description":"HCPCS-B0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC0","description":"ICD-CCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst metastic/ recur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9075","description":"Onc dx brst metastic/ recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doxorubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9000","description":"Doxorubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91316","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ bivalent_ preservative free_ 10 mcg/0.2 mL dosa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt cran bone flap to abdo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61316","description":"Implt cran bone flap to abdo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKE1","description":"ICD-JAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCA0","description":"ICD-GGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVC1","description":"ICD-KDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES104","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD0","description":"ICD-LBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43338","description":"Esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein six or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33516","description":"Cabg vein six or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv rna vrl ldnot85y no hx colo ca/rsn scope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9659","description":">85y no hx colo ca/rsn scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD1","description":"ICD-PHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl skn surf brachytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77768","description":"Hdr rdncl skn surf brachytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA1","description":"ICD-JBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subs eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1121F","description":"Subs eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0296","description":"Hosp bed total elect w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWD0","description":"ICD-PEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remis 12m phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9509","description":"Remis 12m phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD1","description":"ICD-BBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVC0","description":"ICD-FHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD0","description":"ICD-GIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC1","description":"ICD-OGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBC1","description":"ICD-OGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag rigid frame cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0632","description":"Lso sag rigid frame cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF1","description":"ICD-OEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF0","description":"ICD-CFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0205","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0205","description":"CDT-D0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC0","description":"ICD-OBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTD1","description":"ICD-NHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rotavirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86759","description":"Rotavirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRC1","description":"ICD-LFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01390","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","description":"CPT-01390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD1","description":"ICD-HDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0659T","description":"Transcatheter intracoronary infusion of supersaturated oxygen in conjunction w/percutaneous coronary revascularization during acute myocardial infarction_ including catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF0","description":"ICD-NAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX60","description":"Medium Rehab plus Extensive_ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD0","description":"ICD-PHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC0","description":"ICD-IAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFB0","description":"ICD-GHFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No knee/ankle joints w/ ft b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5210","description":"No knee/ankle joints w/ ft b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF1","description":"ICD-MGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95984","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA1","description":"ICD-KHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA113","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIF0","description":"ICD-BIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99425","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARE1","description":"ICD-PARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day <2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90967","description":"Esrd home pt serv p day <2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB0","description":"ICD-GHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLB0","description":"ICD-NLLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2088","description":"Office-Based Treatment For Opioid Use Disorder_ Including Care Coordination_ Individual Therapy And Group Therapy And Counseling; Each Additional 30 Minutes Beyond The First 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE1","description":"ICD-HEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA03","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF0","description":"ICD-OFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA1","description":"ICD-KGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC1","description":"ICD-HHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA05","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1047","description":"Functional status was measured by the Oxford Knee Score (OKS) patient reported outcome tool within three months preoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHB0","description":"ICD-MAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE1","description":"ICD-OAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0899T","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF)_ derived from augmentative algorithmic analysis of the dataset acquired via contrast cardia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC0","description":"ICD-OINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD0","description":"ICD-FHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC26","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD217","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62327","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC0","description":"ICD-JGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTF0","description":"ICD-GFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB0","description":"ICD-NJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0616U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","description":"CPT-0616U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF0","description":"ICD-JIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLF1","description":"ICD-KBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nikaidoh proc w/ostia implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33783","description":"Nikaidoh proc w/ostia implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF1","description":"ICD-OCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vit for macular pucker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67041","description":"Vit for macular pucker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB13B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0090","description":"Interest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE1","description":"ICD-GGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor pancreas/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48552","description":"Prep donor pancreas/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32506","description":"Wedge resect of lung add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00796","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","description":"CPT-00796","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJC0","description":"ICD-BCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDME1","description":"ICD-IDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pca3 testing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3721","description":"Pca3 testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWC1","description":"ICD-ODWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEB1","description":"ICD-CCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDF1","description":"ICD-MIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab porc/ceram crown pri","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2929","description":"Prefab porc/ceram crown pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWA0","description":"ICD-KGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99492","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1130","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX03","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33902","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE1","description":"ICD-NAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUE0","description":"ICD-AHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEB0","description":"ICD-MEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD1","description":"ICD-NIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTD0","description":"ICD-NKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF1","description":"ICD-GHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80350","description":"Cannabinoids synthetic 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35103","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytp dx eval fna 1st ea site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88172","description":"Cytp dx eval fna 1st ea site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64708","description":"Revise arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX35","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA1","description":"ICD-BEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange dirprobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81341","description":"Trb@ gene rearrange dirprobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA0","description":"ICD-BHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKA1","description":"ICD-NFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD0","description":"ICD-OASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","description":"CPT-98009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC0","description":"ICD-PFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF1","description":"ICD-PJQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2045","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","description":"HCPCS-A2045","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAE1","description":"ICD-MKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Autosomal Dominant Thromboc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269U","description":"Hematology (autosomal dominant congenital thrombocytopenia)_ genomic sequence analysis of 14 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Autosomal Dominant Thromboc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICB1","description":"ICD-AICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC0","description":"ICD-BFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toilet rail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0243","description":"Toilet rail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE0","description":"ICD-CCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPC0","description":"ICD-NJPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3028F","description":"O2 saturation doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00834","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","description":"CPT-00834","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJE0","description":"ICD-FAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB1","description":"ICD-PBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA0","description":"ICD-BDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB50","description":"Ultra High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko immob canvas long pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1830","description":"Ko immob canvas long pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2101","description":"HCPCS-A2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3425","description":"Root surgery molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAC0","description":"ICD-BAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic sgd interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2351","description":"Electronic sgd interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIE0","description":"ICD-BEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCA1","description":"ICD-BFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD1","description":"ICD-BGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorp drg >48 suc pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0746","description":"Absorp drg >48 suc pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 29-31 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2266","description":"Induced abortion 29-31 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF1","description":"ICD-KHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30410","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFB1","description":"ICD-FFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE1","description":"ICD-OIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXD0","description":"ICD-KBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPE0","description":"ICD-CGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME0","description":"ICD-KFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostate biopsy_ any mthd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0416","description":"Prostate biopsy_ any mthd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Single lens spectacle mount","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2610","description":"Single lens spectacle mount","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME0","description":"ICD-CDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE1","description":"ICD-MBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPE1","description":"ICD-KIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap ileo/jejuno-stomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44187","description":"Lap ileo/jejuno-stomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF0","description":"ICD-CAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITB0","description":"ICD-GITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Misc dialysis supplies noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4913","description":"Misc dialysis supplies noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system liquid station","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0440","description":"Oxygen system liquid station","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB1","description":"ICD-ICAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9035","description":"Injection_ aripiprazole lauroxil (Aristada Initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF1","description":"ICD-GGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC0","description":"ICD-LCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE1","description":"ICD-MLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFE1","description":"ICD-BHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43123","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92538","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD1","description":"ICD-KIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00454","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","description":"CPT-00454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA1","description":"ICD-MFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bamlanivimab_ 700 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0239","description":"Bamlanivimab_ 700 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJE0","description":"ICD-CDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVF1","description":"ICD-OFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC1","description":"ICD-KGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGA0","description":"ICD-NAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4347","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","description":"HCPCS-Q4347","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA0","description":"ICD-CBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA1","description":"ICD-CGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1176","description":"Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC0","description":"ICD-KCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNA0","description":"ICD-GHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYF0","description":"ICD-LDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA0","description":"ICD-BCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHC0","description":"ICD-OAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62194","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE1","description":"ICD-ODUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE0","description":"ICD-BFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBD0","description":"ICD-FBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB1","description":"ICD-GIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC1","description":"ICD-KBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC21","description":"ICD-1LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF1","description":"ICD-HGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA0","description":"ICD-KGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF0","description":"ICD-DCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESC0","description":"ICD-DESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate inf turbinate superf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30801","description":"Ablate inf turbinate superf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITF1","description":"ICD-IITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA0","description":"ICD-OKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stress tte only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93350","description":"Stress tte only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25455","description":"Revision of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9562","description":"Home injectable therapy_ palivizumab_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2042","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","description":"HCPCS-A2042","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE1","description":"ICD-OFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1001","description":"Electronic Positional Obstructive Sleep Apnea Treatment_ With Sensor_ Includes All Components And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXC0","description":"ICD-CEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020M","description":"Oncology (central nervous system)_ analysis of 30000 DNA methylation loci by methylation array_ utilizing DNA extracted from tumor tissue_ diagnostic algorithm reported as pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36470","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26428","description":"Repair/graft finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID0","description":"ICD-CHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF1","description":"ICD-DDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVD0","description":"ICD-OGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX23","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF0","description":"ICD-OFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVF0","description":"ICD-KGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCD0","description":"ICD-ECCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14B","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES306","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFB0","description":"ICD-FEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD1","description":"ICD-MEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1802","description":"HCPCS-A1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Positional change of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26555","description":"Positional change of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dynamic standing frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0642","description":"Dynamic standing frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA0","description":"ICD-KCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEF0","description":"ICD-CAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB0","description":"ICD-OAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no min inv dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8876","description":"Doc reas no min inv dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8B","description":"Very High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA0","description":"ICD-AIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA0","description":"ICD-NLPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DA31","description":"ICD-4DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9741","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90750","description":"Zoster (shingles) vaccine (HZV)_ recombinant_ sub-unit_ adjuvanted_ for intramuscular injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF0","description":"ICD-FDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE1","description":"ICD-FICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF0","description":"ICD-NFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADB0","description":"ICD-EADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthr0 w/synovectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29863","description":"Hip arthr0 w/synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB0","description":"ICD-GIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJF0","description":"ICD-JEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13C","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPA0","description":"ICD-NIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0073U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D7-2D6 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Omalizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2357","description":"Omalizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYE0","description":"ICD-OFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC25","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTF1","description":"ICD-IDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28C","description":"Special Care High _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPF1","description":"ICD-KBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD0","description":"ICD-GBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj secretin synthetic human","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2850","description":"Inj secretin synthetic human","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB0","description":"ICD-OBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC0","description":"ICD-KARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Thrombosis Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278U","description":"Hematology (genetic thrombosis)_ genomic sequence analysis of 12 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Thrombosis Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo remove w/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50548","description":"Laparo remove w/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA1","description":"ICD-EAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRC0","description":"ICD-KDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC1","description":"ICD-EDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mh clubhouse svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2031","description":"Mh clubhouse svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE0","description":"ICD-OETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC1","description":"ICD-DEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB0","description":"ICD-FGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUE1","description":"ICD-IHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA0","description":"ICD-OKRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0617","description":"Hospital Special Treatment Room Support Component (Hstrsc) Laser Surgical Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRA1","description":"ICD-DIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3d render w/intrp postproces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76376","description":"3d render w/intrp postproces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxytetracycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2460","description":"Oxytetracycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86258","description":"Gliadin (Deamidated) (Dgp) Antibody_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentur repr broken compl bas","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5510","description":"Dentur repr broken compl bas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF1","description":"ICD-OCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32668","description":"Thoracoscopy w/w resect diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXF1","description":"ICD-BEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC0","description":"ICD-OGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEF1","description":"ICD-KBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9727","description":"Patient unable to complete the FOTO knee intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an adequ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA0","description":"ICD-NDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc fx & test/txmnt for op","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5015F","description":"Doc fx & test/txmnt for op","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB0","description":"ICD-ECEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF1","description":"ICD-OJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC20","description":"Very High Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7539","description":"Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s)_ with insertion of pacing electrode_ cardiac venous system_ for lef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKF1","description":"ICD-FGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63085","description":"Remove vert body dcmprn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAB0","description":"ICD-OGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF1","description":"ICD-OLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE1","description":"ICD-AAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIME1","description":"ICD-CIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYF0","description":"ICD-KDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","description":"HCPCS-Q4399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum over 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49204","description":"Exc abd tum over 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA21","description":"ICD-2LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF0","description":"ICD-KGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD210","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41823","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC234","description":"Clinically Complex _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0650T","description":"Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system_ with iterative adjustment of the implantable device to test the function of the device an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEF1","description":"ICD-MIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40810","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB1","description":"ICD-JGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86325","description":"Other immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA0","description":"ICD-OCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPA0","description":"ICD-CBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVE1","description":"ICD-OLVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6221","description":"Gauze > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq revasc byp graft addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92938","description":"Prq revasc byp graft addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22D","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIF0","description":"ICD-EIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5148","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","description":"HCPCS-Q5148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC150","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lwr xtr vasc stdy bilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93924","description":"Lwr xtr vasc stdy bilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61870","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOC0","description":"ICD-CFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB1","description":"ICD-FIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJC0","description":"ICD-GCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25675","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB0","description":"ICD-JGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5281","description":"Removable partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJB0","description":"ICD-BHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE0","description":"ICD-KEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD141","description":"Clinically Complex _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ chloroprocaine hydrochloride_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2401","description":"Injection_ chloroprocaine hydrochloride_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD0","description":"ICD-JGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy with injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9742","description":"Laryngoscopy with injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC1","description":"ICD-CFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAE1","description":"ICD-KBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB1","description":"ICD-FGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sheath upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8415","description":"Sheath upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0235","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","description":"HCPCS-M0235","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0566T","description":"Autologous Cellular Implant Derived From Adipose Tissue For The Treatment Of Osteoarthritis Of The Knees; Injection Of Cellular Implant Into Knee Joint Including Ultrasound Gu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWC1","description":"ICD-CDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDC0","description":"ICD-JCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB1","description":"ICD-IEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remis 6m w/o 6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9574","description":"Remis 6m w/o 6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF1","description":"ICD-IATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated porcelain/ceramic crown - permanent tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2928","description":"Prefabricated porcelain/ceramic crown - permanent tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUC0","description":"ICD-MIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCE1","description":"ICD-ABCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc a aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4020","description":"Ivf canc a aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGD0","description":"ICD-CBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCA0","description":"ICD-MDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6750","description":"Crown porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMF1","description":"ICD-CFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC0","description":"ICD-OJOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/fhd w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21160","description":"Lefort iii w/fhd w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ golodirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1429","description":"Injection_ golodirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58805","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFD0","description":"ICD-CGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAB0","description":"ICD-BGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIC0","description":"ICD-KEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ single chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1722","description":"Aicd_ single chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDA0","description":"ICD-AGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE0","description":"ICD-KHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOE1","description":"ICD-LIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3D","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2015","description":"Comp comm supp svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6116","description":"Imp/abut fixed dent part max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC1","description":"ICD-CALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye implant material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67120","description":"Remove eye implant material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD104","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31297","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC12","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX51","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAE1","description":"ICD-CIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMC0","description":"ICD-IHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB41","description":"Very High Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA1","description":"ICD-FECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD1","description":"ICD-GDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Athletic train reeval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97006","description":"Athletic train reeval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE0","description":"ICD-JDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRE1","description":"ICD-HBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAF1","description":"ICD-JBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forearm/arm cuffs free motio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3720","description":"Forearm/arm cuffs free motio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGB0","description":"ICD-JAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD1","description":"ICD-GHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEB1","description":"ICD-AAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIE1","description":"ICD-BGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt ed re comp thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4268F","description":"Pt ed re comp thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBF1","description":"ICD-AEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11422","description":"Exc h-f-nk-sp b9+marg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE0","description":"ICD-GFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOF0","description":"ICD-KFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA1","description":"ICD-EGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gr24 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2363","description":"Gr24 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33285","description":"Insertion_ subcutaneous cardiac rhythm monitor_ including programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSF0","description":"ICD-OHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ziv-aflibercept_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9400","description":"Inj_ ziv-aflibercept_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKE0","description":"ICD-OFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0450U","description":"Oncology (multiple myeloma)_ liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ monoclonal paraprotein sequencing analysis_ serum_ results reported as baseline pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID0","description":"ICD-ABID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traction frame attach pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0890","description":"Traction frame attach pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE0","description":"ICD-EAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRE0","description":"ICD-KCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKA0","description":"ICD-BIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCE1","description":"ICD-FFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD1","description":"ICD-KDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE1","description":"ICD-BDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF0","description":"ICD-CFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPE1","description":"ICD-OCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1001","description":"Antepartum management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB1","description":"ICD-CAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescrl fuse w/ instr l4/l5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0309T","description":"Prescrl fuse w/ instr l4/l5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOC0","description":"ICD-HEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGID1","description":"ICD-FGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE0","description":"ICD-GAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBND0","description":"ICD-FBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDE1","description":"ICD-MHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC1","description":"ICD-ACCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID1","description":"ICD-JFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD1","description":"ICD-KGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF1","description":"ICD-NDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVD0","description":"ICD-OFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVE0","description":"ICD-OEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEC1","description":"ICD-IAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90965","description":"Esrd home pt serv p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert and remove bone pin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20650","description":"Insert and remove bone pin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC1","description":"ICD-CEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE1","description":"ICD-MKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5273","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF1","description":"ICD-AIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0010","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRD1","description":"ICD-PLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETA0","description":"ICD-EETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX24","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92020","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB1","description":"ICD-ICMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC1","description":"ICD-OHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOA0","description":"ICD-CIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA0","description":"ICD-NLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6541","description":"Gc stocking waistlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of neonatal thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84437","description":"Assay of neonatal thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81257","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; common deletions or variant (eg_ Southeast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band >=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6450","description":"Lt compres band >=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASE1","description":"ICD-KASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9887","description":"Behavioral counseling for diabetes prevention_ distance learning_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIF1","description":"ICD-GCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0107","description":"Stroke with Motor >26.15 & Motor <30.05._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28G","description":"Special Care High _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40530","description":"Partial removal of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81177","description":"ATN1 (atrophin 1) (eg_ dentatorubral-pallidoluysian atrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37274","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","description":"CPT-37274","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMB0","description":"ICD-JDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD0","description":"ICD-JBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Talk pt/crgvr re areds prev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4177F","description":"Talk pt/crgvr re areds prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECF0","description":"ICD-AECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA0","description":"ICD-OFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJC1","description":"ICD-KDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMA1","description":"ICD-KBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF0","description":"ICD-MJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIF1","description":"ICD-OIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUA1","description":"ICD-FAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8I","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB1","description":"ICD-GHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF0","description":"ICD-JBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9145","description":"Injection_ daratumumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93591","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA1","description":"ICD-GAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiaxial ankle w dorsiflex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5968","description":"Multiaxial ankle w dorsiflex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGC1","description":"ICD-GIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB21C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD0","description":"ICD-OBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound srfc culturetech used","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4260F","description":"Wound srfc culturetech used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVB1","description":"ICD-GEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35901","description":"Excision graft neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOF1","description":"ICD-GIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF0","description":"ICD-KGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pedicle e/n/e/l/ntroral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15576","description":"Pedicle e/n/e/l/ntroral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev modifier wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6805","description":"Term dev modifier wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vaccine adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90632","description":"Hepa vaccine adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDD0","description":"ICD-FIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2155","description":"Patient Had History Of At Least One Of The Following Contraindications Any Time During Or Before The Measurement Period: Anaphylaxis Due To Tdap Vaccine_ Anaphylaxis Due To Td","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD0","description":"ICD-BEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/dye_ upper extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8934","description":"Mra_ w/dye_ upper extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apc gene dup/delet variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81203","description":"Apc gene dup/delet variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJF0","description":"ICD-OBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKD1","description":"ICD-JAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placement bile duct support","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47801","description":"Placement bile duct support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9291","description":"Not nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G3002","description":"Chronic pain management and treatment_ monthly bundle including_ diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF0","description":"ICD-FFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD1","description":"ICD-AFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF0","description":"ICD-KBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF1","description":"ICD-OCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21461","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSA1","description":"ICD-KGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0602","description":"Manual breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0664","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","description":"HCPCS-G0664","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA1","description":"ICD-NKVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE0","description":"ICD-KAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Capecitabine_ oral_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8521","description":"Capecitabine_ oral_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEA1","description":"ICD-KGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD0","description":"ICD-KCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01150","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","description":"CPT-01150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2096","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Was Not Prescribed_ Reason Not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex h rate sz 30+ day ri only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0386T","description":"Ex h rate sz 30+ day ri only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icg angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92240","description":"Icg angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65865","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF0","description":"ICD-KCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA1","description":"ICD-OHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEE1","description":"ICD-EHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22C","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407T","description":"Nasal endoscopy_ surgical_ ethmoid sinus_ placement of drug eluting implant; with biopsy_ polypectomy or debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE1","description":"ICD-NJKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE1","description":"ICD-BBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDD1","description":"ICD-IBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENC1","description":"ICD-FENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43334","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC1","description":"ICD-NJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF1","description":"ICD-OGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB0","description":"ICD-CGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC154","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE1","description":"ICD-BGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA1","description":"ICD-KAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAB1","description":"ICD-CDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB1","description":"ICD-JGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVB0","description":"ICD-OHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58322","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth penis nodes removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93651","description":"Anesth penis nodes removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB26","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD0","description":"ICD-BDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trcath replace aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33366","description":"Trcath replace aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB0","description":"ICD-KCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Canakinumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0638","description":"Canakinumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHB0","description":"ICD-MIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9021","description":"Injection_ Asparaginase_ Recombinant_ (Rylaze)_ 0.1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transab or transvag us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8806","description":"Transab or transvag us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC23","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB1","description":"ICD-BBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDF1","description":"ICD-OJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB0","description":"ICD-KGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19271","description":"Revision of chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD0","description":"ICD-CFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not medically necessary svc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9986","description":"Not medically necessary svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76965","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF1","description":"ICD-EILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp w/optical endomicroscpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0397T","description":"Ercp w/optical endomicroscpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas no pneumococcal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8866","description":"Doc pt reas no pneumococcal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVD0","description":"ICD-BGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27395","description":"Lengthening of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx dprsd front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21343","description":"Open tx dprsd front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBA1","description":"ICD-GHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8B","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81416","description":"Exome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap ing hernia repair init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49650","description":"Lap ing hernia repair init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part pulp for apexogenesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3222","description":"Part pulp for apexogenesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD1","description":"ICD-CIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC0","description":"ICD-GFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA0","description":"ICD-CEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB1","description":"ICD-CBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLF1","description":"ICD-MJLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB2A","description":"Low Rehab_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/90d mrs >2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9648","description":"Pt w/90d mrs >2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC1","description":"ICD-CGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso s/c shell/panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0639","description":"Lso s/c shell/panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48520","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIF0","description":"ICD-OBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn bilat hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5100","description":"Body-worn bilat hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTD0","description":"ICD-ECTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE105","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC0","description":"ICD-MCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc ob care/deliver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59898","description":"Laparo proc ob care/deliver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE0","description":"ICD-NBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUE1","description":"ICD-IBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD0","description":"ICD-OBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLC1","description":"ICD-GGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXC0","description":"ICD-NCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA1","description":"ICD-ACUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy inject material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52327","description":"Cystoscopy inject material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3244","description":"Injection_ tigecycline (accord) not therapeutically equivalent to j3243_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOF1","description":"ICD-HDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE101","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMB1","description":"ICD-IIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esw wound healing init wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299T","description":"Esw wound healing init wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of etiocholanolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82696","description":"Assay of etiocholanolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC22","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown full high noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6790","description":"Crown full high noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA0","description":"ICD-MJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate epi sz 14 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381T","description":"Ext h rate epi sz 14 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTC1","description":"ICD-JHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cadmium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82300","description":"Assay of cadmium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recement cast or prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2915","description":"Recement cast or prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place ndl musc/tis for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20555","description":"Place ndl musc/tis for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC0","description":"ICD-KBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pos elder mal scrn plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8733","description":"Doc pos elder mal scrn plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motion fluoroscopy/swallow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92611","description":"Motion fluoroscopy/swallow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE0","description":"ICD-BFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF1","description":"ICD-ODLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA20C","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body mass index docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3008F","description":"Body mass index docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABA1","description":"ICD-BABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF1","description":"ICD-OGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF1","description":"ICD-NHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum care only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59425","description":"Antepartum care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIC1","description":"ICD-FFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWA0","description":"ICD-OBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEC1","description":"ICD-MKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD206","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ruptured tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24342","description":"Repair of ruptured tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD0","description":"ICD-KBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95976","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene dup/delet variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81304","description":"Mecp2 gene dup/delet variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family/couple counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1006","description":"Family/couple counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC0","description":"ICD-JHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64712","description":"Revision of sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA1","description":"ICD-BFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0502","description":"HCPCS-A0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA116","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA30","description":"Medium Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXC1","description":"ICD-JDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71271","description":"Computed Tomography_ Thorax_ Low Dose For Lung Cancer Screening_ Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJF0","description":"ICD-JFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intentional replantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3470","description":"Intentional replantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBC1","description":"ICD-MFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED0","description":"ICD-GBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSD1","description":"ICD-PCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4A","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44620","description":"Repair bowel opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5%dextrose/0.45%saline1000ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5013","description":"5%dextrose/0.45%saline1000ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00567","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","description":"CPT-00567","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/lesion removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45384","description":"Colonoscopy w/lesion removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB1","description":"ICD-GFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD1","description":"ICD-GBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRC1","description":"ICD-DGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE1","description":"ICD-PJRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride infected skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11000","description":"Debride infected skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1574","description":"Injection_ ganciclovir sodium (exela) not therapeutically equivalent to j1570_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2 saturation >88%/pao>55 hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3037F","description":"O2 saturation >88%/pao>55 hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9993","description":"Patient Was Provided Pallative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed hvy dty xtra wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0303","description":"Hosp bed hvy dty xtra wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGC1","description":"ICD-CAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"G-esoph reflx tst w/electrod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91035","description":"G-esoph reflx tst w/electrod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF0","description":"ICD-BHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1004T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","description":"CPT-1004T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNB1","description":"ICD-GCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3471","description":"Surgical repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0772T","description":"Virtual reality (VR) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCF1","description":"ICD-ODCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD0","description":"ICD-BDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumophilia ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87278","description":"Legion pneumophilia ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKE1","description":"ICD-KEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA0","description":"ICD-KARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOA1","description":"ICD-PLOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUD0","description":"ICD-NCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD1","description":"ICD-AETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJA0","description":"ICD-FDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOB0","description":"ICD-GAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLC1","description":"ICD-OJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLF0","description":"ICD-GFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC1","description":"ICD-MCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD0","description":"ICD-FCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA0","description":"ICD-EBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC1","description":"ICD-CIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18X","description":"Special Care Low _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB1","description":"ICD-BBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALA1","description":"ICD-CALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF0","description":"ICD-MKTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF1","description":"ICD-OKPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0677","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0677","description":"HCPCS-G0677","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSB1","description":"ICD-OKSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87809","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; adenovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex remove fb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43215","description":"Esophagoscopy flex remove fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Omnicardiogram/cardiointegra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9025","description":"Omnicardiogram/cardiointegra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise lesion testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54512","description":"Excise lesion testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bendamustine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9033","description":"Bendamustine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD0","description":"ICD-AHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home infusion each addtl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99602","description":"Home infusion each addtl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKC1","description":"ICD-NFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTB0","description":"ICD-FGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD1","description":"ICD-LARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC0","description":"ICD-MBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA26","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 4 visits p mo <2yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90951","description":"Esrd serv 4 visits p mo <2yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96936","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD0","description":"ICD-CHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93224","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft iliofemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35565","description":"Art byp grft iliofemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17283","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB0","description":"ICD-JCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA0","description":"ICD-MFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB0","description":"ICD-MEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0987T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","description":"CPT-0987T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aud rehab postling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92633","description":"Aud rehab postling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD155","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNC1","description":"ICD-CBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB1","description":"ICD-ODUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA0","description":"ICD-NGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRC1","description":"ICD-PLRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0516U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","description":"CPT-0516U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBE0","description":"ICD-BDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pessary_ non rubber_any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4562","description":"Pessary_ non rubber_any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gs mg intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9237","description":"Gs mg intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65426","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXD0","description":"ICD-KFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA1","description":"ICD-OBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9370","description":"Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00873","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","description":"CPT-00873","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2171","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ using magnetic-guided arterial and venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md recertification hha pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0179","description":"Md recertification hha pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF1","description":"ICD-CGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","description":"HCPCS-M1426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA212","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyoscyamine sulfate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1980","description":"Hyoscyamine sulfate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93898","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","description":"CPT-93898","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE0","description":"ICD-CCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHD0","description":"ICD-BIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITB1","description":"ICD-IITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43757","description":"Dx duod intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMF1","description":"ICD-IEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA1","description":"ICD-ADAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ clevidipine butyrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9248","description":"Inj_ clevidipine butyrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA0","description":"ICD-ACMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA13","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1308","description":"Influenza immunization was not administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDD0","description":"ICD-GHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99454","description":"Remote monitoring of physiologic parameter(s) (eg_ weight_ blood pressure_ pulse oximetry_ respiratory flow rate)_ initial; device(s) supply with daily recording(s) or program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9321","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95249","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment_ sensor placement_ hook-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC1","description":"ICD-NEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35022","description":"Repair artery rupture chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF1","description":"ICD-KAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44376","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXF0","description":"ICD-NGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA1","description":"ICD-JAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0571U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","description":"CPT-0571U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Voice amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8510","description":"Voice amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 10-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88273","description":"Cytogenetics 10-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch supp premold metat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3050","description":"Foot arch supp premold metat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add standard toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3550","description":"O shoe add standard toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure ureter/bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50930","description":"Closure ureter/bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC0","description":"ICD-MLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTB0","description":"ICD-AFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVF1","description":"ICD-ODVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m depreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9536","description":"Tc99m depreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj desmopressin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2597","description":"Inj desmopressin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61558","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Youth size brief/diaper","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4533","description":"Youth size brief/diaper","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt nf per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94004","description":"Vent mgmt nf per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA0","description":"ICD-NCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB215","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sio panel custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0624","description":"Sio panel custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1011","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGE0","description":"ICD-BFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIA1","description":"ICD-MAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQA1","description":"ICD-PFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63172","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLC0","description":"ICD-JDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of toe lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28108","description":"Removal of toe lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKE0","description":"ICD-OBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUA1","description":"ICD-BFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE0","description":"ICD-FBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA1","description":"ICD-OJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXD0","description":"ICD-NBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF1","description":"ICD-KCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE0","description":"ICD-NKFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD1","description":"ICD-KCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC1","description":"ICD-ADBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manipulat palm cord post inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26341","description":"Manipulat palm cord post inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86051","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fev<60% pred & copd sym","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8924","description":"Fev<60% pred & copd sym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31360","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91051","description":"Anesth bladder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE124","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thaw preserved stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38208","description":"Thaw preserved stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj growth horm diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9558","description":"Ht inj growth horm diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILF0","description":"ICD-CILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB1","description":"ICD-AFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carbon graphite lamination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2755","description":"Carbon graphite lamination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF1","description":"ICD-MKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF0","description":"ICD-CEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB0","description":"ICD-IALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA0","description":"ICD-HIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1303","description":"HCPCS-B1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sensory integration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97533","description":"Sensory integration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFA1","description":"ICD-NGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIE0","description":"ICD-IAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC1","description":"ICD-EFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bath/shower chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0240","description":"Bath/shower chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUD0","description":"ICD-MKUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95060","description":"Eye allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBF1","description":"ICD-BBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1154","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB0","description":"ICD-GEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak flex inner socket ext fra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5651","description":"Ak flex inner socket ext fra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnt pain noted pain prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1125F","description":"Amnt pain noted pain prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD0","description":"ICD-IBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACB0","description":"ICD-JACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAC0","description":"ICD-OKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal invas px w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59897","description":"Fetal invas px w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEC1","description":"ICD-KCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA0","description":"ICD-ODNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUD0","description":"ICD-BCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20B","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJD0","description":"ICD-FAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgigraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4183","description":"Surgigraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80143","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMC0","description":"ICD-GHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ intra echocardiography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1759","description":"Cath_ intra echocardiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE1","description":"ICD-MICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00880","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","description":"CPT-00880","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC1","description":"ICD-MBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid >","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4178","description":"Parenteral sol amino acid >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC1","description":"ICD-KACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC1","description":"ICD-KFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB1","description":"ICD-CFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of hemosiderin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83070","description":"Assay of hemosiderin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF0","description":"ICD-LEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID0","description":"ICD-JGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2141","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indic for head ct not valid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9533","description":"Indic for head ct not valid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF0","description":"ICD-GGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARD0","description":"ICD-PARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA03","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thor rib belt custom fabrica","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0220","description":"Thor rib belt custom fabrica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15B","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB1","description":"ICD-NITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNC1","description":"ICD-GBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA1","description":"ICD-OLNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXF1","description":"ICD-CAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF0","description":"ICD-FHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIC0","description":"ICD-JDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous laser 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36478","description":"Endovenous laser 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33660","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD0","description":"ICD-GGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA0","description":"ICD-CIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE11A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB31","description":"High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No conformal radn thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4182F","description":"No conformal radn thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB0","description":"ICD-FDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYA1","description":"ICD-GIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD1","description":"ICD-NFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complex body section x-rays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76102","description":"Complex body section x-rays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj unspecified therapy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7899","description":"Tmj unspecified therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEB0","description":"ICD-BFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC0","description":"ICD-GCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87850","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Neisseria gonorrhoeae","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB36","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB1","description":"ICD-MJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCA0","description":"ICD-FFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Memory d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9170","description":"Memory d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLA0","description":"ICD-NHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE1","description":"ICD-OIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi blw low param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8418","description":"Calc bmi blw low param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso r fram soft ant pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0466","description":"Tlso r fram soft ant pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBA1","description":"ICD-FBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF1","description":"ICD-KHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTF0","description":"ICD-JGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj trigeminal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64400","description":"N block inj trigeminal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVA0","description":"ICD-BFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE1","description":"ICD-OJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1036","description":"Supplies and accessories (e.g._ transducer) for low frequency ultrasonic diathermy treatment device_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC1","description":"ICD-NHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBC1","description":"ICD-MGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF1","description":"ICD-JCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX33","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tear ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68700","description":"Repair tear ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Es sph augmnt device removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0393T","description":"Es sph augmnt device removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKD0","description":"ICD-NDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78433","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Combined Perfusion With Metabolic Evaluation Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDF1","description":"ICD-ADDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porcelin 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2642","description":"Dental onlay porcelin 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leflunomide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80193","description":"Leflunomide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOB1","description":"ICD-OHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urea nitrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84520","description":"Assay of urea nitrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA0","description":"ICD-CHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA15","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC1","description":"ICD-EADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA221","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA21","description":"ICD-2HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE1","description":"ICD-OKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7500","description":"Debridement_ bone including epidermis_ dermis_ subcutaneous tissue_ muscle and/or fascia_ if performed_ first 20 sq cm or less with manual preparation and insertion of deep (e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKF1","description":"ICD-NIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bicarbonate conc pow per pac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4707","description":"Bicarbonate conc pow per pac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOA1","description":"ICD-GGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup gauntlet plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4013","description":"Cast sup gauntlet plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release muscles of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26593","description":"Release muscles of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVA1","description":"ICD-KEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC146","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXB1","description":"ICD-BBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hern recur comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49657","description":"Lap inc hern recur comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL53","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9258","description":"Injection_ paclitaxel protein-bound particles (teva) not therapeutically equivalent to j9264_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1004","description":"HCPCS-A1004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophys map 3d add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93613","description":"Electrophys map 3d add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1404","description":"HCPCS-B1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD1","description":"ICD-BCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prost cncr rsk not lw/md/hgh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3274F","description":"Prost cncr rsk not lw/md/hgh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy vag method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58145","description":"Myomectomy vag method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth/nose fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30600","description":"Repair mouth/nose fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIB0","description":"ICD-EFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD1","description":"ICD-NHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harness chest/shlder saddle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6672","description":"Harness chest/shlder saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWD0","description":"ICD-PKWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD1","description":"ICD-ODAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77431","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61522","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVC1","description":"ICD-BAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92004","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cont airway pressure device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0601","description":"Cont airway pressure device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42408","description":"Excision of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urea-n clearance test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84545","description":"Urea-n clearance test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPE0","description":"ICD-KHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHC0","description":"ICD-BDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETD0","description":"ICD-OETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0529T","description":"Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQF0","description":"ICD-OLQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDE0","description":"ICD-EDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ pmkr_ other than trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1898","description":"Lead_ pmkr_ other than trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19350","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise lumb artif disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0165T","description":"Revise lumb artif disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA0","description":"ICD-ACLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWD0","description":"ICD-KBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFE1","description":"ICD-NLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of corneal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65450","description":"Treatment of corneal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD220","description":"Reduced Physical Function _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC1","description":"ICD-CIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE130","description":"Special Care Low _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWF1","description":"ICD-HAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdtrans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0248","description":"Hdtrans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFF1","description":"ICD-JAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF0","description":"ICD-FHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of rbc pg6d enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84085","description":"Assay of rbc pg6d enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9991","description":"Injection_ buprenorphine extended-release (Sublocade)_ less than or equal to 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54105","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t1no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9077","description":"Onc dx prostate t1no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoprostenol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1325","description":"Epoprostenol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD135","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB1","description":"ICD-CENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0039U","description":"Deoxyribonucleic acid (DNA) antibody_ double stranded_ high avidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA1","description":"ICD-OIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA240","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD1","description":"ICD-KFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFE1","description":"ICD-NDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE1","description":"ICD-OGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray exam of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74210","description":"Contrst x-ray exam of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQC1","description":"ICD-DBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQB0","description":"ICD-GFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA10","description":"High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC0","description":"ICD-FBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCE0","description":"ICD-FGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7740","description":"Clsd reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25695","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNA1","description":"ICD-BDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection glatiramer acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1595","description":"Injection glatiramer acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46900","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temp obturator prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5936","description":"Temp obturator prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA1","description":"ICD-FFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL45","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient glove","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8427","description":"Ready gradient glove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom breast prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8035","description":"Custom breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj common digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64632","description":"N block inj common digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach pros cleaning device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8513","description":"Trach pros cleaning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12C","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63662","description":"Remove spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAF0","description":"ICD-IHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73723","description":"MRI joint lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Airway inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94640","description":"Airway inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIF0","description":"ICD-KHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD1","description":"ICD-OFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45114","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD0","description":"ICD-IDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE1","description":"ICD-OHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99457","description":"Remote physiologic monitoring treatment management services_ 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Morphine sulfate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2270","description":"Morphine sulfate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0635T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast_ Followed By Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70015","description":"Contrast x-ray of brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRC0","description":"ICD-KGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPF1","description":"ICD-BCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPA1","description":"ICD-BHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD1","description":"ICD-ODSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDA0","description":"ICD-JDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUE1","description":"ICD-IGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81329","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg_ carrier testing)_ includes SMN2 (survival of motor neur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9933","description":"Adenoma(s) or colorectal cancer detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAA0","description":"ICD-BBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","description":"HCPCS-J7521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXA0","description":"ICD-CAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBE0","description":"ICD-OCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43192","description":"Esophagoscp rig trnso inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJB1","description":"ICD-OHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED1","description":"ICD-JFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA0","description":"ICD-IGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0443U","description":"Neurofilament light chain (NfL)_ ultra-sensitive immunoassay_ serum or cerebrospinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB1","description":"ICD-JATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair uro sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53449","description":"Repair uro sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32905","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHA0","description":"ICD-IBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAB0","description":"ICD-ICAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC02","description":"High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyzine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3410","description":"Hydroxyzine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQD0","description":"ICD-DGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2113","description":"Patient Receiving >5 Mg Daily Prednisone (Or Equivalent) For Longer Than 6 Months_ And Improvement Or No Change In Disease Activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0701","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0701","description":"CDT-D0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUE0","description":"ICD-EEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47540","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB1","description":"ICD-CIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wedging of clubfoot cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29750","description":"Wedging of clubfoot cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c lateral trunk/hip suppor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0956","description":"W/c lateral trunk/hip suppor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE0","description":"ICD-KCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMC0","description":"ICD-MEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA0","description":"ICD-EBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB0","description":"ICD-OJXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD1","description":"ICD-CIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arm trough each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2209","description":"Arm trough each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUB0","description":"ICD-NKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGME1","description":"ICD-JGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1138","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB105","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC1","description":"ICD-GCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA1","description":"ICD-ODRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0947T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","description":"CPT-0947T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium nitrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1457","description":"Gallium nitrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47538","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath insertion tray w/bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4354","description":"Cath insertion tray w/bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4342","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF1","description":"ICD-FCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50630","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75970","description":"Vascular biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB42","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC0","description":"ICD-KCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA235","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE1","description":"ICD-EFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC0","description":"ICD-MDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27610","description":"Explore/treat ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlordiazepoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1990","description":"Chlordiazepoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA1","description":"ICD-IFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation shield","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5984","description":"Radiation shield","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF1","description":"ICD-GBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC0","description":"ICD-NHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC1","description":"ICD-FEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Omental flap extra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49904","description":"Omental flap extra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKA0","description":"ICD-NEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee manual lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5925","description":"Above knee manual lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIE0","description":"ICD-MAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANE1","description":"ICD-CANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0774T","description":"Virtual reality (VR) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD1","description":"ICD-PFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB0","description":"ICD-FIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC0","description":"ICD-OIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBF1","description":"ICD-FEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPE1","description":"ICD-NHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue mouth jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41150","description":"Tongue mouth jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28308","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metl 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2530","description":"Dental inlay metl 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE0","description":"ICD-OCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1257","description":"Cvd risk assessment not performed or incomplete (e.g._ cvd risk assessment was not documented)_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl Graft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4331","description":"Axolotl Graft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFA0","description":"ICD-JIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOF0","description":"ICD-PBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB0","description":"ICD-IFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHC1","description":"ICD-KFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE0","description":"ICD-OKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA0","description":"ICD-AGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFD1","description":"ICD-JGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA45","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68500","description":"Removal of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44950","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID0","description":"ICD-MBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2374","description":"HCPCS-J2374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sex offend tx svc_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2028","description":"Sex offend tx svc_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE0","description":"ICD-BBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ammonia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82140","description":"Assay of ammonia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7401","description":"Mometasone furoate sinus implant_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID0","description":"ICD-FIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integra matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4108","description":"Integra matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEE0","description":"ICD-AHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDD1","description":"ICD-AFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0802","description":"HCPCS-A0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGC1","description":"ICD-NBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28F","description":"Special Care Low _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand tum deep 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26113","description":"Exc hand tum deep 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAD1","description":"ICD-OGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDF1","description":"ICD-BBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXA0","description":"ICD-BFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC1","description":"ICD-KEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0557U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","description":"CPT-0557U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28615","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Batt pack/cart_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1356","description":"Batt pack/cart_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF1","description":"ICD-CEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIA0","description":"ICD-MGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADC1","description":"ICD-GADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF0","description":"ICD-GDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF0","description":"ICD-CHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA0","description":"ICD-IGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF0","description":"ICD-ODHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC11","description":"ICD-4GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC1","description":"ICD-OKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A7021","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","description":"HCPCS-A7021","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/o he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1406","description":"O2/water vapor enrich w/o he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADA1","description":"ICD-AADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND0","description":"ICD-KDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg epiphyses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27740","description":"Repair of leg epiphyses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA0","description":"ICD-GGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Administration of home sleep apnea test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9956","description":"Administration of home sleep apnea test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE0","description":"ICD-CEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHD0","description":"ICD-MKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA1","description":"ICD-DEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD111","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA0","description":"ICD-EDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD0","description":"ICD-CIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX14","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft face/nck/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15135","description":"Derm autograft face/nck/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31235","description":"Nasal/sinus endoscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","description":"HCPCS-J1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA51","description":"Very High Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0776T","description":"Therapeutic induction of intra-brain hypothermia_ including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head_ including monit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2384","description":"Pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9779","description":"Endoscopic submucosal dissection (ESD)_ including endoscopyor colonoscopy_ mucosal closure_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHC0","description":"ICD-FEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA1","description":"ICD-NHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB201","description":"Special Care High _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc abd aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236T","description":"Trluml perip athrc abd aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vinorelbine tartrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9390","description":"Vinorelbine tartrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4100","description":"Skin substitute_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB0","description":"ICD-DCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal scaling & root","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4341","description":"Periodontal scaling & root","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES141","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF0","description":"ICD-BBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0630U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","description":"CPT-0630U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE1","description":"ICD-NGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Personal Emergency Response System (Installation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1894","description":"Personal Emergency Response System (Installation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEF0","description":"ICD-IGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl bleaching per arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9972","description":"Extrnl bleaching per arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC1","description":"ICD-AGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC1","description":"ICD-FCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36160","description":"Establish access to aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA1","description":"ICD-GEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIA0","description":"ICD-MKIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWE0","description":"ICD-HHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE0","description":"ICD-IBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRE0","description":"ICD-OBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC1","description":"ICD-NAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of acth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82024","description":"Assay of acth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43112","description":"Total or near total esophagectomy_ with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy_ with or without pyloroplasty (ie_ McKeown esophagectomy or tri-i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immune admin oral/nasal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90474","description":"Immune admin oral/nasal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25560","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA0","description":"ICD-CAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68320","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88364","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9766","description":"Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX02","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ArdeoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4333","description":"ArdeoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOB0","description":"ICD-PAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETC1","description":"ICD-AETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF0","description":"ICD-ODJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx dprsd zygomatic arch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21356","description":"Opn tx dprsd zygomatic arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUC1","description":"ICD-KBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18E","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA STREPTOCOCCUS GROUP A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87430","description":"IAAD IA STREPTOCOCCUS GROUP A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARA0","description":"ICD-GARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ coated/cov w/del sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1874","description":"Stent_ coated/cov w/del sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyclosporine oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7515","description":"Cyclosporine oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0321","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMF0","description":"ICD-NIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYA0","description":"ICD-LBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMA0","description":"ICD-KCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA21","description":"ICD-1KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inhalation solution for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7699","description":"Inhalation solution for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96548","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure_ including separate incision(s) and closure_ when performed; each additional 30 minutes (List separa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21431","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thorac cont paraspinal uprig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2670","description":"Thorac cont paraspinal uprig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8977","description":"Oncology measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD260","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oropharyngeal suction catheter_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4628","description":"Oropharyngeal suction catheter_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0683U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683U","description":"CPT-0683U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA1","description":"ICD-KIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQC0","description":"ICD-OBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314U","description":"Oncology (cutaneous melanoma)_ mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping)_ utilizing formalin-fixed paraffin-embedded (FFPE) tissue_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4105","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF0","description":"ICD-NFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF1","description":"ICD-NAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD0","description":"ICD-IIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Next Generation ACO model_ 10-20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9869","description":"Next Generation ACO model_ 10-20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSB0","description":"ICD-CGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0057","description":"Proposed Adopting Best Practices And Promoting Patient Safety Within Emergency Medicine Mips Value Pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELC0","description":"ICD-MELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","description":"CPT-01920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJC1","description":"ICD-OAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76516","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd injection varices","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43243","description":"Egd injection varices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6034","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","description":"HCPCS-L6034","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEE1","description":"ICD-FFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20250","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0362U","description":"Oncology (papillary thyroid cancer)_ gene-expression profiling via targeted hybrid capture–enrichment RNA sequencing of 82 content genes and 10 housekeeping genes_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE0","description":"ICD-CEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33413","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB1","description":"ICD-NKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEF1","description":"ICD-MAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF1","description":"ICD-MFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX55","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELF0","description":"ICD-BELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC0","description":"ICD-GHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB111","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTB1","description":"ICD-CCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJC0","description":"ICD-NDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic duct procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38380","description":"Thoracic duct procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0158U","description":"MLH1 (mutL homolog 1) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB1","description":"ICD-FBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove anal fist 2 stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46285","description":"Remove anal fist 2 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro acetabuloplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29915","description":"Hip arthro acetabuloplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47480","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE1","description":"ICD-ODLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0303","description":"CDT-D0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0988T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","description":"CPT-0988T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIF1","description":"ICD-OCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA0","description":"ICD-CIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXF1","description":"ICD-KAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKB1","description":"ICD-JEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD1","description":"ICD-GIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRF1","description":"ICD-CHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serpina1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81332","description":"Serpina1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBF1","description":"ICD-ABBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: head trauma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2187","description":"Patients with clinical indications for imaging of the head: head trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLC1","description":"ICD-OFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Florbetaben f18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9458","description":"Florbetaben f18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99213","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post fusion lobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31661","description":"Bronch thermoplsty 2/> lobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLB1","description":"ICD-AHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQB0","description":"ICD-GBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEME1","description":"ICD-FEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEA1","description":"ICD-OBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKME1","description":"ICD-OKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dent sutur recent wnd to 5cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7910","description":"Dent sutur recent wnd to 5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam si joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72200","description":"X-ray exam si joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARC1","description":"ICD-HARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal smear for eosinophils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89190","description":"Nasal smear for eosinophils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJC0","description":"ICD-FAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration carotid artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35701","description":"Exploration carotid artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB1","description":"ICD-IFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3241","description":"Injection_ teprotumumab-trbw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAB1","description":"ICD-KDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0681T","description":"Relocation Of Pulse Generator Only_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ With Connection To Existing Dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community-acquired bacterial pneumonia assessment (includes all of the foll","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0118U","description":"Community-acquired bacterial pneumonia assessment (includes all of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29845","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNC0","description":"ICD-JHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45379","description":"Colonoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext antenna phren nerve stim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8696","description":"Ext antenna phren nerve stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain ovary abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58820","description":"Drain ovary abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB0","description":"ICD-FBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDB0","description":"ICD-EFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB0","description":"ICD-IFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSC1","description":"ICD-DCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tun ip cath w/port","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49419","description":"Insert tun ip cath w/port","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38305","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cl mult vsd w/rem pul band","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33677","description":"Cl mult vsd w/rem pul band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIE0","description":"ICD-KGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94667","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-mullerian hormone (AMH)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82166","description":"Anti-mullerian hormone (AMH)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27259","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC256","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA1","description":"ICD-FCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF1","description":"ICD-GICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPD1","description":"ICD-OLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF0","description":"ICD-JEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA1","description":"ICD-GDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB1","description":"ICD-GDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBC0","description":"ICD-FCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC11","description":"ICD-2BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE0","description":"ICD-MDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVE0","description":"ICD-CFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc fcn/care plan w/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8942","description":"Doc fcn/care plan w/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrigation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4398","description":"Ostomy irrigation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE1","description":"ICD-KAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANC1","description":"ICD-OANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC117","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVF1","description":"ICD-KAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICB0","description":"ICD-JICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tactile breast img uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0422T","description":"Tactile breast img uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9292","description":"Prescription digital visual therapy_ software-only_ FDA cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD1","description":"ICD-GESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC40","description":"Very High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE0","description":"ICD-OAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBC1","description":"ICD-OHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC0","description":"ICD-FCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43122","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMC0","description":"ICD-CEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDA0","description":"ICD-EDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle/heel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28100","description":"Removal of ankle/heel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB1","description":"ICD-HCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFF0","description":"ICD-BBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0211","description":"Injection_ sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQF0","description":"ICD-KBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATE0","description":"ICD-OATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA1","description":"ICD-OFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial thyroid excision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60212","description":"Partial thyroid excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14B","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF1","description":"ICD-CHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXE0","description":"ICD-OGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF0","description":"ICD-ABHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQE1","description":"ICD-OFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSA1","description":"ICD-DHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB251","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPA1","description":"ICD-GFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJD1","description":"ICD-CBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUC0","description":"ICD-CIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0204","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0204","description":"CDT-D0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHA0","description":"ICD-CEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26135","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKF0","description":"ICD-OBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWB0","description":"ICD-CGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77334","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of calf tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27687","description":"Revision of calf tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ luspatercept-aamt_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0896","description":"Injection_ luspatercept-aamt_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9148","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTC0","description":"ICD-OJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED0","description":"ICD-BIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6066","description":"Implant supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Internal Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4011","description":"Internal Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB46","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0662U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0662U","description":"CPT-0662U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent same","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37238","description":"Open/perq place stent same","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0550U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0550U","description":"CPT-0550U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBE1","description":"ICD-EEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF1","description":"ICD-LBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental sealant per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1351","description":"Dental sealant per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF0","description":"ICD-NKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQA1","description":"ICD-OJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF0","description":"ICD-FHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQA0","description":"ICD-LIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE1","description":"ICD-GAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEC0","description":"ICD-FBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTC1","description":"ICD-JFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC0","description":"ICD-OEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB1","description":"ICD-KBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF0","description":"ICD-JFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add proc construct new crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2971","description":"Add proc construct new crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - periapical radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0374","description":"intraoral tomosynthesis - periapical radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/.25-2.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2111","description":"Spherocylindr 7.25d/.25-2.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBD1","description":"ICD-OEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15946","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB0","description":"ICD-KCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auricular electrostimulation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8930","description":"Auricular electrostimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA21","description":"ICD-1EA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75820","description":"Vein x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACD0","description":"ICD-NACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB1","description":"ICD-HIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Via matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4309","description":"Via matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131_ Iobenguane_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9590","description":"Iodine I-131_ Iobenguane_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21137","description":"Reduction of forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDE1","description":"ICD-OLDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF1","description":"ICD-GBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93531","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL51","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKB0","description":"ICD-KGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrode stimulation brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95961","description":"Electrode stimulation brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide for gi tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74340","description":"X-ray guide for gi tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop oct breast cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0353T","description":"Intraop oct breast cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 3 dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90634","description":"Hepa vacc ped/adol 3 dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGF0","description":"ICD-NEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGE0","description":"ICD-GHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD212","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC1","description":"ICD-CEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEA0","description":"ICD-EGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF0","description":"ICD-ACAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA1","description":"ICD-GAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0008","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr guidance for needle place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77021","description":"Mr guidance for needle place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE0","description":"ICD-KGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6605","description":"Gradient compression bandaging supply_ padded foam_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE0","description":"ICD-BGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE1","description":"ICD-MIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC0","description":"ICD-EBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5153","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","description":"HCPCS-Q5153","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF0","description":"ICD-OBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD1","description":"ICD-KDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain screened as moderate to severe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1000","description":"Pain screened as moderate to severe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryo embryo transf case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4037","description":"Cryo embryo transf case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIB0","description":"ICD-NLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Miroderm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4175","description":"Miroderm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA21","description":"Default_ /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWE0","description":"ICD-PKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJA1","description":"ICD-BGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein bld hr fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83701","description":"Lipoprotein bld hr fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAB0","description":"ICD-BFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1489","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","description":"HCPCS-M1489","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Left hrt cath w/ventrclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93452","description":"Left hrt cath w/ventrclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAF0","description":"ICD-EDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOD0","description":"ICD-KAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0312","description":"Imm counseling by a physician or other qualified health care professional when the vaccine(s) is not admin on the same date of service for ages under 21 Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bitewings - three films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0273","description":"Bitewings - three films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOF1","description":"ICD-PKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4048","description":"Cast sup sht leg splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99345","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sleep study unatt&resp efft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95806","description":"Sleep study unatt&resp efft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza b ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87275","description":"Influenza b ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC1","description":"ICD-JFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB0","description":"ICD-IGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJE1","description":"ICD-BBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB1","description":"ICD-CGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQC1","description":"ICD-ODQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA1","description":"ICD-NLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronch w/balloon occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31634","description":"Bronch w/balloon occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALF1","description":"ICD-EALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA0","description":"ICD-BDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rx cntact lens aphakia 1 eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92315","description":"Rx cntact lens aphakia 1 eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCC1","description":"ICD-ADCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch urine w lock flng/ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4434","description":"Ost pch urine w lock flng/ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB0","description":"ICD-CHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF0","description":"ICD-MAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA125","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC1","description":"ICD-GGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heparin infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1520","description":"Heparin infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA1","description":"ICD-ICTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHC1","description":"ICD-FGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC1","description":"ICD-GFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIE0","description":"ICD-NFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","description":"CPT-00830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD235","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE1","description":"ICD-CADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bcg live intravesical vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9031","description":"Bcg live intravesical vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewho cap design w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3961","description":"Sewho cap design w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0038U","description":"Vitamin D_ 25 hydroxy D2 and D3_ by LC-MS/MS_ serum microsample_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYC0","description":"ICD-OGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epstein-barr nuclear antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86664","description":"Epstein-barr nuclear antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIE1","description":"ICD-JCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA24D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWD1","description":"ICD-CCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD0","description":"ICD-KGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD0","description":"ICD-PKQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 22+ classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0483","description":"Drug test def 22+ classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLB1","description":"ICD-JBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5751","description":"Denture reln cmplt mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC0","description":"ICD-KAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF0","description":"ICD-JENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC0","description":"ICD-OKRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD254","description":"Special Care Low _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixed prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6999","description":"Fixed prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHA1","description":"ICD-CGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD1","description":"ICD-LAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB0","description":"ICD-NBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA0","description":"ICD-MDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9784","description":"Gastric restrictive procedure_ endoscopic sleeve gastroplasty_ with esophagogastroduodenoscopy and intraluminal tube insertion_ if performed_ including all system and tissue a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD1","description":"ICD-KEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYA0","description":"ICD-KHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWE1","description":"ICD-LEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE1","description":"ICD-LBRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC1","description":"ICD-KALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA0","description":"ICD-BFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAC1","description":"ICD-BHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXB0","description":"ICD-NIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE1","description":"ICD-JHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1072T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1072T","description":"CPT-1072T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC45","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9956","description":"Patient received combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0320","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychophysiological therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90875","description":"Psychophysiological therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2130","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB0","description":"ICD-JFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEE1","description":"ICD-JAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA11","description":"ICD-1HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19285","description":"Perq dev breast 1st us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB1","description":"ICD-CEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8A","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0852","description":"Pwc gp 3 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15853","description":"Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRF1","description":"ICD-GIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA241","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE1","description":"ICD-BEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB1","description":"ICD-MKAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m medronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9503","description":"Tc99m medronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCD0","description":"ICD-CBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gi prophylaxis for nsaid rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4017F","description":"Gi prophylaxis for nsaid rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQC0","description":"ICD-LEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF0","description":"ICD-FHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4029","description":"Cast sup long leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICE1","description":"ICD-AICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRF0","description":"ICD-OIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rout foot care per visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0390","description":"Rout foot care per visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduce bowel obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44050","description":"Reduce bowel obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE1","description":"ICD-JFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB1","description":"ICD-CDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF1","description":"ICD-OISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fna w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10021","description":"Fna w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0498U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","description":"CPT-0498U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVD1","description":"ICD-NDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine lumbar/sacral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62311","description":"Inject spine lumbar/sacral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvic abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45000","description":"Drainage of pelvic abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC0","description":"ICD-IDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA244","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGF0","description":"ICD-FHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB1","description":"ICD-NKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGME0","description":"ICD-FGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF1","description":"ICD-CDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB0","description":"ICD-NFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD1","description":"ICD-DFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryptosporidium ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87272","description":"Cryptosporidium ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCF1","description":"ICD-KHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef>=40% doc normal or mild","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8395","description":"Lvef>=40% doc normal or mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8H","description":"High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24D","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC0","description":"ICD-FANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKE1","description":"ICD-NFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB0","description":"ICD-HDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACD0","description":"ICD-CACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth rem bony w/comp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7241","description":"Impact tooth rem bony w/comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB0","description":"ICD-KFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB0","description":"ICD-KHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA0","description":"ICD-OGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of jaw bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21044","description":"Removal of jaw bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0270T","description":"Rev/remvl crtd sns dev lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57310","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43238","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDD1","description":"ICD-OEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF1","description":"ICD-KEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95051","description":"Anesth vaginal endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand restorat thumb/1 finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6900","description":"Hand restorat thumb/1 finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNA0","description":"ICD-OLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal up to 3mg bupreno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0572","description":"Bupren/nal up to 3mg bupreno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47399","description":"Liver surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXF0","description":"ICD-GCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35566","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0604","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0604","description":"CDT-D0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental consultation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9310","description":"Dental consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA1","description":"ICD-KEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert self-contd prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54401","description":"Insert self-contd prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDD1","description":"ICD-CIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466U","description":"Cardiology (coronary artery disease [CAD])_ DNA_ genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs]_ targeted variant genotyping)_ patient lifestyl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extrnl beam other than prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4201F","description":"Extrnl beam other than prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1430","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","description":"HCPCS-M1430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB1","description":"ICD-GHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54230","description":"Prepare penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB1","description":"ICD-BGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGC1","description":"ICD-OEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction rectal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45190","description":"Destruction rectal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29844","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXA1","description":"ICD-FBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB1","description":"ICD-OAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA0","description":"ICD-CCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTF0","description":"ICD-NDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove elctrd transvenously","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33244","description":"Remove elctrd transvenously","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41130","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD0","description":"ICD-JIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32120","description":"Re-exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0037","description":"On Date Of Encounter_ Patient Is Not Able To Participate In Assessment Or Screening_ Including Non-Verbal Patients_ Delirious_ Severely Aphasic_ Severely Developmentally Delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBD0","description":"ICD-FFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIC1","description":"ICD-OJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with dementia at any time prior to or during the month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1271","description":"Patients with dementia at any time prior to or during the month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX25","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIND0","description":"ICD-CIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILE1","description":"ICD-IILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Organic acids total quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83918","description":"Organic acids total quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE1","description":"ICD-CIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANE1","description":"ICD-BANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6538","description":"Gc stocking full lngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRE1","description":"ICD-DGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ladies shoes hightop depth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3217","description":"Ladies shoes hightop depth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0603","description":"CDT-D0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAA1","description":"ICD-EHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF1","description":"ICD-FATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIA0","description":"ICD-AIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (asceniv)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9072","description":"Injection_ immune globulin (asceniv)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta_ esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9972","description":"Epoetin beta_ esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD245","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB0","description":"ICD-GCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAA0","description":"ICD-GHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-62331","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","description":"CPT-62331","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reoperation carotid add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35390","description":"Reoperation carotid add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v <1.2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3082F","description":"Kt/v <1.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9725","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE0","description":"ICD-PAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5160","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","description":"HCPCS-Q5160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB256","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC1","description":"ICD-PCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOA1","description":"ICD-KEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB1","description":"ICD-NGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation Supply; Sleeve_ Disposable_ Per Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4437","description":"Irrigation Supply; Sleeve_ Disposable_ Per Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGC0","description":"ICD-BCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","description":"CPT-01712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC1","description":"ICD-NFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA1","description":"ICD-MJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF1","description":"ICD-MEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64451","description":"Injection(S)_ Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint_ With Image Guidance (Ie_ Fluoroscopy Or Computed Tomography)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehabilitation progr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9472","description":"Cardiac rehabilitation progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum albumin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82040","description":"Assay of serum albumin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert pelv fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22848","description":"Insert pelv fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human fibrinogen conc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7178","description":"Human fibrinogen conc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC1","description":"ICD-GBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMF0","description":"ICD-GGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCD1","description":"ICD-BCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLB0","description":"ICD-IHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC1","description":"ICD-LFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ls not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8662","description":"Fun stat score ls not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD1","description":"ICD-NDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENB1","description":"ICD-JENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMD1","description":"ICD-BHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00840","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","description":"CPT-00840","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","description":"HCPCS-M1372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77046","description":"Magnetic resonance imaging_ breast_ without contrast material; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUF0","description":"ICD-FIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78201","description":"Liver imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mouth piece","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4617","description":"Mouth piece","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0702","description":"HCPCS-B0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC1","description":"ICD-FDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB1","description":"ICD-NCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF1","description":"ICD-CISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMC0","description":"ICD-NFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehabilitation pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9473","description":"Pulmonary rehabilitation pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMC0","description":"ICD-KFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA1","description":"ICD-OIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXE1","description":"ICD-FHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronch thermoplsty 1 lobe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31660","description":"Bronch thermoplsty 1 lobe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ldct for lung ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0297","description":"Ldct for lung ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOB1","description":"ICD-PHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB42","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0764T","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg_ low-ejection fraction_ pulmonary hypertension_ hypertrophic cardiomyopathy); related","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20D","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF0","description":"ICD-KIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB1","description":"ICD-NJVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low risk for retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3072F","description":"Low risk for retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide villus sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76945","description":"Echo guide villus sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 3 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95132","description":"Immntx 3 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Restore/remodel ventricle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33548","description":"Restore/remodel ventricle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Slp stdy unattended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95800","description":"Slp stdy unattended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPA0","description":"ICD-JGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap myotomy heller","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43279","description":"Lap myotomy heller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86851","description":"Anesth kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLA0","description":"ICD-KGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGB0","description":"ICD-NLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluor antb addl stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88350","description":"Immunofluor antb addl stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC1","description":"ICD-LGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00813","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","description":"CPT-00813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE1","description":"ICD-JAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA1","description":"ICD-HHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86021","description":"Wbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gravlee jet washer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4470","description":"Gravlee jet washer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko elastic with joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1810","description":"Ko elastic with joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQD0","description":"ICD-CGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29804","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC1","description":"ICD-MKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD1","description":"ICD-FIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXF0","description":"ICD-OGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise tendon(s) & muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23406","description":"Incise tendon(s) & muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOF1","description":"ICD-GHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7633","description":"Budesonide non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMF0","description":"ICD-OKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUF0","description":"ICD-CDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped hydrolyzed/amino acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4161","description":"Ef ped hydrolyzed/amino acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press headgear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7035","description":"Pos airway press headgear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVE0","description":"ICD-GIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC02","description":"Medium Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF1","description":"ICD-MCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAC0","description":"ICD-MKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE0","description":"ICD-CDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA0","description":"ICD-GIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIA0","description":"ICD-EFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA1","description":"ICD-OENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy br/wa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44380","description":"Small bowel endoscopy br/wa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC0","description":"ICD-JIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITD0","description":"ICD-FITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAA0","description":"ICD-EAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0877","description":"Pwc gp4 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0703","description":"HCPCS-B0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20824","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF0","description":"ICD-KIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE0","description":"ICD-EGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB31","description":"ICD-1CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF1","description":"ICD-ODIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA1","description":"ICD-LFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD1","description":"ICD-DDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAE1","description":"ICD-NBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF1","description":"ICD-CFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary plastic pouch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4381","description":"Urinary plastic pouch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0645U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0645U","description":"CPT-0645U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE1","description":"ICD-EELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilus influenza antibdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86684","description":"Hemophilus influenza antibdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1440","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","description":"HCPCS-M1440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB0","description":"ICD-GCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA1","description":"ICD-NCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9479","description":"Installation_ ciprofloxacin otic suspension_ 6mg (Otiprio)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26735","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD1","description":"ICD-FFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQA1","description":"ICD-OFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE1","description":"ICD-JBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL14","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD212","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monthly supplies for use of device coded at K1016","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1017","description":"Monthly supplies for use of device coded at K1016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTA1","description":"ICD-ABTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB0","description":"ICD-GCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye suture during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67335","description":"Eye suture during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA1","description":"ICD-JDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERC0","description":"ICD-DERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","description":"CPT-00160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA1","description":"ICD-OEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA1","description":"ICD-JGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLF1","description":"ICD-JBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD0","description":"ICD-NIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC1","description":"ICD-KBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27591","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC31","description":"ICD-4IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBB0","description":"ICD-CIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0737","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0737","description":"HCPCS-E0737","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA1","description":"ICD-OHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9355","description":"Injection_ trastuzumab_ excludes biosimilar_ 10mg (Herceptin)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/3-p part","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34803","description":"Endovas aaa repr w/3-p part","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD130","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid lined custom fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0482","description":"Tlso rigid lined custom fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6521","description":"Gradient compression garment_ glove_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Viper venom prothrombin time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85612","description":"Viper venom prothrombin time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF1","description":"ICD-EGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC0","description":"ICD-OKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE0","description":"ICD-ECCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCB1","description":"ICD-EFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLC1","description":"ICD-CHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRE0","description":"ICD-PJRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of thumb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26841","description":"Fusion of thumb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAE0","description":"ICD-KCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQF1","description":"ICD-OFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAA1","description":"ICD-EBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWE1","description":"ICD-OEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC1","description":"ICD-FAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCC1","description":"ICD-KFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38228","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","description":"CPT-38228","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc_ frz/deg/wsh_ l/r_ irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9057","description":"Rbc_ frz/deg/wsh_ l/r_ irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXE1","description":"ICD-GGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Haloperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1630","description":"Haloperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB07","description":"Low Rehab_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ic lbw inf < 1500 gm subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99478","description":"Ic lbw inf < 1500 gm subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB0","description":"ICD-CEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJD1","description":"ICD-NGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA0","description":"ICD-NBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILD1","description":"ICD-GILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic & hip control thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1680","description":"Pelvic & hip control thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWF0","description":"ICD-KBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2982","description":"Onlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ pacing_ transesoph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1756","description":"Cath_ pacing_ transesoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15D","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDB1","description":"ICD-JFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQD0","description":"ICD-DEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manipulate finger w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26340","description":"Manipulate finger w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUE0","description":"ICD-BGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJA1","description":"ICD-JHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKA1","description":"ICD-CCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revis reconst shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23474","description":"Revis reconst shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC0","description":"ICD-NAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEB1","description":"ICD-MCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB0","description":"ICD-CHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD1","description":"ICD-OJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mouth surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40899","description":"Mouth surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50386","description":"Remove stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA0","description":"ICD-KFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142U","description":"Infectious disease (bacteria and fungi)_ gram-negative bacterial identification and drug resistance element detection_ DNA (21 gram-negative bacterial targets_ 6 resistance ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB0","description":"ICD-CHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD0","description":"ICD-EGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95719","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC1","description":"ICD-LHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unusual physician travel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99082","description":"Unusual physician travel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIB1","description":"ICD-JIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA235","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0089","description":"Professional services_ initial visit_ for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administrat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGF0","description":"ICD-KDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF1","description":"ICD-KHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5298","description":"Hearing aid noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUF0","description":"ICD-IGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED0","description":"ICD-KEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF1","description":"ICD-BEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93313","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD1","description":"ICD-NAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7626","description":"Budesonide non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKC0","description":"ICD-NHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUB0","description":"ICD-KEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB51","description":"Very High Rehab _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal scrn; hi risk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0105","description":"Colorectal scrn; hi risk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59350","description":"Repair of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDF1","description":"ICD-NHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA0","description":"ICD-LFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8F","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of spinal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64772","description":"Incision of spinal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB1","description":"ICD-GFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBD0","description":"ICD-OKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D7259","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D7259","description":"CDT-D7259","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9030","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB0","description":"ICD-OHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4524","description":"Adult size brief/diaper xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEF0","description":"ICD-OCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lice treatment_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9180","description":"Lice treatment_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA0","description":"ICD-OBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB146","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33231","description":"Insrt pulse gen w/mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6563","description":"Gradient compression stocking_ waist length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRF1","description":"ICD-PCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKF0","description":"ICD-GHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpowered pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0373","description":"Nonpowered pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLD1","description":"ICD-AFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin sys hydraul stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5848","description":"Knee-shin sys hydraul stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD125","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF0","description":"ICD-JDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC11","description":"ICD-1KC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS BE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87350","description":"IAAD IA HEPATITIS BE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cord blood-derived stem-cell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2142","description":"Cord blood-derived stem-cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE1","description":"ICD-PHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYE0","description":"ICD-HCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAE1","description":"ICD-NDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPE0","description":"ICD-BGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test antiglob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86922","description":"Compatibility test antiglob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9306","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9306","description":"HCPCS-C9306","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4393","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","description":"HCPCS-Q4393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hard protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8003","description":"Hard protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited dental tx adult","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8040","description":"Limited dental tx adult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFE1","description":"ICD-BIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYB0","description":"ICD-PBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interdental wiring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21497","description":"Interdental wiring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0533","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","description":"HCPCS-G0533","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA1","description":"ICD-OLIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6214","description":"Foam drg > 48 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42235","description":"Repair palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA1","description":"ICD-CDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE0","description":"ICD-MHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg during surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95955","description":"Eeg during surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct ankle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27702","description":"Reconstruct ankle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE1","description":"ICD-LAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTC0","description":"ICD-JDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD0","description":"ICD-NEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28107","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXB1","description":"ICD-OCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pessary rubber_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4561","description":"Pessary rubber_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYA0","description":"ICD-CHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51580","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD1","description":"ICD-NEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9942","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWE0","description":"ICD-PHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIE0","description":"ICD-AAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC22D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody elution","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86860","description":"Rbc antibody elution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD0","description":"ICD-JDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50953","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cad meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8498","description":"Cad meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA0","description":"ICD-FCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic biometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92136","description":"Ophthalmic biometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophageal t4 no prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9097","description":"Onc dx esophageal t4 no prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE120","description":"Clinically Complex _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPF0","description":"ICD-CBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8A","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKC1","description":"ICD-OIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL31","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36907","description":"Transluminal balloon angioplasty_ central dialysis segment_ performed through dialysis circuit_ including all imaging and radiological supervision and interpretation required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE0","description":"ICD-OKNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qty act diab retin mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9672","description":"Qty act diab retin mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA34","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTC1","description":"ICD-OBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME1","description":"ICD-KAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33400","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB0","description":"ICD-HHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61850","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33287","description":"Removal and replacement of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kyphectomy 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22819","description":"Kyphectomy 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSB0","description":"ICD-OHSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOC0","description":"ICD-PLOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB110","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped caloric dense>/=0.7kc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4160","description":"Ef ped caloric dense>/=0.7kc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFB1","description":"ICD-NJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB0","description":"ICD-GFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPA0","description":"ICD-NKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contracted services per day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1022","description":"Contracted services per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC1","description":"ICD-KCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDD0","description":"ICD-CCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF1","description":"ICD-MCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD0","description":"ICD-GHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB0","description":"ICD-OJCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIB0","description":"ICD-CHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD0","description":"ICD-CGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD1","description":"ICD-BHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revoshield + amniotic barrier_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4289","description":"Revoshield + amniotic barrier_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCD1","description":"ICD-JBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 40-50","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6535","description":"Gc stocking thighlngth 40-50","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg > 48 sq in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6247","description":"Hydrogel drg > 48 sq in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF1","description":"ICD-NKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy rigid trnso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43180","description":"Esophagoscopy rigid trnso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES321","description":"Extensive Services _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB0","description":"ICD-BEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8G","description":"Very High Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","description":"CPT-92635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRA0","description":"ICD-OIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9481","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLD0","description":"ICD-NKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6119","description":"implant/abutment supported interim fixed denture for edentulous arch – maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF0","description":"ICD-KHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation thumb complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20827","description":"Replantation thumb complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos macroalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3062F","description":"Pos macroalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMF1","description":"ICD-KIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","description":"HCPCS-M1377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXD0","description":"ICD-NFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-75577","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","description":"CPT-75577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28124","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKA0","description":"ICD-KBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral antral fistula closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7260","description":"Oral antral fistula closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91305","description":"Severe acute resp synd coronavirus 2 (SARS-CoV-2) ([COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preserv free_ 30 mcg/0.3 mL dosage_ tris-sucrose formula formula_ for intramus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUF1","description":"ICD-FCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0369U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ gastrointestinal pathogens_ 31 bacterial_ viral_ and parasitic organisms and identification of 21 associated antibiot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA02","description":"Medium Rehab _ ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB115","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immune complex assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86332","description":"Immune complex assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE0","description":"ICD-DIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Burr hole for puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61120","description":"Burr hole for puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc stroke after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9257","description":"Doc stroke after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC1","description":"ICD-BINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35884","description":"Revise graft w/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKA0","description":"ICD-GAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC1","description":"ICD-MKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCC0","description":"ICD-OKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35281","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","description":"HCPCS-Q4390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE154","description":"Special Care Low _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rotator cuff acute","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23410","description":"Repair rotator cuff acute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3388F","description":"Ajcc cln cncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9309","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9309","description":"HCPCS-C9309","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIB0","description":"ICD-AEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB1","description":"ICD-BFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6607","description":"Gradient compression bandaging supply_ tubular protective absorption layer_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise ileoanal reservior","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45136","description":"Excise ileoanal reservior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9391","description":"Patient achieves refraction +-1 d for the eye that underwent cataract surgery_ measured at the one month follow up visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOB1","description":"ICD-KAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB1","description":"ICD-EDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD0","description":"ICD-FEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50393","description":"Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measure venous pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93770","description":"Measure venous pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF1","description":"ICD-GCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF1","description":"ICD-GGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF1","description":"ICD-GALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA07","description":"Low Rehab_ ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE1","description":"ICD-GGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22206","description":"Incis spine 3 column thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0139","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","description":"HCPCS-J0139","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4419","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","description":"HCPCS-Q4419","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE1","description":"ICD-CDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE1","description":"ICD-IABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv tstng asked/docd/revwd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3292F","description":"Hiv tstng asked/docd/revwd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGA1","description":"ICD-BBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0950T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","description":"CPT-0950T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prfrmnc docd 2 wks b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3328F","description":"Prfrmnc docd 2 wks b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJB0","description":"ICD-GEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA1","description":"ICD-NKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28B","description":"Clinically Complex _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9789","description":"Blood pressure recorded during inpatient stays_ emergency room visits_ urgent care visits_ and patient self-reported BP_s (home and health fair BP results)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFE0","description":"ICD-BDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lorazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2060","description":"Lorazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD0","description":"ICD-FBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0841","description":"Injection_ crotalidae immune F(ab_)2 (equine)_ 120 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQF0","description":"ICD-DCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC1","description":"ICD-OLTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFC1","description":"ICD-NEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FUT1 GNOTYP FUT1 EXON 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0185U","description":"FUT1 GNOTYP FUT1 EXON 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCC0","description":"ICD-MFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect prox humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23220","description":"Resect prox humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13D","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF1","description":"ICD-MFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD0","description":"ICD-CIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX43","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOD0","description":"ICD-HDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biomechanical mapping_ transvaginal_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0487T","description":"Biomechanical mapping_ transvaginal_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD0","description":"ICD-OIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0669T","description":"Backbench reconstruction of cadaver or living donor uterus allograft prior to transplantation; venous anastomosis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF0","description":"ICD-MEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC226","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF1","description":"ICD-KFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test for blood flow in graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15860","description":"Test for blood flow in graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED0","description":"ICD-KIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA0","description":"ICD-HBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARC1","description":"ICD-KARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGD0","description":"ICD-BIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63047","description":"Remove spine lamina 1 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB1C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placement of drain pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48001","description":"Placement of drain pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND1","description":"ICD-BCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD1","description":"ICD-KGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX20","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test niemann-pick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3849","description":"Gene test niemann-pick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed xtra hvy dty x wide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0304","description":"Hosp bed xtra hvy dty x wide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coroners autopsy (necropsy)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88045","description":"Coroners autopsy (necropsy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1085","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEE1","description":"ICD-KBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb <10g/dl_ med rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8975","description":"Hgb <10g/dl_ med rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDA0","description":"ICD-BCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SC GNOTYP ERMAP EXONS 4 12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0199U","description":"SC GNOTYP ERMAP EXONS 4 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBB1","description":"ICD-OHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB0","description":"ICD-EBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB0","description":"ICD-OJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC1","description":"ICD-JGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1736","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1736","description":"HCPCS-C1736","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk knee joints polycentric p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5677","description":"Bk knee joints polycentric p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB0","description":"ICD-OFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMC1","description":"ICD-FBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHA1","description":"ICD-OKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of scapula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23190","description":"Partial removal of scapula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75574","description":"Ct angio hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMC1","description":"ICD-EAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC1","description":"ICD-BIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC0","description":"ICD-LHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB1","description":"ICD-GCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB0","description":"ICD-OKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC1","description":"ICD-FGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB1","description":"ICD-AAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services given to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9740","description":"Hospice services given to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE1","description":"ICD-KHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTB1","description":"ICD-GCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construct thumb replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26550","description":"Construct thumb replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBC1","description":"ICD-MHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAB1","description":"ICD-EHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity classified mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1490F","description":"Dem severity classified mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA55","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB0","description":"ICD-CGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28675","description":"Repair of toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUE0","description":"ICD-IFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8993","description":"Sub pt/ot current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGB1","description":"ICD-BFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quan levetiracetam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80177","description":"Drug scrn quan levetiracetam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB0","description":"ICD-HBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9187","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9187","description":"HCPCS-J9187","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drnble ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5062","description":"Drnble ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1476","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","description":"HCPCS-M1476","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF1","description":"ICD-JEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84651","description":"Anesth hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair ortho appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8691","description":"Repair ortho appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB1","description":"ICD-NAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC1","description":"ICD-GDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay blood carbon dioxide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82374","description":"Assay blood carbon dioxide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87471","description":"Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRC0","description":"ICD-HCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF0","description":"ICD-KAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Daunorubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9150","description":"Daunorubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9607","description":"Lutetium Lu 177 vipivotide tetraxetan_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUF1","description":"ICD-CAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0610","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILA0","description":"ICD-JILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPC0","description":"ICD-BGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21602","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; Without Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periradicular surgery","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3427","description":"Periradicular surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF0","description":"ICD-AETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRF1","description":"ICD-OBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj fe-based mr contrast_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9953","description":"Inj fe-based mr contrast_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIA1","description":"ICD-OCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIF1","description":"ICD-EGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB0","description":"ICD-OJHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA1","description":"ICD-CEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic control thoracic ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2660","description":"Thoracic control thoracic ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26516","description":"Fusion of knuckle joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27130","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNF0","description":"ICD-NDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7214","description":"Injection_ Factor VIII/von Willebrand factor complex_ recombinant (Altuviiio)_ per Factor VIII IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated platelet count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85049","description":"Automated platelet count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1828","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","description":"HCPCS-E1828","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBE0","description":"ICD-KIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8F","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQB0","description":"ICD-GDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foscarnet sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1455","description":"Foscarnet sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD0","description":"ICD-GELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3C","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSF1","description":"ICD-GDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB1","description":"ICD-FEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB1","description":"ICD-JGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXF0","description":"ICD-GHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA0","description":"ICD-FHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HB11","description":"ICD-1HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE150","description":"Reduced Physical Function _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND1","description":"ICD-OEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12054","description":"Intmd rpr face/mm 7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC0","description":"ICD-KFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrcp talk b/4 antiv txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4159F","description":"Contrcp talk b/4 antiv txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF0","description":"ICD-OCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6090","description":"Repair implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB0","description":"ICD-CFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB144","description":"Special Care High _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0742","description":"Injection_ imipenem 4mg_ cilastatin 4 mg and relebactam 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFB1","description":"ICD-JHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25600","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYC1","description":"ICD-KDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA0","description":"ICD-CCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compatibility test spin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86920","description":"Compatibility test spin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0685T","description":"Interrogation Device Evaluation (In-Person) With Analysis_ Review And Report By A Physician Or Other Qualified Health Care Professional_ Including Connection_ Recording And Di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87477","description":"Lyme dis dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ketogenic steroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83582","description":"Assay of ketogenic steroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bio-connekt per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4161","description":"Bio-connekt per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carboplatin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9045","description":"Carboplatin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHC1","description":"ICD-IBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intra-atrial recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93602","description":"Intra-atrial recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part hand little/ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6010","description":"Part hand little/ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC0","description":"ICD-NGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF0","description":"ICD-DFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB0","description":"ICD-GGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","description":"HCPCS-M1418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0780T","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast percut w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19100","description":"Bx breast percut w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulders","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73050","description":"X-ray exam of shoulders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0068U","description":"Candida species panel (C. albicans_ C. glabrata_ C. parapsilosis_ C. kruseii_ C tropicalis_ and C. auris)_ amplified probe technique with qualitative report of the presence or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6555","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB11","description":"ICD-2AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAE1","description":"ICD-NJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appliance cleaner","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5131","description":"Appliance cleaner","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF0","description":"ICD-GFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Activity therapy_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2032","description":"Activity therapy_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB1","description":"ICD-NGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOB0","description":"ICD-GEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC0","description":"ICD-OACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFA0","description":"ICD-CHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0801","description":"HCPCS-A0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2D","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD0","description":"ICD-KFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial knee/shin system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5840","description":"Multi-axial knee/shin system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert knee articulat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5656","description":"Socket insert knee articulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC07","description":"Ultra High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lat lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22533","description":"Lat lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA0","description":"ICD-JGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWE0","description":"ICD-CGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAD0","description":"ICD-OLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tubing used w suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7002","description":"Tubing used w suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHE1","description":"ICD-KAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRB0","description":"ICD-CHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB0","description":"ICD-PCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acesso tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4300","description":"Acesso tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73221","description":"MRI joint upr extrem w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF1","description":"ICD-GBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70150","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25685","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thera par drugs 2 or > admin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9612","description":"Thera par drugs 2 or > admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29879","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITB0","description":"ICD-BITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB0","description":"ICD-NLBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp recip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290T","description":"Laser inc for pkp/lkp recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXC0","description":"ICD-GIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No elig ref for oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8857","description":"No elig ref for oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0063","description":"Cardiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATD1","description":"ICD-KATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc lack perm&cont&parox fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1061F","description":"Doc lack perm&cont&parox fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33401","description":"Valvuloplasty open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHA1","description":"ICD-BGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oximeter device for measuring bloodk osygen levels noninvasively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0445","description":"Oximeter device for measuring bloodk osygen levels noninvasively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA1","description":"ICD-GFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAE1","description":"ICD-JIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1078T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1078T","description":"CPT-1078T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0222","description":"Injection_ Patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mass spectrometry qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83789","description":"Mass spectrometry qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70190","description":"X-ray exam of eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE0","description":"ICD-GCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX54","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDD1","description":"ICD-ICDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVE1","description":"ICD-BAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWD0","description":"ICD-OLWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDB0","description":"ICD-OBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUD1","description":"ICD-NJUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHE0","description":"ICD-MGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA1","description":"ICD-MHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","description":"HCPCS-Q4405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of inner eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66770","description":"Removal of inner eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC1","description":"ICD-KDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF0","description":"ICD-OKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0009U","description":"Oncology (breast cancer)_ ERBB2 (HER2) copy number by FISH_ tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (DEP) sorting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12C","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0571","description":"Buprenorphine oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC214","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD0","description":"ICD-OCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD1","description":"ICD-BBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE0","description":"ICD-KIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLB0","description":"ICD-FFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXF1","description":"ICD-CBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0463T","description":"Interrogation device evaluation (in person) with analysis_ review and report_ includes connection_ recording and disconnection per patient encounter_ implantable aortic counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD1","description":"ICD-GFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group mnt 2 or more 30 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0271","description":"Group mnt 2 or more 30 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMB0","description":"ICD-EDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHC1","description":"ICD-ADHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTD0","description":"ICD-NBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC0","description":"ICD-EFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLD0","description":"ICD-KDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27485","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol valerate 10 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1380","description":"Estradiol valerate 10 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC1","description":"ICD-ODRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC0","description":"ICD-NAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOB0","description":"ICD-CBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alloderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4116","description":"Alloderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53460","description":"Revision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB1","description":"ICD-KCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0604U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","description":"CPT-0604U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF0","description":"ICD-AEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWB0","description":"ICD-PEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54500","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA1","description":"ICD-BAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal fb skin/areolar tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7530","description":"Removal fb skin/areolar tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446T","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE0","description":"ICD-HDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB1","description":"ICD-NJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC1","description":"ICD-AIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE1","description":"ICD-FENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB1","description":"ICD-KAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Baseline mrs > 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1236","description":"Baseline mrs > 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEA1","description":"ICD-GHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6213","description":"Foam drg >16<=48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/repair hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69711","description":"Remove/repair hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Restorative foundation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2949","description":"Restorative foundation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric p r1-r2noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9101","description":"Onc dx gastric p r1-r2noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRA1","description":"ICD-PDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFB0","description":"ICD-FBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRE0","description":"ICD-KFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHE1","description":"ICD-OIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1123","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID1","description":"ICD-JBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toxoplasma antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86778","description":"Toxoplasma antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQB0","description":"ICD-CEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular function screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99172","description":"Ocular function screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGNB1","description":"ICD-BGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB1","description":"ICD-CBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","description":"CPT-00472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE0","description":"ICD-ICDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAC0","description":"ICD-GAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic mitomycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7315","description":"Ophthalmic mitomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTF1","description":"ICD-ICTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQF0","description":"ICD-OEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINE1","description":"ICD-BINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4353","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","description":"HCPCS-Q4353","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL13","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMD0","description":"ICD-KEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA0","description":"ICD-BHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28080","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph endoscopy dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43226","description":"Esoph endoscopy dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9116","description":"Onc dx ovarian recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0700T","description":"Molecular Fluorescent Imaging Of Suspicious Nevus; First Lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYD0","description":"ICD-CAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOB0","description":"ICD-PEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cefoxitin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0694","description":"Cefoxitin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC0","description":"ICD-LGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE0","description":"ICD-MBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWA1","description":"ICD-HIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKE0","description":"ICD-KAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5991","description":"Addition to lower extremity prostheses_ osseointegrated external prosthetic connector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF0","description":"ICD-OIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIE0","description":"ICD-GCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC1","description":"ICD-AAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD0","description":"ICD-NLVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF1","description":"ICD-PESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLE1","description":"ICD-JBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral evaluation pt < 3yrs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0145","description":"Oral evaluation pt < 3yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF0","description":"ICD-NEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGF1","description":"ICD-CDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE1","description":"ICD-GIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470U","description":"Oncology (oropharyngeal)_ detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets_ cell-free HPV 16 and 18 DNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB1","description":"ICD-GCBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD0","description":"ICD-KIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGF0","description":"ICD-BAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA0","description":"ICD-MILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD1","description":"ICD-OBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE0","description":"ICD-OBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA1","description":"ICD-NJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYB0","description":"ICD-GBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD0","description":"ICD-CDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/90d mrs 0-2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9646","description":"Pt w/90d mrs 0-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF1","description":"ICD-HDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE0","description":"ICD-FGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJE1","description":"ICD-FIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE1","description":"ICD-NCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0514","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure)_ in the office or other outpatient setting requiring direct patient contact beyond t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52300","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED1","description":"ICD-OLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cad measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8489","description":"Cad measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC0","description":"ICD-BHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDD1","description":"ICD-OLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF0","description":"ICD-DAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of tendons at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25301","description":"Fusion of tendons at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92508","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","description":"HCPCS-A6519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFF0","description":"ICD-OLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7298","description":"Removal of temporary anchorage device [screw retained plate]_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth esophageal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50051","description":"Anesth esophageal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGE1","description":"ICD-NEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA140","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA1","description":"ICD-OHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYF0","description":"ICD-GCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0903","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0903","description":"CDT-D0903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient And/Or Care Partner Decline Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0041","description":"Patient And/Or Care Partner Decline Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD1","description":"ICD-DERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX52","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB114","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHED1","description":"ICD-JHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQF0","description":"ICD-OCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTE0","description":"ICD-ICTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96130","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1842","description":"Retinal prosthesis_ includes all internal and external components; add-on to C1841","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASA1","description":"ICD-DASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBD0","description":"ICD-GCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB1","description":"ICD-IFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i&ii antibody qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86828","description":"Hla class i&ii antibody qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA60","description":"Low Rehab_ ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee hydracadence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5610","description":"Above knee hydracadence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC0","description":"ICD-DCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1102","description":"HCPCS-A1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31572","description":"Laryngoscopy_ flexible; with ablation or destruction of lesion(s) with laser_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC1","description":"ICD-HDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc nhlstg 1-2 no relap no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9134","description":"Onc nhlstg 1-2 no relap no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQF0","description":"ICD-CCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA0","description":"ICD-NEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD1","description":"ICD-CFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8651","description":"Fun stat score hip >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB0","description":"ICD-CFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67950","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cap bld skin piercing laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0620","description":"Cap bld skin piercing laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA50","description":"High Rehab _ ADL Index 0-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUB1","description":"ICD-EBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB1","description":"ICD-GDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF1","description":"ICD-CDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vaccine 3 dose adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90746","description":"Hepb vaccine 3 dose adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA17","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/stimul addl 15m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97814","description":"Acupunct w/stimul addl 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csi per asx pt w/pci 2 yrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8963","description":"Csi per asx pt w/pci 2 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEED0","description":"ICD-OEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFA0","description":"ICD-FEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unskilled respitecare /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5151","description":"Unskilled respitecare /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA1","description":"ICD-ADTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVD1","description":"ICD-GCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSA1","description":"ICD-DGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUD1","description":"ICD-NKUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx iliac spine uni/bil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0412","description":"Open tx iliac spine uni/bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ home monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9006","description":"Mccd_ home monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQF1","description":"ICD-LBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNC1","description":"ICD-KGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC1","description":"ICD-HFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco counseling","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1320","description":"Tobacco counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSA1","description":"ICD-KFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phosphatase forensic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84061","description":"Phosphatase forensic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA0","description":"ICD-LDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2253","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","description":"HCPCS-J2253","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF1","description":"ICD-DHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBF1","description":"ICD-JEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemfexy)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9304","description":"Injection_ pemetrexed (pemfexy)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB1","description":"ICD-NBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOB1","description":"ICD-PFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53251","description":"Anesth vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB0","description":"ICD-FIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auric/peri pain assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1116F","description":"Auric/peri pain assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11B","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC1","description":"ICD-FHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD0","description":"ICD-IDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85301","description":"Antithrombin iii antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAB0","description":"ICD-GAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulance 02 life sustaining","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0422","description":"Ambulance 02 life sustaining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentistry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0067","description":"Dentistry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69210","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6610","description":"Gradient compression stocking_ below knee_ 18-30 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","description":"HCPCS-M1392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJE0","description":"ICD-GBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59400","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O shoe convert to sof counte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3590","description":"O shoe convert to sof counte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD1","description":"ICD-OEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna antibody native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86225","description":"Dna antibody native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOE0","description":"ICD-LCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC0","description":"ICD-ICUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth major vein ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88251","description":"Anesth major vein ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0941T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","description":"CPT-0941T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA1","description":"ICD-GBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic injection/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51715","description":"Endoscopic injection/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC0","description":"ICD-ICCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBF0","description":"ICD-BFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD0","description":"ICD-GGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSD0","description":"ICD-HGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACD1","description":"ICD-AACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCC1","description":"ICD-ICCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSD0","description":"ICD-GHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15933","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEF1","description":"ICD-EFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9859","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long arm adult plst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4005","description":"Cast sup long arm adult plst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9754","description":"Creation of arteriovenous fistula_ percutaneous; direct_ any site_ including all imaging and radiologic supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0324U","description":"Oncology (ovarian)_ spheroid cell culture_ 4-drug panel (carboplatin_ doxorubicin_ gemcitabine_ paclitaxel)_ tumor chemotherapy response prediction for each drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD1","description":"ICD-CARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes orth newington","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1710","description":"Legg perthes orth newington","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casirivimab and imdevimab_ 2400 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0243","description":"Injection_ casirivimab and imdevimab_ 2400 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc lis nurse train ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0164","description":"Hhc lis nurse train ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi-durometer below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5665","description":"Multi-durometer below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNA0","description":"ICD-OCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref doc oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8559","description":"Pt ref doc oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9668","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order(prescription)for statin therapy (e.g.patient with adverse effect_ allergy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72192","description":"Ct pelvis w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE1","description":"ICD-OGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB44","description":"Very High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA0","description":"ICD-OGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLD1","description":"ICD-NJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skills training and development_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2038","description":"Skills training and development_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51705","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGD1","description":"ICD-NGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thi/glut/ischia wgt bearing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2500","description":"Thi/glut/ischia wgt bearing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLF0","description":"ICD-OJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITD0","description":"ICD-BITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame attachmnts ce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0948","description":"Fracture frame attachmnts ce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52235","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD117","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC0","description":"ICD-OCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEE1","description":"ICD-OAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMB1","description":"ICD-JBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE0","description":"ICD-IEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOE1","description":"ICD-GIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA225","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLA1","description":"ICD-MHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parasymp&symp hrt rate test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95943","description":"Parasymp&symp hrt rate test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace non-molded calf lace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4055","description":"Replace non-molded calf lace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB1","description":"ICD-OHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE0","description":"ICD-FGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB0","description":"ICD-MKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6256","description":"Absorpt drg > 48 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA1","description":"ICD-BIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB1","description":"ICD-NHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22513","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2123","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening barbiturates","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80345","description":"Drug screening barbiturates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA0","description":"ICD-KHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEE1","description":"ICD-GCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLE1","description":"ICD-CHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor 3 proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81509","description":"Ftl cgen abnor 3 proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25272","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWB1","description":"ICD-DHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD0","description":"ICD-JBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWC1","description":"ICD-HFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA0","description":"ICD-NCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair esophagus and fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43305","description":"Repair esophagus and fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB42","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0666T","description":"Donor hysterectomy (including cold preservation); laparoscopic or robotic_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVA1","description":"ICD-JHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81445","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD0","description":"ICD-PFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiological examination_ surgical specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76098","description":"Radiological examination_ surgical specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting ramus closed","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7941","description":"Bone cutting ramus closed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB0","description":"ICD-LISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB0","description":"ICD-KACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWC0","description":"ICD-PHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc occup therapy ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0160","description":"Hhc occup therapy ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of salivary fistula","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7983","description":"Closure of salivary fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irinotecan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9206","description":"Irinotecan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00534","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","description":"CPT-00534","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHD0","description":"ICD-GEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC1","description":"ICD-NLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELB0","description":"ICD-MELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB1","description":"ICD-OJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6564","description":"Gradient compression stocking_ waist length_ 40 mmhg or greater_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal tissue transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2103","description":"Adrenal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSB1","description":"ICD-KBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Listeria monocytogenes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86723","description":"Listeria monocytogenes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUC1","description":"ICD-EHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1024","description":"Nonpneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB0","description":"ICD-FEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls initiation artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33947","description":"Ecmo/ecls initiation artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHF0","description":"ICD-JCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97164","description":"Re-evaluation of physical therapy established plan of care_ requiring these components: An examination including a review of history and use of standardized tests and measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33533","description":"Cabg arterial single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB1","description":"ICD-CGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Singlay_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4329","description":"Singlay_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0884T","description":"Esophagoscopy_ flexible_ transoral_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4010","description":"Infectious Disease Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polycarb lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0580","description":"Polycarb lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bethanechol chloride inject","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0520","description":"Bethanechol chloride inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60540","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc viral load <200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9243","description":"Doc viral load <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic cholecystectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47562","description":"Laparoscopic cholecystectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL02","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAD1","description":"ICD-BBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0796T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interface_ cough stim device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7020","description":"Interface_ cough stim device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA1","description":"ICD-AHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdo back wall comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76770","description":"Us exam abdo back wall comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRD1","description":"ICD-KIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking full lngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6536","description":"Gc stocking full lngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYA1","description":"ICD-KFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYD1","description":"ICD-KGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo w/ankle joint_ prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1971","description":"Afo w/ankle joint_ prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63704","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobility cart pneum vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0502","description":"Mobility cart pneum vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81414","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5123","description":"Injection_ rituximab-arrx_ biosimilar_ (riabni)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0897T","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations_ based on selected intervals of interest from 12-lead elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHA0","description":"ICD-KGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of floor of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41108","description":"Biopsy of floor of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJC0","description":"ICD-JAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75658","description":"Artery x-rays arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caspofungin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0637","description":"Caspofungin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temple bne implnt w/stimulat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69715","description":"Temple bne implnt w/stimulat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETE1","description":"ICD-FETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUB1","description":"ICD-JGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med ind for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9361","description":"Med ind for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0556U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","description":"CPT-0556U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELE0","description":"ICD-EELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF0","description":"ICD-KBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD0","description":"ICD-BBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD0","description":"ICD-FBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81360","description":"Zrsr2 (Zinc Finger Ccch-Type_ Rna Binding Motif And Serine/Arginine-Rich 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variant(S) (Eg_ E65Fs_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1311","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMD0","description":"ICD-OHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB1","description":"ICD-CGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1009","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nk cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86357","description":"Nk cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC32","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD1","description":"ICD-FDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEB0","description":"ICD-GDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9159","description":"Injection_ prothrombin complex concentrate (human)_ balfaxar_ per i.u. of factor ix activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGC1","description":"ICD-JFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFE0","description":"ICD-OGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1188","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBD1","description":"ICD-JFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Approp digoxin tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4189F","description":"Approp digoxin tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRD1","description":"ICD-LIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl 250mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0173","description":"Trimethobenzamide hcl 250mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD0","description":"ICD-FEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHD0","description":"ICD-ICHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPB0","description":"ICD-OKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0870T","description":"Implantation of subcutaneous peritoneal ascites pump system_ percutaneous_ including pump-pocket creation_ insertion of tunneled indwelling bladder and peritoneal catheters wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDD0","description":"ICD-CHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA0","description":"ICD-BHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fitting of diaphragm/cap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57170","description":"Fitting of diaphragm/cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD1","description":"ICD-KFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442T","description":"Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0447","description":"Portable oxygen contents_ liquid_ 1 month_s supply = 1 unit_ prescribed amount at rest or nighttime exceeds 4 liters per minute","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKF1","description":"ICD-OFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0768T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ subsequent treatment_ including noninvasive electroneurographic localizat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84410","description":"Testosterone; bioavailable_ direct measurement (eg_ differential precipitation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ashkenazi jewish assoc dis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81412","description":"Ashkenazi jewish assoc dis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not currently on a daily aspirin or other antiplatelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9795","description":"Patient is not currently on a daily aspirin or other antiplatelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE1","description":"ICD-MDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 13/> studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95913","description":"Nrv cndj test 13/> studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86617","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD0","description":"ICD-IITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot and ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28262","description":"Revision of foot and ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24134","description":"Removal of arm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86451","description":"Anesth removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBND0","description":"ICD-NBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DC11","description":"ICD-3DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1811","description":"Insulin (fiasp) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTC1","description":"ICD-EGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0546U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","description":"CPT-0546U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee cuff suspension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5666","description":"Below knee cuff suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB0","description":"ICD-JCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33414","description":"Repair of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr att- conv 1 arm drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0958","description":"Whlchr att- conv 1 arm drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA1","description":"ICD-IGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHB1","description":"ICD-OLHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA0","description":"ICD-NCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recomb novoeight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7182","description":"Factor viii recomb novoeight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQE0","description":"ICD-LEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF0","description":"ICD-PARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA1","description":"ICD-MIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB31","description":"ICD-3IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMB1","description":"ICD-NAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29888","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3D","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB31","description":"ICD-4FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVD0","description":"ICD-JDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20225","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt cat and thck on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9294","description":"Pt cat and thck on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19370","description":"Surgery of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29805","description":"Shoulder arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49594","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC0","description":"ICD-EGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ext hem groups 2+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46250","description":"Remove ext hem groups 2+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18C","description":"Extensive Services _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCC0","description":"ICD-FDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (Evomela)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9246","description":"Injection_ melphalan (Evomela)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pouch clsd w barr attached","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5051","description":"Pouch clsd w barr attached","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscop w/esoph musc exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32665","description":"Thoracoscop w/esoph musc exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTC0","description":"ICD-NCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUD0","description":"ICD-AIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA1","description":"ICD-CBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9325","description":"CT studies not reported to a radiation dose index registry due to medical reasons (eg_ ct studies performed for radiation treatment planning or image-guided radiation trtmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artificial saliva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9155","description":"Artificial saliva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD1","description":"ICD-PIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA1","description":"ICD-CDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision gastroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43848","description":"Revision gastroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETC0","description":"ICD-CETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4268","description":"Surgraft ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5106","description":"Injection_ epoetin alfa_ biosimilar_ (Retacrit) (for non ESRD use)_ 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47142","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX11","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD1","description":"ICD-MFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND0","description":"ICD-NFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB20","description":"Very High Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC0","description":"ICD-JGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct sft tsue nck w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70492","description":"Ct sft tsue nck w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVE0","description":"ICD-CEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fremanezumab-vfrm_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9040","description":"Injection_ fremanezumab-vfrm_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recd f/u w/in 7d disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9405","description":"Recd f/u w/in 7d disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72141","description":"MRI neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB1","description":"ICD-NCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sbrt delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77373","description":"Sbrt delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB16","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYE0","description":"ICD-DIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy one injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95120","description":"Immunotherapy one injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo below knee alignable sy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5910","description":"Endo below knee alignable sy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD1","description":"ICD-KERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD0","description":"ICD-KIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD111","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99191","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC231","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMC1","description":"ICD-KBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC1","description":"ICD-GIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX20","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0607U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","description":"CPT-0607U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC1","description":"ICD-CIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Site not small cell lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9285","description":"Site not small cell lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVA0","description":"ICD-GFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brst cncr stage 1 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3374F","description":"Ajcc brst cncr stage 1 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB1","description":"ICD-FCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj protirelin per 250 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2725","description":"Inj protirelin per 250 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24B","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was provided hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9710","description":"Patient was provided hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA0","description":"ICD-BCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0337U","description":"Oncology (plasma cell disorders and myeloma)_ circulating plasma cell immunologic selection_ identification_ morphological characterization_ and enumeration of plasma cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMF1","description":"ICD-IAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD256","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOB1","description":"ICD-PIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXF0","description":"ICD-BHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA1","description":"ICD-MGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment facehood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6503","description":"Compres burngarment facehood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 5MCG/.5ML AS03B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104A","description":"ADM SARSCOV2 5MCG/.5ML AS03B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBC1","description":"ICD-MBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPC0","description":"ICD-GGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIND1","description":"ICD-GIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Per pm reeval est pat infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99391","description":"Per pm reeval est pat infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22845","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ketamine and norketamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80357","description":"Ketamine and norketamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMD1","description":"ICD-IAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEA0","description":"ICD-AFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKB1","description":"ICD-FCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93587","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; venovenous collaterals originating at or above the he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDE1","description":"ICD-NFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12D","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRB1","description":"ICD-OCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCD1","description":"ICD-IDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA1","description":"ICD-LAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTC0","description":"ICD-FGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no pos air press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8849","description":"Doc reas no pos air press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01202","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","description":"CPT-01202","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB1","description":"ICD-FCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXA0","description":"ICD-GBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8F","description":"Very High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0684T","description":"Peri-Procedural Device Evaluation (In-Person) And Programming Of Device System Parameters Before Or After A Surgery_ Procedure_ Or Test With Analysis_ Review_ And Report By A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE0","description":"ICD-CISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB1","description":"ICD-NLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE1","description":"ICD-ODIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEA1","description":"ICD-IHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC11","description":"ICD-4FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB0","description":"ICD-PGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADA1","description":"ICD-OADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair communication device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5336","description":"Repair communication device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOF1","description":"ICD-PGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tonsil tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42860","description":"Excision of tonsil tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt disagree w/gui","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9058","description":"Onc prac mgmt disagree w/gui","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3d-crt/imrt received","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4165F","description":"3d-crt/imrt received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB1","description":"ICD-FFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC1","description":"ICD-PJRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPF1","description":"ICD-GGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7680","description":"Terbutaline sulf comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no us","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8807","description":"Doc reas no us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0689T","description":"Quantitative Ultrasound Tissue Characterization (Non-Elastographic)_ Including Interpretation And Report_ Obtained Without Diagnostic Ultrasound Examination Of The Same Anatom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD0","description":"ICD-NKVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD1","description":"ICD-CEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES24A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Swivel adaptor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8186","description":"Swivel adaptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Expired gas collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94250","description":"Expired gas collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIB1","description":"ICD-ACIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA204","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUC0","description":"ICD-MBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD215","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWA1","description":"ICD-GGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA1","description":"ICD-FBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVD1","description":"ICD-JHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUF0","description":"ICD-BIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE254","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC1","description":"ICD-OCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81110","description":"Human Platelet Antigen 6 genotyping (HPA-6w)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa_ antigen CD61] [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ po","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKA1","description":"ICD-BBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE0","description":"ICD-ECEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 11-20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98967","description":"Hc pro phone call 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXC1","description":"ICD-FIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE1","description":"ICD-FDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylphenidate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80360","description":"Methylphenidate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUA0","description":"ICD-IGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Christian sci pract visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9900","description":"Christian sci pract visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATF0","description":"ICD-OATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1362","description":"Patients who died during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF1","description":"ICD-GHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB31","description":"ICD-1LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/urinary repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58267","description":"Vag hyst w/urinary repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWA0","description":"ICD-GBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD1","description":"ICD-DCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59851","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC0","description":"ICD-EGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF1","description":"ICD-OAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTE1","description":"ICD-OGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant breast silicone/eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8600","description":"Implant breast silicone/eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTD1","description":"ICD-NLTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rpl car modulj pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414T","description":"Rmvl & rpl car modulj pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB0","description":"ICD-GBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40702","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30430","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUB1","description":"ICD-GFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYB1","description":"ICD-DIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQF0","description":"ICD-PAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA1","description":"ICD-CHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Novachor_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4194","description":"Novachor_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9379","description":"Hit noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE241","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact layer >16<= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6207","description":"Contact layer >16<= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE1","description":"ICD-FDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD0","description":"ICD-NKPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF1","description":"ICD-PJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE0","description":"ICD-AAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD1","description":"ICD-GBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME1","description":"ICD-IHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBA1","description":"ICD-JCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF0","description":"ICD-OHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE1","description":"ICD-OGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASB1","description":"ICD-KASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB1","description":"ICD-OFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4149F","description":"Hep b vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Keramatrix_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4165","description":"Keramatrix_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4396","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","description":"HCPCS-Q4396","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46922","description":"Excision of anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIED1","description":"ICD-BIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD1","description":"ICD-GIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44403","description":"Colonoscopy w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA1","description":"ICD-EHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of sternum separation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21750","description":"Repair of sternum separation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF0","description":"ICD-NAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB0","description":"ICD-BIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC45","description":"High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2003","description":"HCPCS-A2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSF0","description":"ICD-PHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB0","description":"ICD-JBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splnt ped f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4020","description":"Cast sup lng arm splnt ped f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52648","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev precision pinch dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6810","description":"Term dev precision pinch dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ CYP2D6-2D7 hybrid gene) (List separately in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE0","description":"ICD-GEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64891","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3501","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD1","description":"ICD-OFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80504","description":"Pathology Clinical Consultation; For A Moderately Complex Clinical Problem_ With Review Of Patient_S History And Medical Records And Moderate Level Of Medical Decision Making","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histrelin acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1675","description":"Histrelin acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 2nd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36246","description":"Ins cath abd/l-ext art 2nd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ampicillin 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0290","description":"Ampicillin 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB1","description":"ICD-AIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6068","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC1","description":"ICD-JEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD1","description":"ICD-EITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc mntl tst b/4 bk trxmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2044F","description":"Doc mntl tst b/4 bk trxmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt nrostm pls gen dua rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8687","description":"Implt nrostm pls gen dua rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap sleeve gastrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43775","description":"Lap sleeve gastrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx multi myeloma stage i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9128","description":"Onc dx multi myeloma stage i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"G compression stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6549","description":"G compression stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophageal sphincter augmentation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43285","description":"Removal of esophageal sphincter augmentation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CB21","description":"ICD-1CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18H","description":"Special Care Low _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB0","description":"ICD-EGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATD1","description":"ICD-MATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habilitation_ prevocational_ waiver; per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2047","description":"Habilitation_ prevocational_ waiver; per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","description":"HCPCS-J3389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle or intracatheter_ upper or lower extremity artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36140","description":"Introduction of needle or intracatheter_ upper or lower extremity artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEF0","description":"ICD-CHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferential stim 4 chan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8131","description":"Interferential stim 4 chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC1","description":"ICD-OEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation arm complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20802","description":"Replantation arm complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBD0","description":"ICD-IGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont chem diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9330","description":"Hit cont chem diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE0","description":"ICD-HCRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert nasal septal button","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30220","description":"Insert nasal septal button","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUA0","description":"ICD-MBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC1","description":"ICD-PBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC0","description":"ICD-OFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMA1","description":"ICD-GCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58920","description":"Partial removal of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0913T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","description":"CPT-0913T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLB0","description":"ICD-KFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0033U","description":"HTR2A (5-hydroxytryptamine receptor 2A)_ HTR2C (5-hydroxytryptamine receptor 2C) (eg_ citalopram metabolism) gene analysis_ common variants (ie_ HTR2A rs7997012 [c.614-2211T>C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2078","description":"Take-Home Supply Of Methadone; Up To 7 Additional Day Supply (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Addition To Code F","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25290","description":"Incise wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD1","description":"ICD-DDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA0","description":"ICD-ODSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLE0","description":"ICD-BHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA0","description":"ICD-GEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alefacept","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0215","description":"Alefacept","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECF0","description":"ICD-NECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB0","description":"ICD-OGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDA1","description":"ICD-MIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87154","description":"Culture_ Typing; Identification Of Blood Pathogen And Resistance Typing_ When Performed_ By Nucleic Acid (Dna Or Rna) Probe_ Multiplexed Amplified Probe Technique Including Mu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1203","description":"HCPCS-B1203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of prostate abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55720","description":"Drainage of prostate abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEF1","description":"ICD-BFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas biopsy not review","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8884","description":"Doc reas biopsy not review","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUE0","description":"ICD-IEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE1","description":"ICD-OJGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25A","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC1","description":"ICD-IACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8G","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAD1","description":"ICD-IFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst hgh nbl mtl 2 srfc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6610","description":"Onlay cst hgh nbl mtl 2 srfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF1","description":"ICD-CGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE1","description":"ICD-JICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67916","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF1","description":"ICD-PBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42890","description":"Partial removal of pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC1","description":"ICD-GHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ocriplasmin_ 0.125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7316","description":"Inj_ ocriplasmin_ 0.125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFB0","description":"ICD-OEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1009T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","description":"CPT-1009T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE0","description":"ICD-IHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biodfence 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4140","description":"Biodfence 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXE0","description":"ICD-FCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAE1","description":"ICD-AGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVB0","description":"ICD-NGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE1","description":"ICD-KAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD1","description":"ICD-FHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE160","description":"Special Care Low _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Negative pressure ventilator; portable or stationary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0460","description":"Negative pressure ventilator; portable or stationary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE1","description":"ICD-KGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Free myo/skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15756","description":"Free myo/skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXE1","description":"ICD-BCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC110","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIE0","description":"ICD-JHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj hypogas plxs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64517","description":"N block inj hypogas plxs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDB1","description":"ICD-FCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD1","description":"ICD-BEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE1","description":"ICD-GCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45400","description":"Laparoscopic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21433","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC217","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0474U","description":"Hereditary pan-cancer (eg_ hereditary sarcomas_ hereditary endocrine tumors_ hereditary neuroendocrine tumors_ hereditary cutaneous melanoma)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDB1","description":"ICD-AFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA0","description":"ICD-ECIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia sympts assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1181F","description":"Neuropsychia sympts assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil ed waiver per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2013","description":"Habil ed waiver per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFD1","description":"ICD-BEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC0","description":"ICD-JENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWD0","description":"ICD-OEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8A","description":"High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluvirin vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2037","description":"Fluvirin vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Growth hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80428","description":"Growth hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61601","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50949","description":"Laparoscope proc ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","description":"HCPCS-J0608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF1","description":"ICD-FDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Situximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9455","description":"Injection_ Situximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shrinker above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8460","description":"Shrinker above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDC0","description":"ICD-NBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC0","description":"ICD-NBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tb scrng done-interpd 6mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3455F","description":"Tb scrng done-interpd 6mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for salivary x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42550","description":"Injection for salivary x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD245","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasonic generator w svneb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0574","description":"Ultrasonic generator w svneb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0419U","description":"Neuropsychiatry (eg_ depression_ anxiety)_ genomic sequence analysis panel_ variant analysis of 13 genes_ saliva or buccal swab_ report of each gene phenotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMA0","description":"ICD-FAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm autogrft trnk/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15110","description":"Epidrm autogrft trnk/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC0","description":"ICD-CDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD0","description":"ICD-BIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3921","description":"Hfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c 100-129 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3049F","description":"Ldl-c 100-129 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB0","description":"ICD-OFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA1","description":"ICD-OCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC0","description":"ICD-IDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42825","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC1","description":"ICD-BIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLB1","description":"ICD-ABLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXF0","description":"ICD-CDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatic unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9108","description":"Onc dx pancreatic unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAA1","description":"ICD-NBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52276","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGB1","description":"ICD-OIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLE1","description":"ICD-NGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16073","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16073","description":"CPT-16073","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1035T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1035T","description":"CPT-1035T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIE0","description":"ICD-NLIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD0","description":"ICD-FBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF0","description":"ICD-KIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA01","description":"Very High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Basiliximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0480","description":"Basiliximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVA0","description":"ICD-CIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD0","description":"ICD-JHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0A","description":"Medium Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA101","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA0","description":"ICD-ACCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA0","description":"ICD-FEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92622","description":"Diagnostic analysis_ programming_ and verification of an auditory osseointegrated sound processor_ any type; first 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF0","description":"ICD-CFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0536U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","description":"CPT-0536U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1160","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patient_s 13th birthday","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27256","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reclining back add ped w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1014","description":"Reclining back add ped w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE1","description":"ICD-KBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC1","description":"ICD-AHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dtap vaccine < 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90700","description":"Dtap vaccine < 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88167","description":"Cytopath tbs c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneum compressor segmental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0651","description":"Pneum compressor segmental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIB1","description":"ICD-MEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVA1","description":"ICD-FAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTD1","description":"ICD-AHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC130","description":"Clinically Complex _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVD0","description":"ICD-CGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF0","description":"ICD-PBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59852","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUC1","description":"ICD-GAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX25","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB11","description":"ICD-3EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73660","description":"X-ray exam of toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB0","description":"ICD-JFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD0","description":"ICD-KHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF0","description":"ICD-HFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0492T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; each additional 20 sq cm_ or part thereof (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo ankle gauntlet pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1902","description":"Afo ankle gauntlet pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTF1","description":"ICD-NLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision and/or reinsertion of transhepatic tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47530","description":"Revision and/or reinsertion of transhepatic tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAD1","description":"ICD-FBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ delafloxacin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9462","description":"Injection_ delafloxacin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA1","description":"ICD-KCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44212","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97127","description":"Therapeutic interventions that focus on cognitive function (eg_ attention_ memory_ reasoning_ executive function_ problem solving_ and/or pragmatic functioning) and compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deep muscle biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20205","description":"Deep muscle biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAA1","description":"ICD-ICAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect inferior turbinate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30140","description":"Resect inferior turbinate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC1","description":"ICD-KFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26011","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0838T","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp aor-celiac-msn-renal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35631","description":"Art byp aor-celiac-msn-renal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE1","description":"ICD-GEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLD0","description":"ICD-FFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pentazocine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3070","description":"Pentazocine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB0","description":"ICD-BIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYA1","description":"ICD-OIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0694U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694U","description":"CPT-0694U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF1","description":"ICD-IBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv saliv glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64611","description":"Chemodenerv saliv glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFE0","description":"ICD-KDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICA0","description":"ICD-IICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High mount flip-up footrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0037","description":"High mount flip-up footrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add horseshoe toe tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3560","description":"O shoe add horseshoe toe tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBID1","description":"ICD-MBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compression form shoe insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5510","description":"Compression form shoe insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGD0","description":"ICD-GCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9604","description":"Perc d-e cor revasc t cabg s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAE1","description":"ICD-CFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24147","description":"Partial removal of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean birth class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9438","description":"Cesarean birth class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21C","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA213","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSC0","description":"ICD-PFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC131","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKE0","description":"ICD-FFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1708","description":"Pfizer-BioNTech Covid-19 vaccine administration - third dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of upper jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31230","description":"Removal of upper jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND0","description":"ICD-BEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWE0","description":"ICD-CFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE0","description":"ICD-FEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1832","description":"Autograft Suspension_ Including Cell Processing And Application_ And All System Components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ lwr ext","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8912","description":"Mra w/cont_ lwr ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1478","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","description":"HCPCS-M1478","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC1","description":"ICD-LIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc of pain","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8732","description":"No doc of pain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ bal tis dis_ non-vas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1727","description":"Cath_ bal tis dis_ non-vas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Renal abscess open drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50020","description":"Renal abscess open drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Canalith repositioning proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95992","description":"Canalith repositioning proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3398","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation embryo(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89258","description":"Cryopreservation embryo(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of 17-hydroxypregneno","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84143","description":"Assay of 17-hydroxypregneno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA1","description":"ICD-PDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDD0","description":"ICD-MGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF0","description":"ICD-JBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25C","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia- first 15 minutes","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9239","description":"intravenous moderate (conscious) sedation/analgesia- first 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA0","description":"ICD-MLMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNB1","description":"ICD-NKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF0","description":"ICD-GDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD1","description":"ICD-BGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound breast complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76641","description":"Ultrasound breast complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj biperiden lactate/5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0190","description":"Inj biperiden lactate/5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAC0","description":"ICD-GDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB1","description":"ICD-NLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2203","description":"Documentation of medical reason(s) for not providing brief counseling if identified as an unhealthy alcohol user (e.g._ limited life expectancy_ other medical reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87391","description":"IAAD IA HIV-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92326","description":"Replacement of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC1","description":"ICD-MGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daratumumab_ 10mg (Darzalex)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9476","description":"Injection_ daratumumab_ 10mg (Darzalex)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA1","description":"ICD-NIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF0","description":"ICD-GIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQC0","description":"ICD-CFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF1","description":"ICD-CHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACF1","description":"ICD-BACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC1","description":"ICD-LHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7614","description":"Levalbuterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC0","description":"ICD-CCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35206","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB1","description":"ICD-NEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIB0","description":"ICD-NBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant total heart system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051T","description":"Implant total heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","description":"CPT-00522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx periorbital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21386","description":"Opn tx orbit fx periorbital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSA0","description":"ICD-OHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB1","description":"ICD-OLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op asst not doc_ rng","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9617","description":"Pre-op asst not doc_ rng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99239","description":"Hospital discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA256","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC1","description":"ICD-ODEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27823","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIA1","description":"ICD-EAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD0","description":"ICD-FIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99377","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect back tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21935","description":"Resect back tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2C","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB01","description":"Low Rehab_ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak open end sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5321","description":"Ak open end sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC124","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography thoracic spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72255","description":"Myelography thoracic spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC0","description":"ICD-MBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47141","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45905","description":"Dilation of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJA0","description":"ICD-FFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD1","description":"ICD-GGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPF1","description":"ICD-NHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSE1","description":"ICD-OKSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINC0","description":"ICD-FINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26357","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUA0","description":"ICD-ACUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal vitamins 30 day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0197","description":"Prenatal vitamins 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of acute vitreous hemorrhage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1328","description":"Patients with a diagnosis of acute vitreous hemorrhage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB254","description":"Special Care Low _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQC1","description":"ICD-GDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFB1","description":"ICD-BAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGA0","description":"ICD-OAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98978","description":"Remote therapeutic monitoring (eg_ therapy adherence_ therapy response); device(s) supply with scheduled (eg_ daily) recording(s) and/or programmed alert(s) transmission to mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA31","description":"ICD-4KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68326","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYE0","description":"ICD-DGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay urine catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82382","description":"Assay urine catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21454","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16371","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16371","description":"CPT-16371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGD1","description":"ICD-KGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCE0","description":"ICD-BCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE154","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTB0","description":"ICD-MFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile duct endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74328","description":"X-ray bile duct endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0D","description":"Default_ /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHE0","description":"ICD-GIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB0","description":"ICD-MDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIF0","description":"ICD-EFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAA0","description":"ICD-EEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDC0","description":"ICD-MJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","description":"HCPCS-M0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDF1","description":"ICD-BDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUA0","description":"ICD-ECUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4187","description":"Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB0","description":"ICD-EHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIF1","description":"ICD-CBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft carotid-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35508","description":"Art byp grft carotid-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable insert each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6691","description":"Removable insert each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD0","description":"ICD-IEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0258U","description":"Autoimmune (psoriasis)_ mRNA_ next-generation sequencing_ gene expression profiling of 50-100 genes_ skin-surface collection using adhesive patch_ algorithm reported as likeli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2157","description":"Patients Received Both The 13-Valent Pneumococcal Conjugate Vaccine And The 23-Valent Pneumococcal Polysaccharide Vaccine At Least 12 Months Apart_ With The First Occurrence A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFND1","description":"ICD-NFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ pasireotide long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2502","description":"Inj_ pasireotide long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNA0","description":"ICD-CHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA0","description":"ICD-IHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate unknwn nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9083","description":"Onc dx prostate unknwn nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC1","description":"ICD-ABBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21142","description":"Lefort i-2 piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer system >300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1036","description":"Patient transfer system >300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1A","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Water distilled w/nebulizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7018","description":"Water distilled w/nebulizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB0","description":"ICD-CCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF0","description":"ICD-KGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain nobel metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6242","description":"Bridge porcelain nobel metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF1","description":"ICD-KBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC1","description":"ICD-KFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX21","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whfo_ rigid w/o joints","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3808","description":"Whfo_ rigid w/o joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp 5yrs/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99144","description":"Mod sedat phys/qhp 5yrs/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc of dsm-iv init eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9212","description":"Doc of dsm-iv init eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0067U","description":"Oncology (breast)_ immunohistochemistry_ protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1]_ carcinoembryonic antigen-related cell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB1","description":"ICD-GGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMB0","description":"ICD-ECMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC1","description":"ICD-CGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNC1","description":"ICD-KBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDB0","description":"ICD-NLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27784","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFB0","description":"ICD-OAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD0","description":"ICD-BHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB1","description":"ICD-MABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary reflex study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51792","description":"Urinary reflex study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTC0","description":"ICD-JGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCD1","description":"ICD-KHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIC1","description":"ICD-MDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKF1","description":"ICD-CFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt=d(rh)+ or sensitized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3291F","description":"Pt=d(rh)+ or sensitized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVF1","description":"ICD-CFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk molded distal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5668","description":"Bk molded distal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5B","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9320","description":"Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg_CT studies performed for radiation treatment planning)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC0","description":"ICD-DDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair brow defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67900","description":"Repair brow defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible disk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87184","description":"Microbe susceptible disk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2024","description":"Spec collection for sev acute resp synd coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ from an ind in a SNF or by a lab on behalf of an HH agcy any spec srce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath cell enhance tech","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88112","description":"Cytopath cell enhance tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services received by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9692","description":"Hospice services received by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARF1","description":"ICD-PARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF0","description":"ICD-PCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA0","description":"ICD-KICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB0","description":"ICD-NEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXE1","description":"ICD-CAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJB0","description":"ICD-BFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFD1","description":"ICD-GGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTA0","description":"ICD-NJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0C","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0847T","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie_ previously diagnosed) tissue(s) for molecular analysis (eg_ KRAS mutational an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHE0","description":"ICD-NBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHD1","description":"ICD-JBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHC0","description":"ICD-CBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19367","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJE1","description":"ICD-KDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0617U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","description":"CPT-0617U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBF1","description":"ICD-AIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND0","description":"ICD-FFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp femoral-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35661","description":"Art byp femoral-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWB1","description":"ICD-CDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove interim implant component","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6198","description":"Remove interim implant component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXC1","description":"ICD-OBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF1","description":"ICD-FCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tyrosine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84510","description":"Assay of tyrosine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE1","description":"ICD-OGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC0","description":"ICD-JITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGC0","description":"ICD-JCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81166","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ detection of large gene rearrangements)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAD0","description":"ICD-BAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15771","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Trunk_ Breasts_ Scalp_ Arms_ And/Or Legs; 50 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82486","description":"Chromatography_ qualitative; column (eg_ gas liquid or hplc)_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFB1","description":"ICD-NCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE1","description":"ICD-BHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPD0","description":"ICD-GGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF1","description":"ICD-CITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF1","description":"ICD-NKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCF1","description":"ICD-BDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lith ion non prosth recharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4601","description":"Lith ion non prosth recharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90851","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF0","description":"ICD-FEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA21","description":"ICD-4LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dem severity classified mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1491F","description":"Dem severity classified mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECA0","description":"ICD-MECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unspec maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8048","description":"Unspec maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Umbilical cord occlud w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59072","description":"Umbilical cord occlud w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35372","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast semi-rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2134","description":"Kafo fem fx cast semi-rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWB0","description":"ICD-LCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elec w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0266","description":"Hosp bed total elec w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF1","description":"ICD-JHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKF0","description":"ICD-KEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE0","description":"ICD-FIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel face epiderm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15788","description":"Chemical peel face epiderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneum walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4387","description":"Non-pneum walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIF0","description":"ICD-CEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMA1","description":"ICD-OLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27501","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES206","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67412","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4367","description":"Ostomy belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82544","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ multiple analytes_ quantitative_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME1","description":"ICD-BFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTE0","description":"ICD-KGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGC0","description":"ICD-NJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1206","description":"Itch severity assessment score was not reduced by at least 2 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWF0","description":"ICD-DCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDF1","description":"ICD-MKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway press chinstrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7036","description":"Pos airway press chinstrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69740","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXE1","description":"ICD-CIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABC1","description":"ICD-KABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE1","description":"ICD-LBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9748","description":"Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE0","description":"ICD-NIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC1","description":"ICD-MCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC1","description":"ICD-OCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMA0","description":"ICD-AHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJB0","description":"ICD-KCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB241","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles multifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92342","description":"Fit spectacles multifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUD0","description":"ICD-ABUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0843","description":"Pwc gp2 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMF1","description":"ICD-IGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIA1","description":"ICD-OBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17264","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOC0","description":"ICD-CBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA0","description":"ICD-GBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGE0","description":"ICD-NHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged iv inf_ req pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8957","description":"Prolonged iv inf_ req pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64905","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC1","description":"ICD-GHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF1","description":"ICD-NJJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC230","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrin degrade semiquant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85378","description":"Fibrin degrade semiquant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stereoisomer analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80374","description":"Stereoisomer analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC1","description":"ICD-GDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE0","description":"ICD-EAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAC0","description":"ICD-FHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES204","description":"Extensive Services _ ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX56","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"WoundEx_ BioSkin_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4163","description":"WoundEx_ BioSkin_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC1","description":"ICD-GILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54800","description":"Biopsy of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2105","description":"Spherocylinder 4.00d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45541","description":"Correct rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80500","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF0","description":"ICD-GAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo state","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9151","description":"Mapcp demo state","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0650U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0650U","description":"CPT-0650U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0053A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) ([COVID-19]) vacc_ mRNA-LNP_ spike protein_ presev free_ 30mcg/0.3 mL dosage_ tris-sucrose formula; third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD110","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine/uric acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84560","description":"Assay of urine/uric acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44661","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD204","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spirometry up to 2 yrs old","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94011","description":"Spirometry up to 2 yrs old","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF1","description":"ICD-OBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB0","description":"ICD-BELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF0","description":"ICD-KFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLA1","description":"ICD-JGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC1","description":"ICD-LESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA1","description":"ICD-NCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22222","description":"Incis w/discectomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87590","description":"N.gonorrhoeae dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB0","description":"ICD-GCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB1","description":"ICD-AEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOC1","description":"ICD-KAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodic oral evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0120","description":"Periodic oral evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00222","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","description":"CPT-00222","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUA1","description":"ICD-OJUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA0","description":"ICD-PESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional electric stim nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0770","description":"Functional electric stim nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC0","description":"ICD-KHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC26","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9186","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9186","description":"HCPCS-J9186","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGF0","description":"ICD-GGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMF0","description":"ICD-BEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"XWRAP_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4204","description":"XWRAP_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB0","description":"ICD-FIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE0","description":"ICD-AIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So airplane w/wo joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3674","description":"So airplane w/wo joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87481","description":"Candida dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pontic titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6214","description":"Pontic titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC224","description":"Special Care Low _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist endoscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29848","description":"Wrist endoscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15822","description":"Revision of upper eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAE1","description":"ICD-BAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC0","description":"ICD-AIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9757","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE1","description":"ICD-GDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCC0","description":"ICD-NGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB212","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF1","description":"ICD-EDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQB0","description":"ICD-OEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 1 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64493","description":"Inj paravert f jnt l/s 1 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWC1","description":"ICD-GHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9506","description":"Graphite crucible for preparation of Technetium Tc 99m-labeled carbon aerosol_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJC1","description":"ICD-OKJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB156","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0181","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9753","description":"Documentation of medical reason for not conducting a search for DICOM format images for prior patient CT imaging studies completed at non-affiliated external healthcare facili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGE0","description":"ICD-NFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urokinase 5000 iu injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3364","description":"Urokinase 5000 iu injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLF1","description":"ICD-MFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSB1","description":"ICD-ODSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIC1","description":"ICD-MKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPA0","description":"ICD-OHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQE1","description":"ICD-KHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQB0","description":"ICD-CGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL42","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frozen blood prep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86930","description":"Frozen blood prep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kt/v =/> 1.2 & <1.7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3083F","description":"Kt/v =/> 1.2 & <1.7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal hemoglobin assay qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83033","description":"Fetal hemoglobin assay qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA1","description":"ICD-BEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCE1","description":"ICD-FDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc gastro 51 gene nomogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007M","description":"Onc gastro 51 gene nomogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bp not performed/doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8478","description":"Bp not performed/doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"H&p for surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0260","description":"H&p for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA1","description":"ICD-OAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC0","description":"ICD-DHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma protein fract_5%_50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9043","description":"Plasma protein fract_5%_50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0223","description":"IV injection_ bebtelovimab_ include injection and post administration monitoring in the patient’s home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBE0","description":"ICD-IGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLME0","description":"ICD-NLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1315","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm a-grft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15116","description":"Epidrm a-grft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD1","description":"ICD-EFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47555","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALD1","description":"ICD-MALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture bacteria anaerobic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87073","description":"Culture bacteria anaerobic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8G","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9140","description":"Injection_ factor VIII (antihemophilic factor_ recombinant) (Afstyla)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB214","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABA0","description":"ICD-AABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smpd1 gene common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81330","description":"Smpd1 gene common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMF0","description":"ICD-CEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavral qualit analys voice","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92524","description":"Behavral qualit analys voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy titrate-airborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95027","description":"Icut allergy titrate-airborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vkorc1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81355","description":"Vkorc1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0203","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0203","description":"CDT-D0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA1","description":"ICD-OGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFID1","description":"ICD-NFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12A","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF0","description":"ICD-LBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD0","description":"ICD-PISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93279","description":"Pm device progr eval sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIF1","description":"ICD-ECIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had history of immunocompromising conditions prior to or during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1158","description":"Patient had history of immunocompromising conditions prior to or during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manipulation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27275","description":"Manipulation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF1","description":"ICD-OGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGA0","description":"ICD-FCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise parotid gland/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42426","description":"Excise parotid gland/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0816T","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg_ array or leadless)_ and pulse generator or receiver_ in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD0","description":"ICD-GGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNA0","description":"ICD-CGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0426","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0426","description":"CDT-D0426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sysrsn no dicom srch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9344","description":"Sysrsn no dicom srch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photorefractive keratectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0810","description":"Photorefractive keratectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQB1","description":"ICD-CFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVC0","description":"ICD-OLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC0","description":"ICD-JETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNF1","description":"ICD-KGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy orchiectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54690","description":"Laparoscopy orchiectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD0","description":"ICD-KEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGB0","description":"ICD-NCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWE0","description":"ICD-HAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/ matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0260","description":"Hosp bed semi-electr w/ matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFE0","description":"ICD-NBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE1","description":"ICD-DFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIC1","description":"ICD-GDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC0","description":"ICD-EFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGF1","description":"ICD-CBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0175","description":"Commode chair foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermal filler injection(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0429","description":"Dermal filler injection(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITD0","description":"ICD-AITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0021","description":"Alcohol and/or drug training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7050","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3357","description":"Pulpal regeneration complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA46","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA0","description":"ICD-BHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24065","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF1","description":"ICD-DIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43763","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33875","description":"Thoracic aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA0","description":"ICD-KFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA1","description":"ICD-JHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0587T","description":"Percutaneous Implantation Or Replacement Of Integrated Single Device Neurostimulation System Including Electrode Array And Receiver Or Pulse Generator_ Including Analysis_ Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9756","description":"Intraoperative near-infrared fluorescence lymphatic mapping of lymp node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMA1","description":"ICD-EFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQD0","description":"ICD-KDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIF1","description":"ICD-BGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mibm but no dx of breast ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8946","description":"Mibm but no dx of breast ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNA0","description":"ICD-FBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2065","description":"Comprehensive Care Management For A Single High-Risk Disease Services_ E.G. Principal Care Management_ At Least 30 Minutes Of Clinical Staff Time Directed By A Physician Or Ot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral occlusal film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0240","description":"Intraoral occlusal film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE0","description":"ICD-EIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSF0","description":"ICD-OGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPA1","description":"ICD-NLPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69436","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA1","description":"ICD-BCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSC0","description":"ICD-HBSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2186","description":"Patient /caregiver dyad has been referred to appropriate resources and connection to those resources is confirmed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQE1","description":"ICD-DAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427U","description":"Monocyte distribution width_ whole blood (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diab shoe for density insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5500","description":"Diab shoe for density insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc opioid tx 1x at ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9579","description":"No doc opioid tx 1x at ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Etonogestrel implant system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7307","description":"Etonogestrel implant system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA0","description":"ICD-PLYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF1","description":"ICD-OIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86408","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 500 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4217","description":"Sterile water/saline_ 500 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_ non-prog_temp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2626","description":"Infusion pump_ non-prog_temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIE1","description":"ICD-CFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1018","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD1","description":"ICD-CBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA1","description":"ICD-HCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC0","description":"ICD-MIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYF0","description":"ICD-OBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lumb artif disc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22865","description":"Remove lumb artif disc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part removal hip bone deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27071","description":"Part removal hip bone deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF1","description":"ICD-FGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft f/n/hf/g addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15276","description":"Skin sub graft f/n/hf/g addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF0","description":"ICD-PIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EC21","description":"ICD-1EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC56","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX02","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6072","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47451","description":"Anesth surgery of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9881","description":"The MDPP b eneficiary achieved at least 9% weight loss (WL) from his/he r baseline weight in months 1-24 under the MDPP Expanded Model (EM). This is a one-time payment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intraspinl lesion crv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63265","description":"Excise intraspinl lesion crv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace pretibial shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4130","description":"Replace pretibial shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOF0","description":"ICD-OGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJF0","description":"ICD-GHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit chelation diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9355","description":"Hit chelation diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJF0","description":"ICD-NHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHA0","description":"ICD-CDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1603","description":"HCPCS-C1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90703","description":"Tetanus toxoid adsorbed_ for intramuscular or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUE1","description":"ICD-ECUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0505","description":"HCPCS-A0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIB0","description":"ICD-MFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEE1","description":"ICD-MKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXF0","description":"ICD-FEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF0","description":"ICD-NGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE0","description":"ICD-OCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC1","description":"ICD-JAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC23","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE1","description":"ICD-CAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD1","description":"ICD-GECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92930","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","description":"CPT-92930","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0541U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","description":"CPT-0541U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA1","description":"ICD-JBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAB1","description":"ICD-IFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibuloplasty ridge extens","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7340","description":"Vestibuloplasty ridge extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1133","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy not rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8475","description":"Ace/arb thxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF1","description":"ICD-GGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18A","description":"Clinically Complex _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATF1","description":"ICD-NATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA3C","description":"Default_ /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXA0","description":"ICD-NLXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND1","description":"ICD-KFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVA0","description":"ICD-GHVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD0","description":"ICD-BFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB1","description":"ICD-BGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID1","description":"ICD-IBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 100-300","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88275","description":"Cytogenetics 100-300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEC1","description":"ICD-KFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPB1","description":"ICD-NFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure cpap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94660","description":"Pos airway pressure cpap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWD1","description":"ICD-PFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPF1","description":"ICD-OEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1429","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","description":"HCPCS-M1429","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biliary endoscopy thru skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47554","description":"Biliary endoscopy thru skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE1","description":"ICD-HCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA24","description":"Medium Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6565","description":"Gradient compression gauntlet_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPA0","description":"ICD-BBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arformoterol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7605","description":"Arformoterol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA1","description":"ICD-AGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9471","description":"Hyaluronan or derivative_ Hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4A","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15D","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg cerebral death only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95824","description":"Eeg cerebral death only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2272","description":"Injection_ morphine sulfate (fresenius kabi) not therapeutically equivalent to j2270_ up to 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA0","description":"ICD-KAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEF0","description":"ICD-IEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA0","description":"ICD-KAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB212","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWA0","description":"ICD-HFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95713","description":"Electroencephalogram With Video (Veeg)_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB1","description":"ICD-KADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nondisposable pump canister","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7001","description":"Nondisposable pump canister","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENC0","description":"ICD-OENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KC21","description":"ICD-2KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF1","description":"ICD-KIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prp i/hern init reduc >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49505","description":"Prp i/hern init reduc >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF1","description":"ICD-FBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E2403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2403","description":"HCPCS-E2403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBA1","description":"ICD-GEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7980","description":"Sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allergy immunology services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95199","description":"Allergy immunology services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD1","description":"ICD-JIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1483","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","description":"HCPCS-M1483","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMA1","description":"ICD-NEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA0","description":"ICD-KEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA0","description":"ICD-KGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11B","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE1","description":"ICD-LFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA0","description":"ICD-JFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKC0","description":"ICD-KBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2158","description":"Patient Had Prior Pneumococcal Vaccine Adverse Reaction Any Time During Or Before The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB0","description":"ICD-OKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB0","description":"ICD-NHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVF0","description":"ICD-GCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HIV-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87390","description":"IAAD IA HIV-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69530","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17276","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7192","description":"Factor viii recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYE0","description":"ICD-LBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA0","description":"ICD-MGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1097","description":"Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJF1","description":"ICD-OIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA22","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA1","description":"ICD-GCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98001","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","description":"CPT-98001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF1","description":"ICD-OIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAC1","description":"ICD-EFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp remove forgn body duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43275","description":"Ercp remove forgn body duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver & spleen image/flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78216","description":"Liver & spleen image/flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad w/backup non inv intrfc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0471","description":"Rad w/backup non inv intrfc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC1","description":"ICD-JATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQD1","description":"ICD-OEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE0","description":"ICD-ODCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLB1","description":"ICD-ADLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFB1","description":"ICD-OIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYF1","description":"ICD-HFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvng antivir txmnt hepc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4150F","description":"Pt recvng antivir txmnt hepc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCA1","description":"ICD-OBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE0","description":"ICD-BEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE0","description":"ICD-OARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWF0","description":"ICD-GGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1806","description":"HCPCS-A1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBA0","description":"ICD-NFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGE0","description":"ICD-FDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metabolic panel total ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80048","description":"Metabolic panel total ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHA1","description":"ICD-ICHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC1","description":"ICD-IEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4287","description":"Disposable collection and storage bag for breast milk_ any size_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27503","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKB0","description":"ICD-BGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE0","description":"ICD-LDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Val rsn hd ct ord reg indic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9595","description":"Val rsn hd ct ord reg indic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL10","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYA1","description":"ICD-HEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma impairment assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2015F","description":"Asthma impairment assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27614","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval on foot not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8415","description":"Eval on foot not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML21","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA1","description":"ICD-MJTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply hand/wrist cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29085","description":"Apply hand/wrist cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAD1","description":"ICD-NAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 125","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86304","description":"Immunoassay tumor ca 125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWB1","description":"ICD-OGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE1","description":"ICD-LCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc thigh/knee tum deep <5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27328","description":"Exc thigh/knee tum deep <5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJA1","description":"ICD-JDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","description":"HCPCS-A2031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1>=risk or>= mod risk for te","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8972","description":"1>=risk or>= mod risk for te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB21","description":"Low Rehab_ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0963T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","description":"CPT-0963T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC0","description":"ICD-OFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE1","description":"ICD-KEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIB0","description":"ICD-CFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE15A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJE1","description":"ICD-JCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual diff wbc count b-coat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85009","description":"Manual diff wbc count b-coat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc recpt counsl vit d/calc+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4019F","description":"Doc recpt counsl vit d/calc+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE1","description":"ICD-CBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1343","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0503","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0503","description":"CDT-D0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCC0","description":"ICD-BFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2189","description":"Patients with clinical indications for imaging of the head: abnormal neurologic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA1","description":"ICD-DFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-putty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9359","description":"Implnt_bon void filler-putty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.6-1 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11441","description":"Exc face-mm b9+marg 0.6-1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67039","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is undergoing palliative dialysis with a catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9747","description":"Patient is undergoing palliative dialysis with a catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHC0","description":"ICD-GCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65260","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opiate(s)_ drug and metabolites_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6056","description":"Opiate(s)_ drug and metabolites_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00126","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","description":"CPT-00126","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA0","description":"ICD-AHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63744","description":"Revision of spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift mechanism toilet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0172","description":"Seat lift mechanism toilet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr extnd >4 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4410","description":"Ost skn barr extnd >4 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0619U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","description":"CPT-0619U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE0","description":"ICD-EDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML22","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EC31","description":"ICD-2EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD1","description":"ICD-GFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35302","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone diacetate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3302","description":"Triamcinolone diacetate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPC0","description":"ICD-CFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27508","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC44","description":"Medium Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33762","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFD0","description":"ICD-NEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYB1","description":"ICD-HHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0632T","description":"Percutaneous Transcatheter Ultrasound Ablation Of Nerves Innervating The Pulmonary Arteries_ Including Right Heart Catheterization_ Pulmonary Artery Angiography_ And All Imagi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oth resp proc_ group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0239","description":"Oth resp proc_ group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB0","description":"ICD-GBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2A","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA0","description":"ICD-FIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0407","description":"HCPCS-B0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCB1","description":"ICD-MKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0975T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","description":"CPT-0975T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73040","description":"Contrast x-ray of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise flexor carpi radialis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25001","description":"Incise flexor carpi radialis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD235","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF0","description":"ICD-OCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304U","description":"Hematology_ Red Blood Cell (Rbc) Adhesion To Endothelial/Subendothelial Adhesion Molecules_ Functional Assessment_ Whole Blood_ With Algorithmic Analysis And Result Reported A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1192","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33900","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL1C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD1","description":"ICD-IHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No interv req for leak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9305","description":"No interv req for leak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJB1","description":"ICD-GBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBB1","description":"ICD-OBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC1","description":"ICD-LGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB0","description":"ICD-EFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALC0","description":"ICD-AALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82248","description":"Bilirubin direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I&d absc intraoral soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7510","description":"I&d absc intraoral soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6006","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPC1","description":"ICD-GHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adalimumab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80145","description":"Adalimumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE1","description":"ICD-BEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reason for no ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9196","description":"Med reason for no ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAB0","description":"ICD-IAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA0","description":"ICD-FEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTE1","description":"ICD-MBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6539","description":"Gc stocking waistlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hand vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6708","description":"Term dev mech hand vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHE1","description":"ICD-AAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF0","description":"ICD-OJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC0","description":"ICD-OJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy lysis adhesn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7873","description":"Tmj arthroscopy lysis adhesn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81237","description":"EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg_ diffuse large B-cell lymphoma) gene analysis_ common variant(s) (eg_ codon 646)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/ch access det adj armrest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0973","description":"W/ch access det adj armrest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRE0","description":"ICD-PBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7351","description":"Injection_ bimatoprost_ intracameral implant_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26862","description":"Fusion/graft of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD1","description":"ICD-MEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF0","description":"ICD-FEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj fem cont inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64448","description":"N block inj fem cont inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace molded calf lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4050","description":"Replace molded calf lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA1","description":"ICD-KFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak/hip alignable system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5920","description":"Endo ak/hip alignable system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD112","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXA1","description":"ICD-JDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spinal cord ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63180","description":"Revise spinal cord ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2787","description":"Riboflavin 5_-phosphate_ ophthalmic solution_ up to 3 mL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF0","description":"ICD-GDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61320","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE0","description":"ICD-OBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPC1","description":"ICD-JFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD1","description":"ICD-MAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIF1","description":"ICD-KAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shorten radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25392","description":"Shorten radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF1","description":"ICD-MHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2B","description":"Medium Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External ambulatory infus pu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0781","description":"External ambulatory infus pu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF1","description":"ICD-OJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD0","description":"ICD-NJKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF1","description":"ICD-KCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTB1","description":"ICD-KGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE1","description":"ICD-KCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAD1","description":"ICD-CFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD0","description":"ICD-AHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert epicard eltrd open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33202","description":"Insert epicard eltrd open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILD0","description":"ICD-CILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKE1","description":"ICD-FIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB1","description":"ICD-AITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme histochemistry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88319","description":"Enzyme histochemistry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Keroxx (2.5 g/cc)_ 1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4202","description":"Keroxx (2.5 g/cc)_ 1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vit for membrane dissect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67043","description":"Vit for membrane dissect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJE0","description":"ICD-CCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay triiodothyronine (t3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84480","description":"Assay triiodothyronine (t3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB1","description":"ICD-CFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD1","description":"ICD-KAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE1","description":"ICD-DEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB0","description":"ICD-GHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7545","description":"Percutaneous exchange of biliary drainage catheter (eg_ external_ internal-external_ or conversion of internal-external to external only)_ with removal of calculi/debris from","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad intra w/o bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33982","description":"Replace vad intra w/o bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXF0","description":"ICD-GBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXA1","description":"ICD-NAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEA1","description":"ICD-AIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special supply_ nos waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2028","description":"Special supply_ nos waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHB1","description":"ICD-CEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Car seat/bed test + 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94781","description":"Car seat/bed test + 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE1","description":"ICD-PAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA0","description":"ICD-OLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBND1","description":"ICD-GBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXA1","description":"ICD-GDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIND1","description":"ICD-KIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB216","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYA0","description":"ICD-DDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36904","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE0","description":"ICD-IBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC1","description":"ICD-FDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE0","description":"ICD-JFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90964","description":"Esrd home pt serv p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide sol_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9529","description":"I131 iodide sol_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTA0","description":"ICD-MGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49596","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1904","description":"HCPCS-C1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126U","description":"Anesthesia for intraoral procedures_ including biopsy; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene known variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81303","description":"Mecp2 gene known variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-cov surg proc_clin trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0293","description":"Non-cov surg proc_clin trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUA0","description":"ICD-KIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF0","description":"ICD-CIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAD1","description":"ICD-BCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE0","description":"ICD-NJJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKA1","description":"ICD-KAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9982","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2753","description":"Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASE1","description":"ICD-PASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Off assis eol iss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9380","description":"Off assis eol iss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJD1","description":"ICD-JDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOE0","description":"ICD-CIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWF1","description":"ICD-PCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD0","description":"ICD-IADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc p aspir case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4021","description":"Ivf canc p aspir case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE1","description":"ICD-CHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC1","description":"ICD-GEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB1","description":"ICD-MLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper lg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4523","description":"Adult size brief/diaper lg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lsh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58541","description":"Lsh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0495T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31554","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFB1","description":"ICD-CIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHF1","description":"ICD-OCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRC0","description":"ICD-OHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB255","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD1","description":"ICD-JIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB0","description":"ICD-CCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0136U","description":"Targeted genomic sequence analysis panel_ non-small cell lung neoplasia_ DN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBB0","description":"ICD-KCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC1","description":"ICD-CACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYE1","description":"ICD-KHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNF0","description":"ICD-OLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD0","description":"ICD-LEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCD1","description":"ICD-JGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAF1","description":"ICD-GBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v redo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88153","description":"Cytopath c/v redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHC1","description":"ICD-MLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTC0","description":"ICD-MKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult companioncare per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5136","description":"Adult companioncare per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0519","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0519","description":"HCPCS-Q0519","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no dchg home postop day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9602","description":"Pt no dchg home postop day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were deceased when the hu survey reached them","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1254","description":"Patients who were deceased when the hu survey reached them","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-specific kinase (MuSK) antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86366","description":"Muscle-specific kinase (MuSK) antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC0","description":"ICD-KHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oliceridine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9101","description":"Injection_ oliceridine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAF1","description":"ICD-GIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRB1","description":"ICD-LDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27596","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9084","description":"Injection_ loncastuximab tesirine-lpyl_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Finasteride_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0138","description":"Finasteride_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXF0","description":"ICD-CFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9902","description":"Patient screened for tobacco use and identified as a tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSC0","description":"ICD-KDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar derotation pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1240","description":"Lumbar derotation pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD0","description":"ICD-KCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB0","description":"ICD-BBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of inner eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67036","description":"Removal of inner eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57330","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Or Care Partner Decline Assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0036","description":"Patient Or Care Partner Decline Assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA0","description":"ICD-JHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99221","description":"Initial hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC1","description":"ICD-AGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRD1","description":"ICD-PIRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBE0","description":"ICD-JEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8E","description":"Very High Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOB0","description":"ICD-OJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPB0","description":"ICD-OIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD1","description":"ICD-AHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25635","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mast subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19304","description":"Mast subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00914","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","description":"CPT-00914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66840","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJA1","description":"ICD-FAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAA0","description":"ICD-IDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXB1","description":"ICD-BHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap paraesophag hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43281","description":"Lap paraesophag hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA1","description":"ICD-FHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart failure composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0001F","description":"Heart failure composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA1","description":"ICD-NFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zneuroendoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62163","description":"Zneuroendoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOB1","description":"ICD-OBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA1","description":"ICD-OBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB31","description":"ICD-4KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr trunk addl 5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13102","description":"Cmplx rpr trunk addl 5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJE1","description":"ICD-OJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE1","description":"ICD-CCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE0","description":"ICD-BBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61582","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFE0","description":"ICD-JDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLA1","description":"ICD-OCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGE0","description":"ICD-CAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWD0","description":"ICD-CDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC11","description":"ICD-4AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQC1","description":"ICD-PKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENA1","description":"ICD-GENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC124","description":"Clinically Complex _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF1","description":"ICD-BGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACB0","description":"ICD-MACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","description":"HCPCS-J3387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE0","description":"ICD-JGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB0","description":"ICD-NCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEB1","description":"ICD-JIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCE1","description":"ICD-CCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA0","description":"ICD-JEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIA1","description":"ICD-FAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0589T","description":"Electronic Analysis With Simple Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse Wi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB0","description":"ICD-MJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA25","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD151","description":"Special Care Low _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation without programming of implanted phrenic nerve stimulator system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93153","description":"Interrogation without programming of implanted phrenic nerve stimulator system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYA1","description":"ICD-DIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE1","description":"ICD-MBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJD0","description":"ICD-KDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of neck wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15825","description":"Removal of neck wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB11","description":"ICD-4AB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBB1","description":"ICD-MHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB1","description":"ICD-OCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35201","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJD0","description":"ICD-JGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE0","description":"ICD-KFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21620","description":"Partial removal of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15D","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt immunity to hep a docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3215F","description":"Pt immunity to hep a docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB0","description":"ICD-OLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cltx med ankle fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27762","description":"Cltx med ankle fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct hrt w/3d image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75572","description":"Ct hrt w/3d image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXC0","description":"ICD-JFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTE0","description":"ICD-IGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEME1","description":"ICD-JEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA1","description":"ICD-OGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB60","description":"Medium Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOE0","description":"ICD-OKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat slipped epiphysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27175","description":"Treat slipped epiphysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF1","description":"ICD-GITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUB0","description":"ICD-FHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDD0","description":"ICD-NDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vitreoretinal surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14551","description":"Anesth vitreoretinal surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPF0","description":"ICD-CGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF1","description":"ICD-ECTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFND1","description":"ICD-BFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC0","description":"ICD-FADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF0","description":"ICD-ADCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruct premalg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17000","description":"Destruct premalg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cult epiderm grft f/n/hfg +%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15157","description":"Cult epiderm grft f/n/hfg +%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE1","description":"ICD-NCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID1","description":"ICD-AIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF1","description":"ICD-KCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flex foot system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5980","description":"Flex foot system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMC1","description":"ICD-MBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUC0","description":"ICD-IBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kyphectomy 1-2 segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22818","description":"Kyphectomy 1-2 segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg monit/reprt up to 48 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93225","description":"Ecg monit/reprt up to 48 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB31","description":"ICD-1FB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36466","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; multi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED0","description":"ICD-BBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52318","description":"Remove bladder stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAF1","description":"ICD-EGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28H","description":"Clinically Complex _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","description":"HCPCS-E1032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAC1","description":"ICD-OJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB0","description":"ICD-MFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYD1","description":"ICD-GAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angio upr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73225","description":"Mr angio upr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23670","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric analy w/ph ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82930","description":"Gastric analy w/ph ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bed cradle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0280","description":"Bed cradle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genetic test spec analysis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0423","description":"Genetic test spec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB0","description":"ICD-BACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIND1","description":"ICD-FIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE145","description":"Special Care Low _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE1","description":"ICD-OBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUA0","description":"ICD-AEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2172","description":"All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFD1","description":"ICD-FIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE1","description":"ICD-HFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEE1","description":"ICD-NHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj metaraminol bitartrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0380","description":"Inj metaraminol bitartrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB1","description":"ICD-OFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF1","description":"ICD-MFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC206","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJC0","description":"ICD-CGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBF0","description":"ICD-MDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAB1","description":"ICD-ECAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF1","description":"ICD-GISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF1","description":"ICD-FGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDE0","description":"ICD-NCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA52","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mecp2 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81302","description":"Mecp2 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAB0","description":"ICD-NBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD1","description":"ICD-DBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0104","description":"Structured Day Habilitation Group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD1","description":"ICD-GEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF1","description":"ICD-CHXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ spinal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8933","description":"Mra_ w/o&w/dye_ spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNB1","description":"ICD-JHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGB1","description":"ICD-JFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0046U","description":"FLT3 (fms-related tyrosine kinase 3) (eg_ acute myeloid leukemia) internal tandem duplication (ITD) variants_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQF1","description":"ICD-HHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB1","description":"ICD-ECUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1037T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1037T","description":"CPT-1037T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98970","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB0","description":"ICD-ACLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amphetamines 3or 4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80325","description":"Amphetamines 3or 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5D","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA1","description":"ICD-MKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVA1","description":"ICD-NEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8712","description":"Not pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB1","description":"ICD-MITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC1","description":"ICD-KHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9787","description":"Gastric electrophysiology mapping with simultaneous patient symptom profiling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE1","description":"ICD-KEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE1","description":"ICD-FHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTE0","description":"ICD-KCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93150","description":"Therapy activation of implanted phrenic nerve stimulator system_ including all interrogation and programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVC0","description":"ICD-JAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUA1","description":"ICD-KCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB1","description":"ICD-ODWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQB1","description":"ICD-GCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9075","description":"Injection_ cyclophosphamide_ not otherwise specified_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8E","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIF0","description":"ICD-BHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5129","description":"Injection_ bevacizumab-adcd (vegzelma)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0D","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB1","description":"ICD-MJMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair middle ear structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69666","description":"Repair middle ear structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4032","description":"Cast sup lng leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNF1","description":"ICD-JDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB1","description":"ICD-KDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA1","description":"ICD-GHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB24","description":"Very High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMD1","description":"ICD-AAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA0","description":"ICD-OGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYD0","description":"ICD-HBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE0","description":"ICD-CEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE1","description":"ICD-AHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair maxillofacial prosth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8049","description":"Repair maxillofacial prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE1","description":"ICD-BCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42800","description":"Biopsy of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versiti™ Comprehensive Bleeding Disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272U","description":"Hematology (genetic bleeding disorders)_ genomic sequence analysis of 51 genes_ blood_ buccal swab_ or amniotic fluid_ comprehensive (Versiti™ Comprehensive Bleeding Disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJF0","description":"ICD-KDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7514","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","description":"HCPCS-J7514","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC0","description":"ICD-IFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF0","description":"ICD-LBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYA0","description":"ICD-PJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE106","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRD1","description":"ICD-OBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0812T","description":"Remote multi-day complex uroflowmetry (eg_ calibrated electronic equipment); device supply with automated report generation_ up to 10 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83930","description":"Assay of blood osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF1","description":"ICD-HIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYC0","description":"ICD-HFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0330","description":"Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g._ general_ intravenous sedation (monitored anesthesia ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXD0","description":"ICD-JFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQF1","description":"ICD-GAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23550","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1504","description":"HCPCS-A1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image spect mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78452","description":"Ht muscle image spect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBE0","description":"ICD-CHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD0","description":"ICD-JHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF1","description":"ICD-LEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26499","description":"Revision of finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who utilize hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9768","description":"Patients who utilize hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD1","description":"ICD-CHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQA0","description":"ICD-PHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA0","description":"ICD-AGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-91125","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","description":"CPT-91125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBB0","description":"ICD-KFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB21B","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLC1","description":"ICD-IGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC03","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0506","description":"Non-traumatic spinal cord injury with Motor <23.75._without comorbidities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31084","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50130","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid frame pre subclav","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0470","description":"Tlso rigid frame pre subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHF1","description":"ICD-OGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC1","description":"ICD-MIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1806","description":"HCPCS-B1806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE1","description":"ICD-EFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE1","description":"ICD-JBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mepolizumab_ 1 mg (Nucala)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9473","description":"Injection_ mepolizumab_ 1 mg (Nucala)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC0","description":"ICD-CGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVD0","description":"ICD-NFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr s/a/l 10.1-30 sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14021","description":"Tis trnfr s/a/l 10.1-30 sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray of mammary ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77054","description":"X-ray of mammary ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKC1","description":"ICD-OLKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF1","description":"ICD-LARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lith ion batt cid_non-earlvl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8623","description":"Lith ion batt cid_non-earlvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFMA0","description":"ICD-MFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTB1","description":"ICD-CBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF1","description":"ICD-BETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg congen hernia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2400","description":"Fetal surg congen hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBE1","description":"ICD-NIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDA1","description":"ICD-BBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80306","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; read by instrument assisted direct optical observation (eg_ utilizing immunoassay [","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA0","description":"ICD-KBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99090","description":"Analysis of clinical data stored in computers (eg_ ECGs_ blood pressures_ hematologic data)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fistula repair transperine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57308","description":"Fistula repair transperine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWC0","description":"ICD-DIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKB1","description":"ICD-BHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protector heel or elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0191","description":"Protector heel or elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANB0","description":"ICD-CANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC0","description":"ICD-BGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD1","description":"ICD-JBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFE1","description":"ICD-FGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9918","description":"Functional status not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject for lymphatic x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38790","description":"Inject for lymphatic x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1643","description":"Injection_ heparin sodium (pfizer)_ not therapeutically equivalent to j1644_ per 1000 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63271","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn no comm comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9232","description":"Docrsn no comm comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8E","description":"Very High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB160","description":"Special Care Low _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE1","description":"ICD-GEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED0","description":"ICD-IHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC0","description":"ICD-GEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE111","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFE1","description":"ICD-KAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOD0","description":"ICD-PHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF1","description":"ICD-CDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cane adjust/fixed quad/3 pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0105","description":"Cane adjust/fixed quad/3 pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special joystick handle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2323","description":"Special joystick handle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42104","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDF0","description":"ICD-BCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDC1","description":"ICD-CGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryosurgery anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46916","description":"Cryosurgery anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic mens shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3221","description":"Orthopedic mens shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8042","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65150","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext h rate sz 15-30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383T","description":"Ext h rate sz 15-30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt offered tx for pseudobulb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4541F","description":"Pt offered tx for pseudobulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7516","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ with endoluminal imaging of initial coronar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24670","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/graft eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68335","description":"Revise/graft eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA0","description":"ICD-KEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC0","description":"ICD-KEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC0","description":"ICD-PHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRA1","description":"ICD-PJRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYC1","description":"ICD-HCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Desipramine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6032","description":"Desipramine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10B","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3051F","description":"Most recent hemoblobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB0","description":"ICD-NEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB0","description":"ICD-KISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible mic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87186","description":"Microbe susceptible mic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq & icut allg test venoms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95017","description":"Perq & icut allg test venoms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise urethra stage 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53400","description":"Revise urethra stage 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1403","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1403","description":"CDT-D1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE1","description":"ICD-OJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81178","description":"ATXN1 (ataxin 1) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61313","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUC1","description":"ICD-ACUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lecanemab-irmb_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0174","description":"Injection_ lecanemab-irmb_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9978","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD0","description":"ICD-OIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTB0","description":"ICD-KDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27758","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRE1","description":"ICD-HCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANF1","description":"ICD-OANF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0726T","description":"Removal of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF1","description":"ICD-MDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEC0","description":"ICD-EFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62223","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61583","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVB0","description":"ICD-KGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16251","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA0","description":"ICD-OLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES201","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0572U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","description":"CPT-0572U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8919","description":"Mra w/o cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87811","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"100 insulin syringes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8490","description":"100 insulin syringes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUE0","description":"ICD-AEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYA0","description":"ICD-CGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJA1","description":"ICD-KIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo mnl lock ultra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5711","description":"Knee-shin exo mnl lock ultra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0371T","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crgvr prov w/ ed addl rsrcs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4322F","description":"Crgvr prov w/ ed addl rsrcs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA0","description":"ICD-GAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEB1","description":"ICD-NFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB135","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA0","description":"ICD-CDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF0","description":"ICD-GHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1080T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1080T","description":"CPT-1080T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD0","description":"ICD-OKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90480","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ single dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGB1","description":"ICD-FHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD250","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF1","description":"ICD-CBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD1","description":"ICD-AEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC1","description":"ICD-NEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB1","description":"ICD-EBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","description":"HCPCS-J2351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF1","description":"ICD-NCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF1","description":"ICD-OJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg > 48 sq in w/o brdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6211","description":"Foam drg > 48 sq in w/o brdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBE1","description":"ICD-MEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB0","description":"ICD-JGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io ga n-stim subsq w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95982","description":"Io ga n-stim subsq w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB1","description":"ICD-BIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJD0","description":"ICD-NLJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27696","description":"Repair of ankle ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPC0","description":"ICD-KIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCF0","description":"ICD-EDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF0","description":"ICD-EICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44800","description":"Excision of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLB1","description":"ICD-ICLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1012T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","description":"CPT-1012T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech/hearing therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92507","description":"Speech/hearing therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87280","description":"Respiratory syncytial ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2399","description":"Lens trifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE0","description":"ICD-NDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA0","description":"ICD-IHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0699","description":"Injection_ cefiderocol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE221","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTA0","description":"ICD-EDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJB0","description":"ICD-GIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6552","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXE0","description":"ICD-NKXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA0","description":"ICD-OIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory bp analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93788","description":"Ambulatory bp analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB0","description":"ICD-OKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLA0","description":"ICD-CCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB0","description":"ICD-JGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx atrial fib pulm vein isol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93656","description":"Tx atrial fib pulm vein isol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA0","description":"ICD-BDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief alcohol misuse counsel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0443","description":"Brief alcohol misuse counsel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD0","description":"ICD-MAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME0","description":"ICD-MGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB1","description":"ICD-EECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE230","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth biopsy of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16451","description":"Anesth biopsy of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0870","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","description":"HCPCS-J0870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE1","description":"ICD-KBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF0","description":"ICD-FCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC1","description":"ICD-NGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0303","description":"HCPCS-B0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHE0","description":"ICD-JCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay malate dehydrogenase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83775","description":"Assay malate dehydrogenase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB0","description":"ICD-GIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78270","description":"Vitamin B-12 absorption study (eg_ Schilling test); without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLB1","description":"ICD-BBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniotic fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82143","description":"Amniotic fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45112","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0080U","description":"Onc Lung 5 Clinical Risk Factors Alg Prblty Mal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB1","description":"ICD-BDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Encephaltis st louis antbody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86653","description":"Encephaltis st louis antbody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLB1","description":"ICD-JHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD131","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Translum dil eye canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66174","description":"Translum dil eye canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNA0","description":"ICD-JFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCC1","description":"ICD-JGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC225","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNB1","description":"ICD-KHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF0","description":"ICD-KGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB0","description":"ICD-OGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/replace knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27486","description":"Revise/replace knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBB1","description":"ICD-MFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOC0","description":"ICD-OBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF1","description":"ICD-CDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC145","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0472U","description":"Carbonic anhydrase VI (CA VI)_ parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG_ IgM_ and IgA antibodies_ enzyme-linked immunosorbent assay (ELISA)_ sem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobility goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8979","description":"Mobility goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation cheek bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21270","description":"Augmentation cheek bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55880","description":"Ablation Of Malignant Prostate Tissue_ Transrectal_ With High Intensity-Focused Ultrasound (Hifu)_ Including Ultrasound Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive remover_ wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4456","description":"Adhesive remover_ wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWD0","description":"ICD-OCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJED1","description":"ICD-NJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE0","description":"ICD-BAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA0","description":"ICD-DEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA0","description":"ICD-OHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC51","description":"High Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of contrast for knee arthrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27370","description":"Injection of contrast for knee arthrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1714","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 2)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytherapy radioelements","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3001","description":"Brachytherapy radioelements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKA1","description":"ICD-GHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARD0","description":"ICD-CARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak ultra-light material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5950","description":"Endo ak ultra-light material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC0","description":"ICD-KFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDF1","description":"ICD-EIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0503","description":"HCPCS-C0503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB1","description":"ICD-CDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCD0","description":"ICD-BBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramuscular inj of (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074A","description":"Imm admin by intramuscular inj of (SARS[1]CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNALNP_ spike protein_ pres free_ 10 mcg/0.2 mL dosage; booster dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATC1","description":"ICD-OATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1009","description":"Clinical Decision Support Mechanism Sage Health Management Solutions_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUA0","description":"ICD-CHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein four","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33521","description":"Cabg artery-vein four","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC0","description":"ICD-FGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE1","description":"ICD-GHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94626","description":"Physician Or Other Qualified Health Care Professional Services For Outpatient Pulmonary Rehabilitation; With Continuous Oximetry Monitoring (Per Session)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide gu dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74485","description":"X-ray guide gu dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE0","description":"ICD-KDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD224","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC0","description":"ICD-IEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB0","description":"ICD-EHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB0","description":"ICD-BBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy swallow tst (fees)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92612","description":"Endoscopy swallow tst (fees)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALB0","description":"ICD-MALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDC0","description":"ICD-KBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA1","description":"ICD-BGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC0","description":"ICD-KAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteric identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87118","description":"Mycobacteric identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD1","description":"ICD-GERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detach adjust armrest base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0017","description":"Detach adjust armrest base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28D","description":"Clinically Complex _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBC1","description":"ICD-MIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDE0","description":"ICD-IEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF0","description":"ICD-MJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 2-8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88187","description":"Flowcytometry/read 2-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair deformity of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28313","description":"Repair deformity of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA0","description":"ICD-CGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0003","description":"Lightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA0","description":"ICD-MJCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE1","description":"ICD-KBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35286","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE0","description":"ICD-MLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult electric hook","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7009","description":"Adult electric hook","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryo-Cord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4237","description":"Cryo-Cord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGE1","description":"ICD-BBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64864","description":"Repair of facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peri-px pacemaker device evl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93286","description":"Peri-px pacemaker device evl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBF1","description":"ICD-ICBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISB1","description":"ICD-LISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWB1","description":"ICD-PJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7514","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crisis intervention mental h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9485","description":"Crisis intervention mental h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4B","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open ablate liver tumor cryo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47381","description":"Open ablate liver tumor cryo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUF0","description":"ICD-ICUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation heart device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93640","description":"Evaluation heart device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50782","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364T","description":"Adaptive behavior treatment by protocol_ administered by technician_ face-to-face with one patient; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD1","description":"ICD-CGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0604","description":"HCPCS-C0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF0","description":"ICD-OFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPF1","description":"ICD-CHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCD0","description":"ICD-NKCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB0","description":"ICD-KICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD0","description":"ICD-ACDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE0","description":"ICD-BHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ betibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3393","description":"Injection_ betibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIA1","description":"ICD-FBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF0","description":"ICD-EGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUC0","description":"ICD-ABUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD0","description":"ICD-GGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA1","description":"ICD-AHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHC0","description":"ICD-MEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0022","description":"Community health integration services_ each additional 30 minutes per calendar month (list separately in addition to g0019)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC1","description":"ICD-NJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF1","description":"ICD-GCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD0","description":"ICD-KEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD1","description":"ICD-GBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55700","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop kinetic balnce sensr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0396T","description":"Intraop kinetic balnce sensr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 6/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72052","description":"X-ray exam neck spine 6/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Htlv-i antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86687","description":"Htlv-i antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF0","description":"ICD-NGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c acc_saf belt pelv strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0978","description":"W/c acc_saf belt pelv strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF1","description":"ICD-OHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATF0","description":"ICD-JATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC0","description":"ICD-ODGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0610U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","description":"CPT-0610U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE0","description":"ICD-EFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA104","description":"Reduced Physical Function _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC31","description":"ICD-1FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAND1","description":"ICD-CAND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGE0","description":"ICD-OAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTA0","description":"ICD-ACTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evasc rpr iliac art bifr s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0255T","description":"Evasc rpr iliac art bifr s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD0","description":"ICD-EHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQC1","description":"ICD-CDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD1","description":"ICD-MLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB141","description":"Special Care High _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of paste boot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29580","description":"Application of paste boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0444T","description":"Initial Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9269","description":"Programmable_ transient_ orally ingested capsule_ for use with external programmer_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath smear other source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88161","description":"Cytopath smear other source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLC0","description":"ICD-BGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDA0","description":"ICD-OLDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVB1","description":"ICD-FDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Co2 breathing response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94400","description":"Co2 breathing response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23520","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPB1","description":"ICD-CFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC0","description":"ICD-EBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC1","description":"ICD-NIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90682","description":"Influenza virus vaccine_ quadrivalent (RIV4)_ derived from recombinant DNA_ hemagglutinin (HA) protein only_ preservative and antibiotic free_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34A","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWF1","description":"ICD-OAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd bed tilted 1st day vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4167F","description":"Hd bed tilted 1st day vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA0","description":"ICD-CHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair skull cavity lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62120","description":"Repair skull cavity lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure dev_ vasc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1760","description":"Closure dev_ vasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lab labial veneer resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2961","description":"Lab labial veneer resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUC0","description":"ICD-MFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC0","description":"ICD-GDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Who nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3916","description":"Who nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAA1","description":"ICD-OAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB1","description":"ICD-FHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90611","description":"Smallpox and monkeypox vaccine_ attenuated vaccinia virus_ live_ non-replicating_ preservative free_ 0.5 mL dosage_ suspension_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB0","description":"ICD-LIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84075","description":"Assay alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vedolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3380","description":"Injection_ vedolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv semi-rig adj molded chn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0150","description":"Cerv semi-rig adj molded chn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRF1","description":"ICD-CFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID1","description":"ICD-OHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIA1","description":"ICD-ODIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA0","description":"ICD-BDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acesso_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4311","description":"Acesso_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUF0","description":"ICD-AAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1244","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL34","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9769","description":"Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pouch w bltinconv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4429","description":"Urine ost pouch w bltinconv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck organ 1yr/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32051","description":"Anesth neck organ 1yr/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADB0","description":"ICD-GADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA0","description":"ICD-OCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16072","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16072","description":"CPT-16072","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWB1","description":"ICD-LHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBC0","description":"ICD-EIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of spinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63173","description":"Drainage of spinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF1","description":"ICD-HGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted misc prosthetic ser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8499","description":"Unlisted misc prosthetic ser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB1","description":"ICD-BHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coupling gel or paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4559","description":"Coupling gel or paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6039","description":"Acetaminophen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome banding study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88283","description":"Chromosome banding study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBC1","description":"ICD-JCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0715","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0715","description":"HCPCS-E0715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALB1","description":"ICD-IALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix recombinan rixubis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7200","description":"Factor ix recombinan rixubis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8B","description":"Medium Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPD1","description":"ICD-CIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPB1","description":"ICD-BGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue removal neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41145","description":"Tongue removal neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1485","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","description":"HCPCS-M1485","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61682","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWC0","description":"ICD-CEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD0","description":"ICD-CBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice general care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2045","description":"Hospice general care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLD0","description":"ICD-BDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVA0","description":"ICD-JBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","description":"HCPCS-E1033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3473","description":"Surgical repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED0","description":"ICD-KFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76519","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD0","description":"ICD-KGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB1","description":"ICD-FGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt mult chr msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9669","description":"Intend rpt mult chr msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27407","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDA0","description":"ICD-IDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAD0","description":"ICD-FDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bend only l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72120","description":"X-ray bend only l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSA1","description":"ICD-HFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJF0","description":"ICD-JGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42215","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXB1","description":"ICD-KBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRE0","description":"ICD-OKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0509T","description":"Electroretinography (ERG) with interpretation and report_ pattern (PERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi norm parameters","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8420","description":"Calc bmi norm parameters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFC1","description":"ICD-KDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8B","description":"Medium Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag w/us_ ct or MRI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9455","description":"Abd imag w/us_ ct or MRI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech evaluation complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70371","description":"Speech evaluation complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWD0","description":"ICD-KFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB1","description":"ICD-OCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYE0","description":"ICD-LDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTA0","description":"ICD-MKTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDA1","description":"ICD-NLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg dev eval impltbl sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93260","description":"Prgrmg dev eval impltbl sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC0","description":"ICD-CBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CO GNOTYP AQP1 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0181U","description":"CO GNOTYP AQP1 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap impl electrode antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43647","description":"Lap impl electrode antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVC1","description":"ICD-JEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD1","description":"ICD-CIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA1","description":"ICD-AHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDC0","description":"ICD-ACDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0841","description":"Pwc gp2 std mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTF0","description":"ICD-GGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPD1","description":"ICD-KDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMB0","description":"ICD-EEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC1","description":"ICD-OKEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00162","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","description":"CPT-00162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUE0","description":"ICD-CGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC1","description":"ICD-IEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF0","description":"ICD-GCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC1","description":"ICD-ADAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLB0","description":"ICD-IDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation Pros Tr Hifu Incl I Guid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9747","description":"Ablation Pros Tr Hifu Incl I Guid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB13A","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC1","description":"ICD-ICAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQA0","description":"ICD-OEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2004","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","description":"HCPCS-J2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx crisis initial 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90839","description":"Psytx crisis initial 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA0","description":"ICD-FFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL15","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA0","description":"ICD-IIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE241","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23530","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF0","description":"ICD-OJPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA31","description":"ICD-3LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDC1","description":"ICD-CHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAE0","description":"ICD-JGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUE0","description":"ICD-FAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mycophenolate mofetil_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7519","description":"Injection_ mycophenolate mofetil_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mini-prop remote joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2312","description":"Mini-prop remote joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAF0","description":"ICD-BFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLC0","description":"ICD-KDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31086","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal biophys profile w/nst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76818","description":"Fetal biophys profile w/nst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD0","description":"ICD-JILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore treat shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23107","description":"Explore treat shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF1","description":"ICD-BGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXD1","description":"ICD-CHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC0","description":"ICD-OHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMC1","description":"ICD-EFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSD1","description":"ICD-HFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSB1","description":"ICD-CFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21422","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5127","description":"Injection_ pegfilgrastim-fpgk (stimufend)_ biosimilar_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7201","description":"Factor ix fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYC0","description":"ICD-CAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8B","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUA1","description":"ICD-KEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj dexamethasone acetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1094","description":"Inj dexamethasone acetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXC0","description":"ICD-KAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEF1","description":"ICD-AEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF1","description":"ICD-GCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icatibant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1744","description":"Icatibant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81337","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; known familial sequence variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID0","description":"ICD-EBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA52","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE1","description":"ICD-AEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHED0","description":"ICD-GHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA0","description":"ICD-KFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01941","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","description":"CPT-01941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAB0","description":"ICD-NKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB1","description":"ICD-GDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28292","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94777","description":"Ped home apnea rec report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of palm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26450","description":"Incision of palm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1313","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA0","description":"ICD-OFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA1","description":"ICD-GHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4B","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32540","description":"Removal of lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mech amb infusion pump <8hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0780","description":"Mech amb infusion pump <8hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX12","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC0","description":"ICD-CDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise bladder & ureter(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51565","description":"Revise bladder & ureter(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt tobacco screen rcvd tlk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4004F","description":"Pt tobacco screen rcvd tlk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE0","description":"ICD-GAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IC11","description":"ICD-4IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","description":"CPT-00842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1GB31","description":"ICD-1GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBE1","description":"ICD-OBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF0","description":"ICD-EETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF0","description":"ICD-GGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD105","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1104T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1104T","description":"CPT-1104T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9470","description":"Injection_ aripiprazole lauroxil_ 1 mg (Aristada)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF0","description":"ICD-EBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF1","description":"ICD-PBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHB1","description":"ICD-GBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temp anchorage dev w flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7293","description":"Temp anchorage dev w flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYB1","description":"ICD-LGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPD1","description":"ICD-BHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF0","description":"ICD-MDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC0","description":"ICD-BHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD0","description":"ICD-ODYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUD1","description":"ICD-JBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF1","description":"ICD-GBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD1","description":"ICD-NITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB1","description":"ICD-ADEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95832","description":"Hand muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMB1","description":"ICD-OKMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB1","description":"ICD-KALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAF0","description":"ICD-MBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ phenylephrine ketorolac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9447","description":"Inj_ phenylephrine ketorolac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDID0","description":"ICD-EDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc system reas adv imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9537","description":"Doc system reas adv imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytomeg dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87496","description":"Cytomeg dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integra drt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4105","description":"Integra drt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB1","description":"ICD-BBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc limited","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9068","description":"Onc dx sclc/nsclc limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC0","description":"ICD-FGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUF0","description":"ICD-GFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55711","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","description":"CPT-55711","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA0","description":"ICD-NLTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91304","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant spike protein nanoparticle_ saponin-based adjuvant_5mcg/0.5m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75716","description":"Artery x-rays arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF1","description":"ICD-JCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2640","description":"Brachytx_ stranded_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIB1","description":"ICD-CGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25C","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCC1","description":"ICD-BGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF0","description":"ICD-OCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31020","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr hern preemie reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49491","description":"Rpr hern preemie reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC1","description":"ICD-JAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9002","description":"Intra-vaginal motion sensor system_ provides biofeedback for pelvic floor muscle rehabilitation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOC1","description":"ICD-LDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANA0","description":"ICD-GANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD1","description":"ICD-CFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB0","description":"ICD-BHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB0","description":"ICD-PLOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins lt atrl mont pres lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0294T","description":"Ins lt atrl mont pres lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Homedelivered prepared meal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5170","description":"Homedelivered prepared meal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITF1","description":"ICD-AITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2182","description":"Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOC1","description":"ICD-KGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD1","description":"ICD-CBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eltrd/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33243","description":"Remove eltrd/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval opioid use instr/pt int","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9584","description":"Eval opioid use instr/pt int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA0","description":"ICD-CFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adm Tocilizu COVID-19 1st dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0249","description":"Adm Tocilizu COVID-19 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE0","description":"ICD-PFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF1","description":"ICD-HEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIB0","description":"ICD-NKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carotid intima atheroma eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93895","description":"Carotid intima atheroma eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA1","description":"ICD-KFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLF1","description":"ICD-MLLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40830","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF1","description":"ICD-BEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Report ckd measures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8487","description":"Report ckd measures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add tooth to partial denture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5650","description":"Add tooth to partial denture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB11","description":"ICD-3HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD0","description":"ICD-PGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diaphragm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4266","description":"Diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAA1","description":"ICD-ODAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","description":"HCPCS-Q4382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRC1","description":"ICD-HBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE0","description":"ICD-MLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHA1","description":"ICD-MKHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD0","description":"ICD-AADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJB0","description":"ICD-KGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDF1","description":"ICD-MJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1493","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","description":"HCPCS-M1493","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0221","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF1","description":"ICD-JFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21600","description":"Partial removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clozapine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0136","description":"Clozapine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD1","description":"ICD-NDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attendant care service /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5126","description":"Attendant care service /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Droperidol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1790","description":"Droperidol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":">85y scope othr rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9661","description":">85y scope othr rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF0","description":"ICD-ADBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD1","description":"ICD-OBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0001","description":"CDC Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC1","description":"ICD-NAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE1","description":"ICD-FGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE1","description":"ICD-DEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA0","description":"ICD-BHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOC0","description":"ICD-CHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEE0","description":"ICD-JBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Centerbased day care perdiem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5105","description":"Centerbased day care perdiem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE0","description":"ICD-JIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23065","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF1","description":"ICD-OKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61698","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmv ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90291","description":"Cmv ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk back check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5686","description":"Bk back check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA234","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald telephone amplifier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5268","description":"Ald telephone amplifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colorectal cancer screening; blood-based biomarker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0327","description":"Colorectal cancer screening; blood-based biomarker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11A","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ekg tracing for initial prev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0404","description":"Ekg tracing for initial prev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTA0","description":"ICD-ECTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD1","description":"ICD-AFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEA1","description":"ICD-JIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/thymus resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32673","description":"Thoracoscopy w/thymus resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXF0","description":"ICD-JIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQB1","description":"ICD-DEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 no remiss >=5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9395","description":"Ini phq9 >9 no remiss >=5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF1","description":"ICD-PEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE1","description":"ICD-AGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNA0","description":"ICD-JCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPB1","description":"ICD-FEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD0","description":"ICD-HBRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF0","description":"ICD-MAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0625U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","description":"CPT-0625U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec stains for microorganis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0476","description":"Spec stains for microorganis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital observation per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0378","description":"Hospital observation per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC0","description":"ICD-OEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect ovarian malignancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58950","description":"Resect ovarian malignancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC0","description":"ICD-NHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE0","description":"ICD-PISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEE0","description":"ICD-FHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt nephroureteral catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50433","description":"Plmt nephroureteral catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35521","description":"Art byp grft axill-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE115","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCD0","description":"ICD-BFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA0","description":"ICD-CDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBD0","description":"ICD-NLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexrazoxane hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1190","description":"Dexrazoxane hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE0","description":"ICD-ACHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD1","description":"ICD-NAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1190","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA0","description":"ICD-NAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breath tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2326","description":"Breath tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCE0","description":"ICD-OKCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMD0","description":"ICD-CGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin immune fab (ovine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1162","description":"Digoxin immune fab (ovine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0694T","description":"3-Dimensional Volumetric Imaging And Reconstruction Of Breast Or Axillary Lymph Node Tissue_ Each Excised Specimen_ 3-Dimensional Automatic Specimen Reorientation_ Interpretat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10D","description":"Special Care High _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0485U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","description":"CPT-0485U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd endo mucosal resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43254","description":"Egd endo mucosal resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuroendoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62160","description":"Neuroendoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB13","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2006","description":"Knee Ankle Foot Device_ Any Material_ Single Or Double Upright_ Swing And/Or Stance Phase Microprocessor Control With Adjustability_ Includes All Components (E.G._ Sensors_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB1","description":"ICD-KFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMF1","description":"ICD-EDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA1","description":"ICD-KIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACD0","description":"ICD-MACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACC0","description":"ICD-AACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3503","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - molar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE0","description":"ICD-PIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF1","description":"ICD-JHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABF0","description":"ICD-AABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ translumin angio laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1885","description":"Cath_ translumin angio laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIID1","description":"ICD-NIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB1","description":"ICD-GHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mdd severe w/o psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3090F","description":"Mdd severe w/o psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1058T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1058T","description":"CPT-1058T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53020","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD0","description":"ICD-CISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE1","description":"ICD-IDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46942","description":"Treatment of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC21","description":"ICD-3KC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-phospholipid antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86148","description":"Anti-phospholipid antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA1","description":"ICD-FAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHA0","description":"ICD-KAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUB1","description":"ICD-CBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB1","description":"ICD-GFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC1","description":"ICD-FAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALD0","description":"ICD-OALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66030","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86008","description":"Allergen specific IgE; quantitative or semiquantitative_ recombinant or purified component_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBE1","description":"ICD-OKBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tear film img uni/bi w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330T","description":"Tear film img uni/bi w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE0","description":"ICD-ABTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA0C","description":"Default_ /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITD0","description":"ICD-MITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flt3 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81245","description":"Flt3 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1904","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1904","description":"CDT-D1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHB1","description":"ICD-MKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging with flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78701","description":"Kidney imaging with flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHF0","description":"ICD-KAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBA0","description":"ICD-ODBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental recement crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2920","description":"Dental recement crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3967","description":"Sewho airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNF0","description":"ICD-GHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDB0","description":"ICD-KIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE0","description":"ICD-NGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45327","description":"Proctosigmoidoscopy w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE0","description":"ICD-NIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9484","description":"Injection_ eteplirsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUC1","description":"ICD-AIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDB0","description":"ICD-OKDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sermorelin acetate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0515","description":"Sermorelin acetate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC1","description":"ICD-EEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3D printing of a 3D dental surfacet scan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0396","description":"3D printing of a 3D dental surfacet scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76942","description":"Echo guide for biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB0","description":"ICD-CARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFD0","description":"ICD-BCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOC1","description":"ICD-DDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2196","description":"Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLA1","description":"ICD-KFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEA0","description":"ICD-BCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB1","description":"ICD-OLJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVE0","description":"ICD-OBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE0","description":"ICD-AGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12D","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJD0","description":"ICD-JHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD0","description":"ICD-CCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTA1","description":"ICD-AGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND1","description":"ICD-NGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPD0","description":"ICD-OGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection anistreplase 30 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0350","description":"Injection anistreplase 30 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE1","description":"ICD-AIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transition service coordination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7337","description":"Transition service coordination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUD0","description":"ICD-OFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDC0","description":"ICD-MBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVE1","description":"ICD-KHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25C","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA1","description":"ICD-GFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29905","description":"Subtalar arthro w/exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKB1","description":"ICD-KEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFD0","description":"ICD-BHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWE1","description":"ICD-OBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dt vaccine under 7 yrs im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90702","description":"Dt vaccine under 7 yrs im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDC1","description":"ICD-CFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAC1","description":"ICD-GIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB0","description":"ICD-CCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10D","description":"Extensive Services _ ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE211","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gatifloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1590","description":"Gatifloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNB1","description":"ICD-OHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2090","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATC1","description":"ICD-NATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID0","description":"ICD-AHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB1","description":"ICD-KFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Docetaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9171","description":"Docetaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA55","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22220","description":"Incis w/discectomy cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVB1","description":"ICD-JEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQB0","description":"ICD-HCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE1","description":"ICD-NHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD0","description":"ICD-IECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE1","description":"ICD-KFJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA46","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8669","description":"Fun stat score ue pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68115","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANA0","description":"ICD-NANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNA1","description":"ICD-BCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE0","description":"ICD-ODQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 2-3 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73502","description":"X-ray exam hip uni 2-3 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD1","description":"ICD-NJBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBF1","description":"ICD-OKBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF1","description":"ICD-PGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm adult plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4009","description":"Cast sup sht arm adult plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENB0","description":"ICD-GENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD1","description":"ICD-OGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0538T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg_ cryopreservation_ storage)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKE1","description":"ICD-JHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Demonstrate use home inr mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0248","description":"Demonstrate use home inr mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ciliary transsleral therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66710","description":"Ciliary transsleral therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70552","description":"MRI brain stem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj pudendal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64430","description":"N block inj pudendal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA0","description":"ICD-NCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC1","description":"ICD-OCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF0","description":"ICD-KEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB46","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC0","description":"ICD-NFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRD1","description":"ICD-DBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq transcath septal reduxn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93583","description":"Perq transcath septal reduxn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0491","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with thepower source and control electronics unit_ controlled by hardw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYF0","description":"ICD-KHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCE1","description":"ICD-OLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1653","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","description":"HCPCS-L1653","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHB0","description":"ICD-NCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF1","description":"ICD-NHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE1","description":"ICD-JFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA1","description":"ICD-ICMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDB0","description":"ICD-BHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD1","description":"ICD-KISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21242","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB0","description":"ICD-KHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPB1","description":"ICD-OBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87899","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFME1","description":"ICD-GFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMF1","description":"ICD-MJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of arsenic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82175","description":"Assay of arsenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1203","description":"Ace inhibitor or arb therapy not prescribed during the measurement period_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracostomy w/rib resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32035","description":"Thoracostomy w/rib resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAC0","description":"ICD-ECAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB226","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA1","description":"ICD-MATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCB1","description":"ICD-KBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18F","description":"Special Care Low _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTA0","description":"ICD-KFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC0","description":"ICD-CGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUF0","description":"ICD-BGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC1","description":"ICD-GGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC06","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILC0","description":"ICD-EILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOE1","description":"ICD-KFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise hernia & sperm veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55540","description":"Revise hernia & sperm veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHD1","description":"ICD-KHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","description":"HCPCS-A9611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22C","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc chro sin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9607","description":"Perc d-e cor revasc chro sin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mopath procedure level 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81408","description":"Mopath procedure level 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA0","description":"ICD-CHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reusable oral thermometer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4931","description":"Reusable oral thermometer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast molded to p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2128","description":"Kafo fem fx cast molded to p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB0","description":"ICD-OCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4C","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av fusion/forearm vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36820","description":"Av fusion/forearm vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB1","description":"ICD-OETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58580","description":"Transcervical ablation of uterine fibroid(s)_ including intraoperative ultrasound guidance and monitoring_ radiofrequency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFE1","description":"ICD-FDFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73220","description":"MRI uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC0","description":"ICD-CEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOC0","description":"ICD-LBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC1","description":"ICD-FDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection ext venography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36005","description":"Injection ext venography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNC1","description":"ICD-BDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC0","description":"ICD-BCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD0","description":"ICD-NBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); modulating antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86043","description":"Acetylcholine receptor (AChR); modulating antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m succimer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9551","description":"Tc99m succimer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0496T","description":"Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional_ including physiological and labo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC1","description":"ICD-AELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLE1","description":"ICD-GDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEB0","description":"ICD-MJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMF1","description":"ICD-IDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plating chrome/nickel pr bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2750","description":"Plating chrome/nickel pr bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1576","description":"Injection_ immune globulin (panzyga)_ intravenous_ non-lyophilized (e.g._ liquid)_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE1","description":"ICD-ODDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27244","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE1","description":"ICD-OFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD1","description":"ICD-PJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISA1","description":"ICD-HISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8663","description":"Fun stat score shdl >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0308","description":"Creation of subcutaneous pocket with insertion of 180 day implantable interstitial glucose sensor_ including system activation and patient training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOA1","description":"ICD-PKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSB0","description":"ICD-PBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSF0","description":"ICD-PKSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTE1","description":"ICD-NKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEB1","description":"ICD-NDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotd art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36224","description":"Place cath carotd art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB115","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA0","description":"ICD-ICUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAA1","description":"ICD-CIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSB1","description":"ICD-KFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC0","description":"ICD-FBKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hand vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6709","description":"Term dev mech hand vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0625T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9857","description":"Patient admitted to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appro rad ds dvcs techs docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6040F","description":"Appro rad ds dvcs techs docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/repair chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32110","description":"Explore/repair chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8667","description":"Fun stat score ue >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB1","description":"ICD-MDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drop lock knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2182","description":"Drop lock knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24546","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA0","description":"ICD-GGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB1","description":"ICD-LERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67974","description":"Reconstruction of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB0","description":"ICD-OFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC1","description":"ICD-IGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSE0","description":"ICD-KCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFD0","description":"ICD-FGFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA1","description":"ICD-OJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gjb2 gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81252","description":"Gjb2 gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fb reaction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7540","description":"Removal of fb reaction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRB0","description":"ICD-PJRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF0","description":"ICD-FHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33746","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD0","description":"ICD-JIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aneurysm press sensor add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34806","description":"Aneurysm press sensor add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum deep <1.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28045","description":"Exc foot/toe tum deep <1.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24500","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extra ambulance attendant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0424","description":"Extra ambulance attendant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0225T","description":"Multiple_ including serial trended analysis and limited reprogramming of device parameter - AV and VV delays_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penile venous occlusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37790","description":"Penile venous occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37223","description":"Iliac revasc w/stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genotype cytomegalovirus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87910","description":"Genotype cytomegalovirus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE1","description":"ICD-CDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMA1","description":"ICD-OIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPA0","description":"ICD-GDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE0","description":"ICD-OLFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTD1","description":"ICD-MJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Im b1 mrw cel ther hrvst onl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0265T","description":"Im b1 mrw cel ther hrvst onl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21260","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health club membership yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9970","description":"Health club membership yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB1","description":"ICD-KARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD1","description":"ICD-NABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61612","description":"Transection or ligation_ carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo w/shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1007","description":"Pwr seat combo w/shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37191","description":"Ins endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81401","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD1","description":"ICD-EDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICE0","description":"ICD-FICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC0","description":"ICD-GDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVD0","description":"ICD-CDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEA1","description":"ICD-JFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9445","description":"Injection_ C-1 Esterase Inhibitor (Recombinant) Ruconest_ 10 Units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0613U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","description":"CPT-0613U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC221","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBA0","description":"ICD-CDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tibia & fibula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27709","description":"Incision of tibia & fibula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin bath unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0235","description":"Paraffin bath unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGE0","description":"ICD-OBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF1","description":"ICD-FBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC0","description":"ICD-ODIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb & op scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31531","description":"Laryngoscopy w/fb & op scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAF1","description":"ICD-EHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICA1","description":"ICD-GICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0508","description":"Telehealth consultation_ critical care_ initial_ physicians typically spend 60 minutes communicating with the patient and providers via telehealth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dxa ordered for osteo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8861","description":"Dxa ordered for osteo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Betadine/phisohex solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4246","description":"Betadine/phisohex solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1607","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1607","description":"HCPCS-C1607","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0575U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","description":"CPT-0575U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEE1","description":"ICD-NFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE0","description":"ICD-BIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE1","description":"ICD-CHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy w/oper scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31526","description":"Dx laryngoscopy w/oper scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE0","description":"ICD-CAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init ak ischal plstr direct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5505","description":"Init ak ischal plstr direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11A","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile water/saline_ 10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4216","description":"Sterile water/saline_ 10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCE0","description":"ICD-EFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4351","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","description":"HCPCS-Q4351","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Herpes simplex 2 ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87273","description":"Herpes simplex 2 ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDE1","description":"ICD-JFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHF1","description":"ICD-MJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHF0","description":"ICD-JEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC1","description":"ICD-FFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE1","description":"ICD-NBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92250","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electron beam computed tomog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8092","description":"Electron beam computed tomog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA1","description":"ICD-PBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRD0","description":"ICD-PFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB1","description":"ICD-JHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYD1","description":"ICD-PDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0651T","description":"Magnetically controlled capsule endoscopy_ esophagus through stomach_ including intraprocedural positioning of capsule_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0486T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX15","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLB1","description":"ICD-BDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJD0","description":"ICD-JBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBB0","description":"ICD-BGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sys bp less 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8752","description":"Sys bp less 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD0","description":"ICD-GGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Any patients who had no asthma controller medications dispensed during the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9808","description":"Any patients who had no asthma controller medications dispensed during the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDID1","description":"ICD-KDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain appendix abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44900","description":"Drain appendix abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply multlay comprs upr arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29583","description":"Apply multlay comprs upr arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26390","description":"Revise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add instep extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3570","description":"O shoe add instep extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHB1","description":"ICD-JEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-43889","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","description":"CPT-43889","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0901","description":"HCPCS-A0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIB0","description":"ICD-GIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE1","description":"ICD-ODWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOF1","description":"ICD-LEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIID1","description":"ICD-JIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMF0","description":"ICD-GHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caries susceptibility test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0425","description":"Caries susceptibility test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME0","description":"ICD-BEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Td vacc no presv 7 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90714","description":"Td vacc no presv 7 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE0","description":"ICD-IHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC1","description":"ICD-KCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGE0","description":"ICD-NAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62256","description":"Remove brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB0","description":"ICD-LDQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA43","description":"Very High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE1","description":"ICD-DCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise gastric port open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43886","description":"Revise gastric port open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAME0","description":"ICD-MAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF1","description":"ICD-IFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE1","description":"ICD-MDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost clsd pouch w att st barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4387","description":"Ost clsd pouch w att st barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL41","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD10B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF1","description":"ICD-NBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic silesian ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5698","description":"Ak/knee disartic silesian ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTF1","description":"ICD-FDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow up pulm nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9345","description":"Follow up pulm nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sio flex pelvic/sacr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0621","description":"Sio flex pelvic/sacr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEC1","description":"ICD-EGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of facial bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21026","description":"Excision of facial bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB0","description":"ICD-PESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJC0","description":"ICD-NKJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOE0","description":"ICD-KDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 3","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9009","description":"Mccd_ risk adj_ level 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit est age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99396","description":"Prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42962","description":"Control throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAF1","description":"ICD-CEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEF0","description":"ICD-FBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2101","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLC0","description":"ICD-ACLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB1","description":"ICD-CCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHA0","description":"ICD-JFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDA1","description":"ICD-JGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99202","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE1","description":"ICD-FFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD22A","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45805","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQA0","description":"ICD-PAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA0","description":"ICD-NCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99253","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE0","description":"ICD-DIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4278","description":"Soft tissue graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD1","description":"ICD-JBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWC0","description":"ICD-HDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHA0","description":"ICD-BFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD124","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDA1","description":"ICD-EIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj >24 hr in ed gcs <15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9532","description":"Inj >24 hr in ed gcs <15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD0","description":"ICD-DDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of corticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82528","description":"Assay of corticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHB0","description":"ICD-GFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRC1","description":"ICD-PDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88106","description":"Cytopath fl nongyn filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKB0","description":"ICD-BAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC1","description":"ICD-NAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74305","description":"Cholangiography and/or pancreatography; through existing catheter_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25126","description":"Remove/graft forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE120","description":"Special Care Low _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOE1","description":"ICD-OLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wig any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9282","description":"Wig any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYF0","description":"ICD-LBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE0","description":"ICD-BIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Max ultrasound capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0370","description":"Max ultrasound capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10B","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE225","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB1","description":"ICD-KHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50392","description":"Introduction of intracatheter or catheter into renal pelvis for drainag and/or injection_ percutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB21","description":"ICD-3DB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1090","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stationary compressed gas 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0424","description":"Stationary compressed gas 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99231","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle-skin graft arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15736","description":"Muscle-skin graft arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJF0","description":"ICD-BEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5247","description":"Hearing aid_ prog_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vendaje_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4252","description":"Vendaje_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advncd care plan addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99498","description":"Advncd care plan addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2112","description":"Patient Receiving <=5 Mg Daily Prednisone (Or Equivalent)_ Or Ra Activity Is Worsening_ Or Glucocorticoid Use Is For Less Than 6 Months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGA1","description":"ICD-FAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35306","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD0","description":"ICD-CFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDB0","description":"ICD-GEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0599","description":"Injection_ C-1 esterase inhibitor (human)_ (Haegarda)_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFF0","description":"ICD-NKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIF1","description":"ICD-NIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA1","description":"ICD-EITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43107","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF1","description":"ICD-MACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj reshaping components","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7865","description":"Tmj reshaping components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF0","description":"ICD-JCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20D","description":"Clinically Complex _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE0","description":"ICD-GEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEF0","description":"ICD-KCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA1","description":"ICD-MGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKE1","description":"ICD-NBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPA1","description":"ICD-OBPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRC1","description":"ICD-CHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA0","description":"ICD-CERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL12","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD1","description":"ICD-CHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXF0","description":"ICD-CHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57100","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUD0","description":"ICD-CBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ventral hern init reduc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49560","description":"Rpr ventral hern init reduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUA1","description":"ICD-CEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABE0","description":"ICD-CABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6012","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4418","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","description":"HCPCS-Q4418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF0","description":"ICD-EDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOB0","description":"ICD-KFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAC1","description":"ICD-JEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUC0","description":"ICD-BDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73200","description":"Ct upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF0","description":"ICD-KELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD0","description":"ICD-OEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFB0","description":"ICD-OLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSB1","description":"ICD-LBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2A","description":"Very High Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Access av dial grft for proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36148","description":"Access av dial grft for proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKC1","description":"ICD-BHKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOD1","description":"ICD-PJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVA0","description":"ICD-NKVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDB1","description":"ICD-JEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genome sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81426","description":"Genome sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF1","description":"ICD-MGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB0","description":"ICD-FFPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB0","description":"ICD-OJFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36905","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis_ dialysis circuit_ any method_ including all imaging and radiological supervision and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUA0","description":"ICD-EFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVB0","description":"ICD-CGVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALA1","description":"ICD-FALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC250","description":"Clinically Complex _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25676","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB11","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haloperidol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80173","description":"Assay of haloperidol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBA1","description":"ICD-FEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE125","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBA0","description":"ICD-OEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE1","description":"ICD-PERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKB1","description":"ICD-GBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA0","description":"ICD-BAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt counsld on exam for moles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5005F","description":"Pt counsld on exam for moles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUA1","description":"ICD-OFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AC11","description":"ICD-2AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fecal bilirubin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82252","description":"Fecal bilirubin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1082","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Propulsion whl excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2224","description":"Propulsion whl excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures immediat mandible","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5140","description":"Dentures immediat mandible","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB1","description":"ICD-NEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject for sacroiliac joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0259","description":"Inject for sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0485T","description":"Optical coherence tomography (OCT) of middle ear_ with interpretation and report; unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0149U","description":"Drug assay_ definitive_ 60 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66635","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded to patient plasti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1940","description":"Afo molded to patient plasti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9171","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9171","description":"HCPCS-C9171","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24331","description":"Revision of arm muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81596","description":"Infectious disease_ chronic hepatitis C virus (HCV) infection_ six biochemical assays (ALT_ A2-macroglobulin_ apolipoprotein A-1_ total bilirubin_ GGT_ and haptoglobin) utiliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKB0","description":"ICD-BDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72090","description":"Radiologic examination_ spine; scoliosis study_ including supine and erect studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLD1","description":"ICD-OJLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA1","description":"ICD-DDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOE1","description":"ICD-PJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB1","description":"ICD-CESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE0","description":"ICD-HASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla x-math non-cytotoxic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86825","description":"Hla x-math non-cytotoxic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSC0","description":"ICD-HDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA1","description":"ICD-KFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67999","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCD0","description":"ICD-AHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIF0","description":"ICD-IFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE0","description":"ICD-DEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND1","description":"ICD-OCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF1","description":"ICD-CCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whfo electric custom fitted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3904","description":"Whfo electric custom fitted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB206","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pressure pneum appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0672","description":"Pressure pneum appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC1","description":"ICD-BIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAD0","description":"ICD-FGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA1","description":"ICD-BITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIF1","description":"ICD-NCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQE0","description":"ICD-KDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC0","description":"ICD-MIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood thymol turbidity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2033","description":"Blood thymol turbidity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52301","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99307","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGB0","description":"ICD-OEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID1","description":"ICD-CCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF0","description":"ICD-GINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0866T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion detection_ characterization_ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plastic eye prosth custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2623","description":"Plastic eye prosth custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87560","description":"M.avium-intra dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD1","description":"ICD-GFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF0","description":"ICD-FFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB0","description":"ICD-EACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBD1","description":"ICD-MDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE0","description":"ICD-OCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behav chng smoking 3-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99406","description":"Behav chng smoking 3-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant ureter in bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50800","description":"Implant ureter in bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal care atrisk assessm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1000","description":"Prenatal care atrisk assessm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20C","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2105","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74260","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF1","description":"ICD-GFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBB0","description":"ICD-GFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA1","description":"ICD-BHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIA0","description":"ICD-NFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRF1","description":"ICD-KGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD0","description":"ICD-BEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 3mod sacro-scap pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0462","description":"Tlso 3mod sacro-scap pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC0","description":"ICD-OCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0916T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","description":"CPT-0916T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME1","description":"ICD-GIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF1","description":"ICD-MLIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUE0","description":"ICD-ODUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative screen metals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83018","description":"Quantitative screen metals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWB1","description":"ICD-KEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB0","description":"ICD-OAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99423","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 21 Or More Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD1","description":"ICD-JDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF0","description":"ICD-KALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8F","description":"Low Rehab_ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63273","description":"Excise intrspinl lesion scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1086","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJD1","description":"ICD-FIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF0","description":"ICD-MHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGB1","description":"ICD-GDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLC1","description":"ICD-JFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD1","description":"ICD-GEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF1","description":"ICD-GETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58960","description":"Exploration of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable home suction pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0743","description":"Portable home suction pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreas lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48120","description":"Removal of pancreas lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME0","description":"ICD-JCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDC1","description":"ICD-JGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCE0","description":"ICD-NDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTF0","description":"ICD-GCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIC0","description":"ICD-EAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91314","description":"SARSCOV2 VACCINE BIVALENT 25 MCG/0.25 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEE1","description":"ICD-MJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20979","description":"Us bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preparation palate mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42280","description":"Preparation palate mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF1","description":"ICD-JDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixed adjust armrest pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0020","description":"Fixed adjust armrest pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51784","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0950","description":"Tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB05","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lumasiran_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0224","description":"Injection_ lumasiran_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj extensive retinopathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67227","description":"Dstrj extensive retinopathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC0","description":"ICD-OIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1060","description":"Thoracic pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1183","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA1","description":"ICD-GIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eosinophil blood count","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3630","description":"Eosinophil blood count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUB0","description":"ICD-BIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99426","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE214","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQA1","description":"ICD-LCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transabdom amnioinfus w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59070","description":"Transabdom amnioinfus w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9894","description":"Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHB0","description":"ICD-AIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUF0","description":"ICD-JEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove contraceptive capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11976","description":"Remove contraceptive capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55874","description":"Transperineal placement of biodegradable material_ peri-prostatic_ single or multiple injection(s)_ including image guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACE0","description":"ICD-GACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF0","description":"ICD-KBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB03","description":"Ultra High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0593U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","description":"CPT-0593U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 2.1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11423","description":"Exc h-f-nk-sp b9+marg 2.1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPE0","description":"ICD-GAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMF0","description":"ICD-OGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC1","description":"ICD-OJVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imp/abut fixed dent part man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6117","description":"Imp/abut fixed dent part man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA1","description":"ICD-KGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28585","description":"Repair foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7542","description":"Endoscopic retrograde cholangiopancreatography (ercp) with biopsy_ single or multiple_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCB1","description":"ICD-KHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICF1","description":"ICD-JICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC30","description":"High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIC0","description":"ICD-JIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4021","description":"Orthopedic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legionella micdadei ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87277","description":"Legionella micdadei ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tissue expander(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11960","description":"Insert tissue expander(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMF0","description":"ICD-GCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACA1","description":"ICD-EACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJE1","description":"ICD-BGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC1","description":"ICD-GFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth fat layer removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80251","description":"Anesth fat layer removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0678","description":"Non-pneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDD0","description":"ICD-JIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC0","description":"ICD-GEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semi-precision attachment - placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6192","description":"Semi-precision attachment - placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 allele hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81381","description":"Hla i typing 1 allele hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHC0","description":"ICD-NDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No unplnd hosp readm in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9309","description":"No unplnd hosp readm in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97761","description":"Prosthetic(s) training_ upper and/or lower extremity(ies)_ initial prosthetic(s) encounter_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEF0","description":"ICD-NIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE1","description":"ICD-KGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEE1","description":"ICD-EIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0411U","description":"Psychiatry (eg_ depression_ anxiety_ attention deficit hyperactivity disorder [ADHD])_ genomic analysis panel_ variant analysis of 15 genes_ including deletion/duplication ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVB1","description":"ICD-OFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA1","description":"ICD-GCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAF1","description":"ICD-KDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC1","description":"ICD-BFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAE1","description":"ICD-FIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUE0","description":"ICD-OBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPF0","description":"ICD-CDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEC1","description":"ICD-IEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABE1","description":"ICD-KABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7902","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ each additional 15 minutes_ provided remotely by hospital staff who are licensed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14C","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pres/absn hmrhg/lesion docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3110F","description":"Pres/absn hmrhg/lesion docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE0","description":"ICD-FFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCD1","description":"ICD-CGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEND0","description":"ICD-OEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF1","description":"ICD-FGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES240","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43453","description":"Dilate esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1851","description":"Knee orthosis (KO)_ single upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intra-articular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79440","description":"Nuclear rx intra-articular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAE0","description":"ICD-NIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSF0","description":"ICD-KFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE0","description":"ICD-NIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCD1","description":"ICD-IFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50526","description":"Closure of nephrovisceral fistula (eg_ renocolic)_ including visceral repair; thoracic approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA1","description":"ICD-LISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult day care per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5102","description":"Adult day care per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLB0","description":"ICD-GBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB210","description":"Special Care High _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEE1","description":"ICD-GAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJE1","description":"ICD-BCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRC0","description":"ICD-GHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA0","description":"ICD-CGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pms2 gene full seq analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81317","description":"Pms2 gene full seq analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0614U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","description":"CPT-0614U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD0","description":"ICD-FGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECE1","description":"ICD-GECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA0","description":"ICD-OFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33915","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1014","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE1","description":"ICD-ODXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Team conf w/o pat by hc pro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99368","description":"Team conf w/o pat by hc pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25274","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96113","description":"Developmental test administration (including assessment of fine and/or gross motor_ language_ cognitive level_ social_ memory and/or executive functions by standardized develo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB0","description":"ICD-CATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPE1","description":"ICD-NLPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ep & ablate ventric tachy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93654","description":"Ep & ablate ventric tachy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXC0","description":"ICD-FGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFE0","description":"ICD-KHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse/graft added joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26863","description":"Fuse/graft added joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE0","description":"ICD-AATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0663U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0663U","description":"CPT-0663U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lacosamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80235","description":"Lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXF1","description":"ICD-ODXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF0","description":"ICD-FBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advancing cancer care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0001","description":"Advancing cancer care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB205","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Idet 1 or more levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22527","description":"Idet 1 or more levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSB1","description":"ICD-DFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9789","description":"Instillation of antineoplastic pharmacologic/biologic agent into renal pelvis_ any method_ including all imaging guidance_including volumetric measurement if performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","description":"HCPCS-M1388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dressing change not for burn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15852","description":"Dressing change not for burn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ugt1a1 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81350","description":"Ugt1a1 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile saline or water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4218","description":"Sterile saline or water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD1","description":"ICD-OEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Root amputation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3450","description":"Root amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt referral for ect docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4067F","description":"Pt referral for ect docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF0","description":"ICD-KITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCB0","description":"ICD-BBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF0","description":"ICD-ICHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA1","description":"ICD-EHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asp not presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9437","description":"Asp not presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA1","description":"ICD-OJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB0","description":"ICD-CBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC0","description":"ICD-LEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acylcarnitines quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82017","description":"Acylcarnitines quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11646","description":"Exc f/e/e/n/l mal+mrg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53453","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; REMOVAL_ EACH BALLOON","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL01","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTA0","description":"ICD-OJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61684","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA1","description":"ICD-IHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXB0","description":"ICD-KGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0145U","description":"Drug assay_ definitive_ 65 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tacrolimus imme rel oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7507","description":"Tacrolimus imme rel oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath therapeutic irrig agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4321","description":"Cath therapeutic irrig agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC212","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA0","description":"ICD-IDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMC1","description":"ICD-AAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin electrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83020","description":"Hemoglobin electrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyse chest fibrin init day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32561","description":"Lyse chest fibrin init day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0143","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attach bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51841","description":"Attach bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB1","description":"ICD-KFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQD0","description":"ICD-KFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBD0","description":"ICD-BEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKB0","description":"ICD-CCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone pellet 75 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0189","description":"Testosterone pellet 75 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHA0","description":"ICD-OCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB204","description":"Reduced Physical Function _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC21","description":"ICD-4AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB1","description":"ICD-PKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYC1","description":"ICD-OEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83690","description":"Assay of lipase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth anorectal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90251","description":"Anesth anorectal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA0","description":"ICD-KBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLE1","description":"ICD-FDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27457","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ removable bilateral_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1526","description":"Space maintainer_ removable bilateral_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ring flange plas/leather mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1110","description":"Ring flange plas/leather mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0504","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0504","description":"CDT-D0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB0","description":"ICD-ODJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA0","description":"ICD-KBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafix plus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4304","description":"Grafix plus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA21","description":"ICD-3AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENA0","description":"ICD-CENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC1","description":"ICD-JGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB1","description":"ICD-MLMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTB0","description":"ICD-MCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31368","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6560","description":"Gradient compression stocking_ full length/chap style_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE1","description":"ICD-GCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF1","description":"ICD-GIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE0","description":"ICD-EIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postpartum care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503F","description":"Postpartum care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27151","description":"Incision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD0","description":"ICD-IHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUF0","description":"ICD-MGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA1","description":"ICD-FDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA01","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB1","description":"ICD-NJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of temporary anchorage device_ requiring flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7299","description":"Removal of temporary anchorage device_ requiring flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1267","description":"Patients not on any kidney or kidney-pancreas transplant waitlist or is not in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","description":"HCPCS-J2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50951","description":"Endoscopy of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00864","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","description":"CPT-00864","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEE0","description":"ICD-NAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft liner for complete or partial removable denture - indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5765","description":"Soft liner for complete or partial removable denture - indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVA1","description":"ICD-NBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interphalangeal joint spacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8658","description":"Interphalangeal joint spacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOA1","description":"ICD-CCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic sentence test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92576","description":"Synthetic sentence test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25B","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0899","description":"Injection_ argatroban (auromedics)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk molded supracondylar susp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5670","description":"Bk molded supracondylar susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8910","description":"Mra w/o cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLE0","description":"ICD-BDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia trachomatis ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87270","description":"Chlamydia trachomatis ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQD1","description":"ICD-GBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33522","description":"Cabg artery-vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF1","description":"ICD-CBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj perflexane lip micros_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9955","description":"Inj perflexane lip micros_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28002","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0502T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE0","description":"ICD-KDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Driver pneumatic vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0480","description":"Driver pneumatic vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA1","description":"ICD-GEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC0","description":"ICD-IIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAC0","description":"ICD-ICAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compressor air power source","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0565","description":"Compressor air power source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rhythm ecg with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93040","description":"Rhythm ecg with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMC1","description":"ICD-CDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGB0","description":"ICD-CBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF0","description":"ICD-OBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5996","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETA0","description":"ICD-JETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01440","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","description":"CPT-01440","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFC1","description":"ICD-OBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scleral cover shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2627","description":"Scleral cover shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sex hormone globul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84270","description":"Assay of sex hormone globul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF0","description":"ICD-CFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF0","description":"ICD-BGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct finger deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26567","description":"Correct finger deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX01","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES231","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA51","description":"Low Rehab_ ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYB0","description":"ICD-GIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWA0","description":"ICD-KCWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF0","description":"ICD-KEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin pedicle flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15570","description":"Skin pedicle flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB1","description":"ICD-OBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE1","description":"ICD-FAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD1","description":"ICD-HHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0814T","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material_ proximal femur_ including imaging guidance_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC1","description":"ICD-JCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE1","description":"ICD-PDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXF1","description":"ICD-KBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home health care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99374","description":"Home health care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5259","description":"Hearing aid_ digit_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolong service w/o contact","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99358","description":"Prolong service w/o contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27848","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDE0","description":"ICD-GGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD0","description":"ICD-GDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical place mini implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6013","description":"Surgical place mini implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB1","description":"ICD-CHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6019","description":"Colonoscopy through stoma; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery or snare technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYC1","description":"ICD-PDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRD1","description":"ICD-PGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDE0","description":"ICD-ABDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVE1","description":"ICD-FCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD0","description":"ICD-EEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQD1","description":"ICD-PCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPE1","description":"ICD-BDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIC0","description":"ICD-FIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE1","description":"ICD-NJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE1","description":"ICD-JABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARC1","description":"ICD-GARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD146","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJC0","description":"ICD-JDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOC1","description":"ICD-PJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum and colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45121","description":"Removal of rectum and colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHB0","description":"ICD-NDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC1","description":"ICD-OAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC1","description":"ICD-BIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiepileptics nos 7/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80341","description":"Antiepileptics nos 7/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429U","description":"Human papillomavirus (HPV)_ oropharyngeal swab_ 14 high-risk types (ie_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 51_ 52_ 56_ 58_ 59_ 66_ and 68)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYF0","description":"ICD-HEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46751","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAB1","description":"ICD-JFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA1","description":"ICD-GCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCB0","description":"ICD-JCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial exam involved joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2004F","description":"Initial exam involved joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj fem single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64447","description":"N block inj fem single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mannitol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2150","description":"Mannitol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flu immunize order/admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8482","description":"Flu immunize order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE1","description":"ICD-OEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31291","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMC1","description":"ICD-JEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVF0","description":"ICD-KBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB1","description":"ICD-FIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of skull seams","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61552","description":"Release of skull seams","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL46","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRB1","description":"ICD-OGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15950","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lamaze class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9436","description":"Lamaze class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID0","description":"ICD-OKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC36","description":"Medium Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sub pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8995","description":"Sub pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0583U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","description":"CPT-0583U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETF1","description":"ICD-OETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX56","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9356","description":"Injection_ trastuzumab_ 10 mg and hyaluronidase-oysk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD0","description":"ICD-FCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA1","description":"ICD-JCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB0","description":"ICD-OKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9772","description":"Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIME1","description":"ICD-OIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iop measurement not documented_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1226","description":"Iop measurement not documented_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAC1","description":"ICD-NLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXA1","description":"ICD-BAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA1","description":"ICD-PFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHB0","description":"ICD-OHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDF1","description":"ICD-NFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMA0","description":"ICD-BDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHC0","description":"ICD-EIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sheath below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8400","description":"Sheath below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior thoracic derotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1260","description":"Anterior thoracic derotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE235","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB0","description":"ICD-JHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDID0","description":"ICD-MDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34201","description":"Removal of artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJA0","description":"ICD-CGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB0","description":"ICD-KGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded plas rig ant tib","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1945","description":"Afo molded plas rig ant tib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA0","description":"ICD-FFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD141","description":"Special Care Low _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPA0","description":"ICD-OFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE0","description":"ICD-DHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rsk fx ref w/n 24 hrs xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5100F","description":"Rsk fx ref w/n 24 hrs xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA1","description":"ICD-NCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXE0","description":"ICD-GBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA0","description":"ICD-AFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL2A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD1","description":"ICD-KGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_maintenance rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9002","description":"Mccd_maintenance rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct entire forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21180","description":"Reconstruct entire forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJD1","description":"ICD-CFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCE1","description":"ICD-MHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME1","description":"ICD-JIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palonosetron hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2469","description":"Palonosetron hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKD0","description":"ICD-CIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE1","description":"ICD-EIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQC0","description":"ICD-OCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3379","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","description":"HCPCS-J3379","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No mrs score in 90d followup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9647","description":"No mrs score in 90d followup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE0","description":"ICD-DBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0407","description":"HCPCS-C0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA0","description":"ICD-KDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reagent strip/blood glucose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82948","description":"Reagent strip/blood glucose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/read 16 & >","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88189","description":"Flowcytometry/read 16 & >","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion insulin pump needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4231","description":"Infusion insulin pump needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA1","description":"ICD-IIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC1","description":"ICD-BAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neisseria meningitidis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86741","description":"Neisseria meningitidis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXB0","description":"ICD-CAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC1","description":"ICD-MDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2146","description":"Leg Pain As Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB0","description":"ICD-KEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8X","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUA1","description":"ICD-FDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF1","description":"ICD-OKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVB0","description":"ICD-OLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2641","description":"Brachytx_ non-stranded_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCA1","description":"ICD-JBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26350","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIC1","description":"ICD-EEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4025","description":"Cast sup hip spica plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA0","description":"ICD-BAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNF1","description":"ICD-KCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF1","description":"ICD-NACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90961","description":"Esrd srv 2-3 vsts p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate inf turbinate submuc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30802","description":"Ablate inf turbinate submuc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0703","description":"CDT-D0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1029T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1029T","description":"CPT-1029T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJB0","description":"ICD-JIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj lo_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9004","description":"Mccd_ risk adj lo_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocate pocket for defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33223","description":"Relocate pocket for defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test for g6pd enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82960","description":"Test for g6pd enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBA1","description":"ICD-CBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5C","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA0","description":"ICD-OLCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOA0","description":"ICD-ODOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB0","description":"ICD-AHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68520","description":"Removal of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB0","description":"ICD-LFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18D","description":"Special Care High _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1022T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","description":"CPT-1022T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0414","description":"Laboratory processing of microbial specimen to include culture and sensitivity studies_ preparation and transmission of written report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01462","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","description":"CPT-01462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53505","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDA0","description":"ICD-OGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Head surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21499","description":"Head surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232U","description":"CSTB (cystatin B) (eg_ progressive myoclonic epilepsy type 1A_ Unverricht-Lundborg disease)_ full gene analysis_ including small sequence changes in exonic and intronic region","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB256","description":"Clinically Complex _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDA1","description":"ICD-JHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQC1","description":"ICD-KHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTF1","description":"ICD-NJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult day care per half day","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5101","description":"Adult day care per half day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANC1","description":"ICD-FANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTA0","description":"ICD-MJTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEA0","description":"ICD-MKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF1","description":"ICD-ADHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB0","description":"ICD-MGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJF0","description":"ICD-BDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIA1","description":"ICD-FFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD1","description":"ICD-AFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGD1","description":"ICD-FBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIB1","description":"ICD-JFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD0","description":"ICD-DIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38572","description":"Laparoscopy lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9678","description":"Oncology Care Model (OCM) Monthly Enhanced Oncology Oncology Services (MEOS) payment for enhanced care management services for OCM beneficiaries.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQF1","description":"ICD-OKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incontinence product_ disposable_ penile wrap_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4545","description":"Incontinence product_ disposable_ penile wrap_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocortisone sodium succ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1720","description":"Hydrocortisone sodium succ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMA0","description":"ICD-ICMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUD0","description":"ICD-KCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAC1","description":"ICD-KHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1006","description":"Suction pump_ home model_ portable or stationary_ electric_ any type_ for use with external urine management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0662","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","description":"HCPCS-G0662","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDF1","description":"ICD-JIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF0","description":"ICD-AEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq coronary mech thrombect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92973","description":"Prq coronary mech thrombect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGE1","description":"ICD-CEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vag lesions simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57061","description":"Destroy vag lesions simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94680","description":"Exhaled air analysis o2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE1","description":"ICD-OBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEB1","description":"ICD-EIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepagam b intravenous_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1573","description":"Hepagam b intravenous_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAB0","description":"ICD-EIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF0","description":"ICD-FCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE1","description":"ICD-JIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab glove for term device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6890","description":"Prefab glove for term device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External recharg sys intern","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8689","description":"External recharg sys intern","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15832","description":"Excise excessive skin thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA0","description":"ICD-OLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4D","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC15","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA1","description":"ICD-CHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHB0","description":"ICD-FFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71275","description":"Ct angiography chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3d photographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0351","description":"3d photographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA1","description":"ICD-GDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF1","description":"ICD-CCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB1","description":"ICD-OJWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD1","description":"ICD-EIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD0","description":"ICD-AFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntsty modul rad tx dlvr cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77386","description":"Ntsty modul rad tx dlvr cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHD0","description":"ICD-MEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49616","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWD1","description":"ICD-CFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF1","description":"ICD-AFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE1","description":"ICD-JADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c screen high risk/other","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0472","description":"Hep c screen high risk/other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermagraft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4106","description":"Dermagraft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sealant_ pulmonary_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2615","description":"Sealant_ pulmonary_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint upr extrem w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73222","description":"MRI joint upr extrem w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB0","description":"ICD-KEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23A","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0601U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","description":"CPT-0601U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ siltuximab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2860","description":"Injection_ siltuximab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARF0","description":"ICD-OARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0561","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","description":"HCPCS-G0561","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGB1","description":"ICD-NDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFB1","description":"ICD-BBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine & cord cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63194","description":"Incise spine & cord cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aducanumab-avwa_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0172","description":"Injection_ aducanumab-avwa_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular stim for scoli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0744","description":"Neuromuscular stim for scoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYA1","description":"ICD-LAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHB0","description":"ICD-FCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWB0","description":"ICD-KDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF0","description":"ICD-OENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21076","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHD0","description":"ICD-NAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE0","description":"ICD-BAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESE1","description":"ICD-CESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTC0","description":"ICD-GGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <=16 in no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6222","description":"Gauze <=16 in no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA231","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA0","description":"ICD-NKKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneuma compresor non-segment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0650","description":"Pneuma compresor non-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVC0","description":"ICD-NHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mmr vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90707","description":"Mmr vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLD0","description":"ICD-KCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leptospira antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86720","description":"Leptospira antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC1","description":"ICD-ECMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat big toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28490","description":"Treat big toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA0","description":"ICD-JELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0542T","description":"Myocardial imaging by magnetocardiography (MCG) for detection of cardiac ischemia_ by signal acquisition using minimum 36 channel grid_ generation of magnetic-field time-serie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0017U","description":"Oncology (hematolymphoid neoplasia)_ JAK2 mutation_ DNA_ PCR amplification of exons 12-14 and sequence analysis_ blood or bone marrow_ report of JAK2 mutation not detected or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAB0","description":"ICD-KIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE206","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAC1","description":"ICD-FEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18B","description":"Clinically Complex _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKD0","description":"ICD-FDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC1","description":"ICD-NLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA0","description":"ICD-NJKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3-d radiotherapy plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77295","description":"3-d radiotherapy plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC0","description":"ICD-CFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0050","description":"Alcohol/drug service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNB0","description":"ICD-CDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC1","description":"ICD-KILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth surgery of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86052","description":"Anesth surgery of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE0","description":"ICD-OGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQC1","description":"ICD-LGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD0","description":"ICD-LCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX26","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01922","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","description":"CPT-01922","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC0","description":"ICD-NFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cus elbo skt in for con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6696","description":"Cus elbo skt in for con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC0","description":"ICD-BCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOC0","description":"ICD-CDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrnl bleaching per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9974","description":"Intrnl bleaching per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSF1","description":"ICD-GGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDE1","description":"ICD-AIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7177","description":"Injection_ human fibrinogen concentrate (Fibryga)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87515","description":"Hepatitis b dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in hospice facility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5006","description":"Hospice in hospice facility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX11","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm tum deep < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25076","description":"Exc forearm tum deep < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gen_ neuro_ non-hf rechg bat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1820","description":"Gen_ neuro_ non-hf rechg bat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAF0","description":"ICD-BAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28052","description":"Biopsy of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision orbitofacial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21275","description":"Revision orbitofacial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGD0","description":"ICD-GHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31785","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28261","description":"Revision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHEA0","description":"ICD-CHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJF1","description":"ICD-JDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB0","description":"ICD-JIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ patisiran_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9036","description":"Injection_ patisiran_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB1","description":"ICD-CGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE1","description":"ICD-KCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0520T","description":"Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter)_ including placement of a new ele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB0","description":"ICD-BHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILF0","description":"ICD-AILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain canal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61050","description":"Remove brain canal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meals for clinical trial par","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9996","description":"Meals for clinical trial par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF1","description":"ICD-OLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25929","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"InnovaBurn or InnovaMatrix XL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2022","description":"InnovaBurn or InnovaMatrix XL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVF0","description":"ICD-NFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF0","description":"ICD-GIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPC1","description":"ICD-BDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01215","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","description":"CPT-01215","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1904","description":"HCPCS-A1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rabies vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90675","description":"Rabies vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3358","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20969","description":"Bone/skin graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47740","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTD0","description":"ICD-ACTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUB0","description":"ICD-GCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0600U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","description":"CPT-0600U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HC11","description":"ICD-3HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD151","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67430","description":"Explore/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1957","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1957","description":"HCPCS-J1957","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSA1","description":"ICD-ODSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUD1","description":"ICD-KGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB1","description":"ICD-JFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0478U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","description":"CPT-0478U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd guide wire insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43248","description":"Egd guide wire insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF0","description":"ICD-IICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4392","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","description":"HCPCS-Q4392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC0","description":"ICD-CDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQF1","description":"ICD-HCQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHC1","description":"ICD-EGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVC1","description":"ICD-GFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA0","description":"ICD-NEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1444","description":"Injection_ ferric pyrophosphate citrate powder_ 0.1mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72146","description":"MRI chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUB1","description":"ICD-MGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of complications","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9930","description":"Treatment of complications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBA1","description":"ICD-NEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA0","description":"ICD-CHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMF0","description":"ICD-EHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDA1","description":"ICD-CEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHF1","description":"ICD-CBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF0","description":"ICD-GFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIA1","description":"ICD-GFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chiropract manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98941","description":"Chiropract manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyclophosphamide oral 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8530","description":"Cyclophosphamide oral 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQE1","description":"ICD-OCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15774","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; Each Additional 25 Cc Injectate_ Or P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glucose blood test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82962","description":"Glucose blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLC1","description":"ICD-MDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip pt no elg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8653","description":"Fun stat score hip pt no elg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBC1","description":"ICD-EFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg myelomeningo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2404","description":"Fetal surg myelomeningo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0404","description":"HCPCS-B0404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylergonovin maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2210","description":"Methylergonovin maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAE1","description":"ICD-IHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF1","description":"ICD-FCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arm supp att to wc rancho ty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2627","description":"Arm supp att to wc rancho ty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMF0","description":"ICD-JAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC115","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMF1","description":"ICD-FHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose fx w/skele fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21330","description":"Open tx nose fx w/skele fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATB1","description":"ICD-AATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJF0","description":"ICD-FHJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown-titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2794","description":"Crown-titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD0","description":"ICD-CEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay toxin or antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87230","description":"Assay toxin or antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXE1","description":"ICD-NBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENC1","description":"ICD-GENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69720","description":"Release facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assist living waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2030","description":"Assist living waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB1","description":"ICD-IBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0066U","description":"Placental alpha-micro globulin-1 (PAMG-1)_ immunoassay with direct optical observation_ cervico-vaginal fluid_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMA1","description":"ICD-CIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hmes filter holder or cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7503","description":"Hmes filter holder or cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert hepatic shunt (tips)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37182","description":"Insert hepatic shunt (tips)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA1","description":"ICD-OAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii type verify lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81371","description":"Hla i & ii type verify lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB0","description":"ICD-MBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3352","description":"Apexification/recalc interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reshaping bone orthognathic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7940","description":"Reshaping bone orthognathic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRF0","description":"ICD-PFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGE1","description":"ICD-GIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE1","description":"ICD-KFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXF0","description":"ICD-NBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro w/c cus wd<22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2622","description":"Adj skin pro w/c cus wd<22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE0","description":"ICD-PKOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA1","description":"ICD-LASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF0","description":"ICD-DHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF0","description":"ICD-CAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venous m-thrombectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37188","description":"Venous m-thrombectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0969T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","description":"CPT-0969T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYB1","description":"ICD-OGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65875","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOB1","description":"ICD-GIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOE0","description":"ICD-KGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8I","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHC0","description":"ICD-BBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject skin lesions ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21014","description":"Exc face tum deep 2 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26460","description":"Incise hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEA1","description":"ICD-OIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Improving care for lower extremity joint repair mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0058","description":"Improving care for lower extremity joint repair mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAE0","description":"ICD-MAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58285","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC5C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGA0","description":"ICD-FHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bat clps elec/comb vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0497","description":"Bat clps elec/comb vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunodiffusion nes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86329","description":"Immunodiffusion nes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE0","description":"ICD-BBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86870","description":"Rbc antibody identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0682","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","description":"HCPCS-G0682","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAB1","description":"ICD-NGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9095","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMF0","description":"ICD-OAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC0","description":"ICD-CELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC1","description":"ICD-JGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of sexual activity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9818","description":"Documentation of sexual activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct skin color ea 20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11922","description":"Correct skin color ea 20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASF0","description":"ICD-CASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA256","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rigid ped w/c tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1231","description":"Rigid ped w/c tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Golimumab for iv use 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1602","description":"Golimumab for iv use 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8540","description":"Functional outcome assessment not documented as being performed_ documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAC0","description":"ICD-NAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPC0","description":"ICD-GIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACC0","description":"ICD-EACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mesna injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9209","description":"Mesna injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA0","description":"ICD-GFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ann breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0613","description":"Ann breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB0","description":"ICD-CBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal pelvic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38562","description":"Removal pelvic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXA0","description":"ICD-FAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB11","description":"ICD-1EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30120","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF1","description":"ICD-GDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB244","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cbc/diffwbc w/o platelet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0306","description":"Cbc/diffwbc w/o platelet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOE1","description":"ICD-GGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSF1","description":"ICD-PGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOE0","description":"ICD-PEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42830","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12A","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26125","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1099","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lympho venereum antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86729","description":"Lympho venereum antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXF1","description":"ICD-OLXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAB1","description":"ICD-BHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGB1","description":"ICD-GGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWD1","description":"ICD-HEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF1","description":"ICD-MJTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTE0","description":"ICD-CHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXA0","description":"ICD-GIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE1","description":"ICD-OFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lysis + lavage w catheters","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7871","description":"Lysis + lavage w catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAF1","description":"ICD-FIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFB1","description":"ICD-JCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA0","description":"ICD-GCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61750","description":"Incise skull/brain biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVB1","description":"ICD-OCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2305","description":"Lens sphcy trifocal 4.0/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE1","description":"ICD-GCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF0","description":"ICD-BENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muramidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85549","description":"Muramidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEC0","description":"ICD-NCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray exam of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74283","description":"Contrast x-ray exam of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45130","description":"Excision of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAF1","description":"ICD-IEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE234","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF0","description":"ICD-GEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA0","description":"ICD-FFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA03","description":"Default_ /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEC0","description":"ICD-AIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQA0","description":"ICD-GAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAED1","description":"ICD-GAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01968","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","description":"CPT-01968","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF1","description":"ICD-KFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLF1","description":"ICD-FFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of peritoneum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74190","description":"X-ray exam of peritoneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHD0","description":"ICD-KCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29450","description":"Application of leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE1","description":"ICD-HBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD1","description":"ICD-KHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATE1","description":"ICD-IATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC235","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC11","description":"ICD-2IC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2070","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0311T","description":"Non-Invasive Calculation And Analysis Of Central Arterial Pressure Waveforms With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCA0","description":"ICD-KHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE1","description":"ICD-OGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEME1","description":"ICD-BEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISB0","description":"ICD-OISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2635","description":"Brachytx_ non-str_ ha_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit picc insert kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5520","description":"Hit picc insert kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33257","description":"Ablate atria lmtd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME1","description":"ICD-ICME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0512U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","description":"CPT-0512U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSC0","description":"ICD-OGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","description":"HCPCS-J7601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1837","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","description":"HCPCS-J1837","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma provocative tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92140","description":"Glaucoma provocative tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC0","description":"ICD-CBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","description":"HCPCS-M1436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAND0","description":"ICD-FAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112U","description":"Fetal aneuploidy (trisomy 21_ and 18) DNA sequence analysis of selected reg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIED1","description":"ICD-NIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF1","description":"ICD-JDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8G","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nos flu vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2039","description":"Nos flu vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLF0","description":"ICD-OHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITA1","description":"ICD-MITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAB0","description":"ICD-KEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA17","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toilet seat raised","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0244","description":"Toilet seat raised","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87799","description":"Detect agent nos dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRA0","description":"ICD-KBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dihydrocodeinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6045","description":"Dihydrocodeinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB0","description":"ICD-GDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGND0","description":"ICD-NGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20B","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML31","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No cont ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4186F","description":"No cont ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78599","description":"Respiratory nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKD0","description":"ICD-KFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp 80-89 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3079F","description":"Diast bp 80-89 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-60660","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","description":"CPT-60660","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB113","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spleen imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78185","description":"Spleen imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heinz bodies direct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85441","description":"Heinz bodies direct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp genet test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3865","description":"Comp genet test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE1","description":"ICD-GFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYB1","description":"ICD-OIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0084","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMB0","description":"ICD-MLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRE1","description":"ICD-PIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11C","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng warf thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4301F","description":"Pt not rcvng warf thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAC1","description":"ICD-NHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCF0","description":"ICD-FGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB1","description":"ICD-CHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLE0","description":"ICD-EFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYE1","description":"ICD-PIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fx rad intra-articul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25608","description":"Treat fx rad intra-articul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB0","description":"ICD-KAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Approp ace/arb tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4188F","description":"Approp ace/arb tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD1","description":"ICD-AEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urea injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3350","description":"Urea injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt or manip for maint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8990","description":"Pt or manip for maint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL45","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0612U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","description":"CPT-0612U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Outer ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69399","description":"Outer ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5C","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma sing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9071","description":"Pathogen reduced plasma sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB1","description":"ICD-CGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72133","description":"Ct lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87530","description":"Hsv dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA21","description":"ICD-1HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain lower leg lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27603","description":"Drain lower leg lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFF0","description":"ICD-CCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE111","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64581","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt dchg home post op day 7","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9601","description":"Pt dchg home post op day 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005U","description":"Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG_ PCA3_ and SPDEF)_ urine_ algorithm reported as risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILB0","description":"ICD-OILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1310","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling_ ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open red comp malar/zygma fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7750","description":"Open red comp malar/zygma fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25107","description":"Remove wrist joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant eye drug system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67027","description":"Implant eye drug system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic propulsion tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2211","description":"Pneumatic propulsion tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pilonidal cyst compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11772","description":"Remove pilonidal cyst compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXC1","description":"ICD-JBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2002","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEA0","description":"ICD-GIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68810","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADC1","description":"ICD-IADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth facial bone surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19251","description":"Anesth facial bone surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay cyclosporine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80158","description":"Drug assay cyclosporine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36558","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2d6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81226","description":"Cyp2d6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","description":"HCPCS-M1395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFB1","description":"ICD-KAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFC1","description":"ICD-FCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venous pressure clamp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4918","description":"Venous pressure clamp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHC1","description":"ICD-KEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture skin/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88233","description":"Tissue culture skin/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34712","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg_ anchor_ screw_ tack) and all associated radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA146","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open wedge/bx lung nodule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32097","description":"Open wedge/bx lung nodule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC104","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA1","description":"ICD-OLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAE1","description":"ICD-AIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacemnt lithium ionbatter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7367","description":"Replacemnt lithium ionbatter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF1","description":"ICD-DHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA0","description":"ICD-BBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGME1","description":"ICD-KGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCF1","description":"ICD-NHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJC0","description":"ICD-KBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lysis penil circumic lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54162","description":"Lysis penil circumic lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76825","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-serv of pt_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0151","description":"Hhcp-serv of pt_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous rf vein add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36476","description":"Endovenous rf vein add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay serum cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82480","description":"Assay serum cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB1","description":"ICD-PGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Romidepsin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9315","description":"Romidepsin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB140","description":"Special Care Low _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFA1","description":"ICD-KAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cpk in blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82552","description":"Assay of cpk in blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUC1","description":"ICD-NIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA0","description":"ICD-FCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHA0","description":"ICD-OIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGA1","description":"ICD-CHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD0","description":"ICD-FCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFE0","description":"ICD-NFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF0","description":"ICD-GIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD0","description":"ICD-NHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0503T","description":"Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC260","description":"Clinically Complex _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE0","description":"ICD-CFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig lesion>1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7414","description":"Excision malig lesion>1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIA1","description":"ICD-GDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME0","description":"ICD-BAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80329","description":"Analgesics non-opioid 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55845","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB1","description":"ICD-CDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE0","description":"ICD-JIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLF1","description":"ICD-CBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEB1","description":"ICD-BCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound tx >50 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97606","description":"Neg press wound tx >50 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWF0","description":"ICD-OFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA1","description":"ICD-OJBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC0","description":"ICD-CIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA0","description":"ICD-OLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ABO GNOTYP NEXT GNRJ SEQ ABO","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0221U","description":"ABO GNOTYP NEXT GNRJ SEQ ABO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel face dermal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15789","description":"Chemical peel face dermal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSD1","description":"ICD-PJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD0","description":"ICD-NHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0667T","description":"Donor hysterectomy (including cold preservation); recipient uterus allograft transplantation from cadaver or living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tah rad debulk/lymph remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58954","description":"Tah rad debulk/lymph remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBD0","description":"ICD-GBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc death after cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9260","description":"Doc death after cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCE0","description":"ICD-NGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deluxe item","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1001","description":"Deluxe item","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2099","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE0","description":"ICD-GHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHD1","description":"ICD-BDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0826T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No bone scn b/4 txmnt/aftrdx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3270F","description":"No bone scn b/4 txmnt/aftrdx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier nonheated w pap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0561","description":"Humidifier nonheated w pap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE23D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD0","description":"ICD-CFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKA0","description":"ICD-CHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF1","description":"ICD-CDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20240","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0177","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand interface joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2321","description":"Hand interface joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFC1","description":"ICD-NAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28E","description":"Special Care Low _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMA0","description":"ICD-GEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63091","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","description":"HCPCS-M1405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC1","description":"ICD-BEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESF0","description":"ICD-LESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNA1","description":"ICD-NCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9393","description":"Injection_ fulvestrant (teva) not therapeutically equivalent to j9395_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 4 vsts p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90957","description":"Esrd srv 4 vsts p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE1","description":"ICD-NCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA1","description":"ICD-AATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse hand bones with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25825","description":"Fuse hand bones with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKC0","description":"ICD-FFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdom complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76700","description":"Us exam abdom complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tunneled ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49422","description":"Remove tunneled ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj for sacroiliac jt anesth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0260","description":"Inj for sacroiliac jt anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF1","description":"ICD-GAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0889T","description":"Personalized target development for accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC141","description":"Clinically Complex _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD1","description":"ICD-GCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD1","description":"ICD-CCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUB0","description":"ICD-AFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB1","description":"ICD-NHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24920","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Slitting of prepuce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54001","description":"Slitting of prepuce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25110","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64624","description":"Destruction By Neurolytic Agent_ Genicular Nerve Branches Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier_ wipe or swab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5120","description":"Skin barrier_ wipe or swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE0","description":"ICD-CENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE1","description":"ICD-LBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF0","description":"ICD-DGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41805","description":"Removal foreign body gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQD1","description":"ICD-CFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWB1","description":"ICD-CCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hm postpar hyper per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9212","description":"Hm postpar hyper per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin intermed 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5552","description":"Insulin intermed 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB0","description":"ICD-DEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5167","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5167","description":"HCPCS-Q5167","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE1","description":"ICD-KCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAD1","description":"ICD-JGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVC0","description":"ICD-BIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAD0","description":"ICD-AHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion unilat rot str","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2070","description":"Hkafo torsion unilat rot str","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJA1","description":"ICD-CDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Water seal drain container","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7041","description":"Water seal drain container","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE0","description":"ICD-FHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHC0","description":"ICD-GIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUB1","description":"ICD-BHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECB0","description":"ICD-CECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0567T","description":"Permanent Fallopian Tube Occlusion With Degradable Biopolymer Implant_ Transcervical Approach_ Including Transvaginal Ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post 2 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2392","description":"Post 2 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise graft w/nonauto graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35883","description":"Revise graft w/nonauto graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRC0","description":"ICD-KFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB0","description":"ICD-EEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID0","description":"ICD-NHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC45","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx crisis ea addl 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90840","description":"Psytx crisis ea addl 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of rib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47051","description":"Anesth removal of rib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9988","description":"Palliative Care Services Provided To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME1","description":"ICD-KIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOC0","description":"ICD-HFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biodfence dryflex_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4138","description":"Biodfence dryflex_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cell enumeration phys interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86153","description":"Cell enumeration phys interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9072","description":"Pathogen reduced platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21632","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLE1","description":"ICD-GFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"J-cell batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4234","description":"J-cell batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1399","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","description":"HCPCS-M1399","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF1","description":"ICD-GIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97037","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie_ nonthermal and non-ablative) for post-operative pain reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD0","description":"ICD-JDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGE0","description":"ICD-GFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC0","description":"ICD-JCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF0","description":"ICD-OLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC1","description":"ICD-METC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX45","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD0","description":"ICD-FHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Locm >= 400 mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9951","description":"Locm >= 400 mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8D","description":"Very High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATC0","description":"ICD-JATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Next Gen aco model>20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9870","description":"Next Gen aco model>20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compres burngarment bodysuit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6501","description":"Compres burngarment bodysuit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBB0","description":"ICD-IIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD1","description":"ICD-KHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXC0","description":"ICD-BEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB0","description":"ICD-NLFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB204","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown lengthen hard tissue","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4249","description":"Crown lengthen hard tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461T","description":"Repositioning of previously implanted aortic counterpulsation ventricular assist device; aortic counterpulsation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2080","description":"Laup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXC0","description":"ICD-NAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA0","description":"ICD-KABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak sleeve susp neoprene/equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5695","description":"Ak sleeve susp neoprene/equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2041","description":"Coordinated specialty care_ team-based_ for first episode psychosis_ per encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBEA0","description":"ICD-JBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC0","description":"ICD-NJUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHC1","description":"ICD-OJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBF1","description":"ICD-JCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pelvis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84451","description":"Anesth pelvis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afluria vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2035","description":"Afluria vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain alg alys data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0611T","description":"Mrs disc pain alg alys data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSC1","description":"ICD-PHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF0","description":"ICD-MLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD150","description":"Reduced Physical Function _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No bld inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9627","description":"No bld inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA1","description":"ICD-NEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAA1","description":"ICD-GEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEB1","description":"ICD-AHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB1","description":"ICD-OGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20B","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove esophagus obstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74235","description":"Remove esophagus obstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction eyelid w/implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67912","description":"Correction eyelid w/implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19125","description":"Excision breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYC1","description":"ICD-PBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fomepizole_ 15 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1451","description":"Fomepizole_ 15 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX30","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELD0","description":"ICD-MELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXD1","description":"ICD-OHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commissure splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5987","description":"Commissure splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9037","description":"Interprofessional telephone/internet/electronic health record clinical question/request for specialty recommendations by a treating/requesting physician or other qualified hea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem mntr pulm flu mntr setup","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0607T","description":"Rem mntr pulm flu mntr setup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF0","description":"ICD-ICAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urokinase 250_000 iu inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3365","description":"Urokinase 250_000 iu inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC1","description":"ICD-IDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDF0","description":"ICD-FGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0087","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUD0","description":"ICD-CCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA1","description":"ICD-NFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add felt w leath insl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3520","description":"O shoe add felt w leath insl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB0","description":"ICD-OCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOB1","description":"ICD-LCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKD1","description":"ICD-NIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp pop-tibl peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35587","description":"Vein byp pop-tibl peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIND0","description":"ICD-NIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD0","description":"ICD-JCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49595","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9811","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9811","description":"HCPCS-C9811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC0","description":"ICD-CGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28200","description":"Repair of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD154","description":"Clinically Complex _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDB0","description":"ICD-NBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE0","description":"ICD-EHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0491","description":"Tlso 2 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGA1","description":"ICD-CEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB1","description":"ICD-NKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43320","description":"Fuse esophagus & stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trapeze bar attached to bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0910","description":"Trapeze bar attached to bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC0","description":"ICD-NKVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA144","description":"Clinically Complex _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty w/cp bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33403","description":"Valvuloplasty w/cp bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA0","description":"ICD-OETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC1","description":"ICD-JCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostate saturation sampling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55706","description":"Prostate saturation sampling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31253","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including frontal sinus exploration_ with removal of tissue from frontal sinus_ when perfor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no sleep apnea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8840","description":"Doc reas no sleep apnea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEE0","description":"ICD-MDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWF1","description":"ICD-GBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF0","description":"ICD-FBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEID0","description":"ICD-KEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQE0","description":"ICD-CGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onco (ovar) two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81500","description":"Onco (ovar) two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF0","description":"ICD-GIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDD1","description":"ICD-FBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVF0","description":"ICD-GGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA0","description":"ICD-JCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair elbow perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24357","description":"Repair elbow perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXA1","description":"ICD-BEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minocycline hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2265","description":"Minocycline hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRF1","description":"ICD-GCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dostarlimab-gxly_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9082","description":"Injection_ dostarlimab-gxly_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBA1","description":"ICD-AIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC1","description":"ICD-KASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB110","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMB1","description":"ICD-EGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAD0","description":"ICD-MFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr tiller","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0984","description":"Add pwr tiller","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KC31","description":"ICD-3KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF0","description":"ICD-FFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBB0","description":"ICD-MDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB1","description":"ICD-OBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Odontoplasty 1-2 teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9971","description":"Odontoplasty 1-2 teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collect & prep genetic samp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0422","description":"Collect & prep genetic samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl garment for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0608","description":"Repl garment for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11105","description":"Punch biopsy of skin (including simple closure_ when performed); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0502","description":"CDT-D0502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intraoral tomosynthesis - bitewing radiographic image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0373","description":"intraoral tomosynthesis - bitewing radiographic image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29883","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB1","description":"ICD-LGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLD0","description":"ICD-CFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgimend_ neonatal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9360","description":"Surgimend_ neonatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHB0","description":"ICD-EGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD0","description":"ICD-MFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA0","description":"ICD-PCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFOC1","description":"ICD-DFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYC0","description":"ICD-PKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"YT GNOTYP ACHE EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0201U","description":"YT GNOTYP ACHE EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOE1","description":"ICD-PBOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD1","description":"ICD-OLCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUF0","description":"ICD-OFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE156","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJB1","description":"ICD-ODJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATF0","description":"ICD-FATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt has symp&signs neuropathy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3753F","description":"Pt has symp&signs neuropathy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDB1","description":"ICD-JIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECF1","description":"ICD-JECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITD0","description":"ICD-EITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALE1","description":"ICD-EALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fondaparinux sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1652","description":"Fondaparinux sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE0","description":"ICD-NLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLE0","description":"ICD-FHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHC1","description":"ICD-BEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Full length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4510","description":"Full length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYB1","description":"ICD-OJYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD1","description":"ICD-FCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC1","description":"ICD-OLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0236U","description":"SMN1 (survival of motor neuron 1_ telomeric) and SMN2 (survival of motor neuron 2_ centromeric) (eg_ spinal muscular atrophy) full gene analysis_ including small sequence chan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam&tx estab pt 1/>vst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92014","description":"Eye exam&tx estab pt 1/>vst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA0","description":"ICD-NFVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alanine amino (alt) (sgpt)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84460","description":"Alanine amino (alt) (sgpt)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma 1 donor frz w/in 8 hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9017","description":"Plasma 1 donor frz w/in 8 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric no recurrence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9100","description":"Onc dx gastric no recurrence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","description":"HCPCS-J0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23C","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spinal cord tract(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63170","description":"Incise spinal cord tract(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5701","description":"Replace socket above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOD0","description":"ICD-HAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01924","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","description":"CPT-01924","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD205","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTE0","description":"ICD-JFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB1","description":"ICD-KFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNA1","description":"ICD-ODNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF0","description":"ICD-KGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOF1","description":"ICD-LAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB1","description":"ICD-JAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42650","description":"Dilation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATF0","description":"ICD-IATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID1","description":"ICD-EIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWE0","description":"ICD-CEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF0","description":"ICD-CBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLC1","description":"ICD-MBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC0","description":"ICD-NIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7557","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQA1","description":"ICD-LEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove kidney living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50320","description":"Remove kidney living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBE0","description":"ICD-NHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shock absorber for power w/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1016","description":"Shock absorber for power w/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE0","description":"ICD-MIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBB1","description":"ICD-CFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB0","description":"ICD-DAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27334","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF1","description":"ICD-JFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4207","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4207","description":"HCPCS-Q4207","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUC0","description":"ICD-EGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ige","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82785","description":"Assay of ige","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC0","description":"ICD-BGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHA0","description":"ICD-CFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervic collar w air bladders","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0856","description":"Cervic collar w air bladders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88368","description":"Insitu hybridization manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1709","description":"Pfizer-BioNTech Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED1","description":"ICD-KBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF0","description":"ICD-NEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9983","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 8.1 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ genitourinary pathogens_ identification of 21 bacterial and fungal organisms and identification of 21 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA1","description":"ICD-NKFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAD1","description":"ICD-KCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA0","description":"ICD-CIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRA0","description":"ICD-DBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXB1","description":"ICD-JHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9748","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFA1","description":"ICD-BCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0877T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVE0","description":"ICD-FFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrical care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59409","description":"Obstetrical care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALF0","description":"ICD-AALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEC1","description":"ICD-OFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27824","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE1","description":"ICD-MJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF1","description":"ICD-OJAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJA0","description":"ICD-BCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC03","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93975","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATE0","description":"ICD-KATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTA0","description":"ICD-OHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture lymphocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88230","description":"Tissue culture lymphocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF1","description":"ICD-IBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFE1","description":"ICD-KEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB260","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA16","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE0","description":"ICD-BDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB1","description":"ICD-GHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAD1","description":"ICD-JCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","description":"CPT-98008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUF0","description":"ICD-OLUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB1","description":"ICD-MDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB0","description":"ICD-CEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA11","description":"ICD-4AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMB0","description":"ICD-CAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9840","description":"RAS (KRAS and NRAS) gene mutation testing performed before initiation of anti-EGFR MoAb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAA0","description":"ICD-OJAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWE1","description":"ICD-OGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB1","description":"ICD-PFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF1","description":"ICD-MKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Routine footcare pt w lops","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0247","description":"Routine footcare pt w lops","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86409","description":"Neutralizing antibody_ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease[COVID-19]);titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97799","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air polymer-type A intrauterine foam_ 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9574","description":"Air polymer-type A intrauterine foam_ 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE1","description":"ICD-KDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32215","description":"Treat chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular dev_ intraop_ det ret","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1784","description":"Ocular dev_ intraop_ det ret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF1","description":"ICD-HIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht hem horm inj diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9537","description":"Ht hem horm inj diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69661","description":"Revise middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90756","description":"Influenza virus vaccine_ quadrizalent (ccIIV4)_ derived from cell cultures_ subunit_ antibiotic free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEB1","description":"ICD-IFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA1","description":"ICD-AFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB125","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB1","description":"ICD-CEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD124","description":"Special Care High _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aac non-electronic board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1902","description":"Aac non-electronic board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB1","description":"ICD-GHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBA0","description":"ICD-KHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of troponin qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84512","description":"Assay of troponin qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calibrated microcap tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4651","description":"Calibrated microcap tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHB1","description":"ICD-KHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC1","description":"ICD-JEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33775","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHF0","description":"ICD-AHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00920","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","description":"CPT-00920","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc md rsn no antipla/p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9610","description":"Doc md rsn no antipla/p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0761T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each additional single antibody stain procedure (List separately in addi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLED0","description":"ICD-OLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTA0","description":"ICD-FCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVA1","description":"ICD-NHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88342","description":"Immunohisto antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVA1","description":"ICD-NIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31552","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ without indwelling stent placement_ age 12 years or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE225","description":"Clinically Complex _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41006","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metallic 3 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2543","description":"Dental onlay metallic 3 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3247","description":"Injection_ secukinumab_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29856","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVE1","description":"ICD-NFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRA0","description":"ICD-KIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1023","description":"Distal transcutaneous electrical nerve stimulator_ stimulates peripheral nerves of the upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE1","description":"ICD-CIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photo patch test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95052","description":"Photo patch test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iron sucrose injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1756","description":"Iron sucrose injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl stg 3-4 not relap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9135","description":"Onc dx nhl stg 3-4 not relap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOA1","description":"ICD-GFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0061","description":"Anesthesiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD1","description":"ICD-NDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraut copper contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7300","description":"Intraut copper contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNC1","description":"ICD-NCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin w/high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6250","description":"Bridge resin w/high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA1","description":"ICD-OAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHF1","description":"ICD-IAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cbt each addl hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94645","description":"Cbt each addl hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFD1","description":"ICD-FEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPA0","description":"ICD-KHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection abdominal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49427","description":"Injection abdominal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43631","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Offset knee joint heavy duty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2395","description":"Offset knee joint heavy duty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA1","description":"ICD-OHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUD0","description":"ICD-GDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj reconstruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7858","description":"Tmj reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of hip casts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29325","description":"Application of hip casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFC0","description":"ICD-GCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLE1","description":"ICD-MCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFE0","description":"ICD-NAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOC0","description":"ICD-HAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGF1","description":"ICD-CFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYC0","description":"ICD-LFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBA1","description":"ICD-BIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0835","description":"Pwc gp2 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMD0","description":"ICD-ABMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSA1","description":"ICD-OFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33956","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA1","description":"ICD-FILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC55","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB0","description":"ICD-OJTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA0","description":"ICD-JCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF1","description":"ICD-HDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID0","description":"ICD-IAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNF0","description":"ICD-CGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEME1","description":"ICD-KEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj testosterone cypionate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1071","description":"Inj testosterone cypionate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1087","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA0","description":"ICD-PARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1A","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXB1","description":"ICD-NJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND1","description":"ICD-FCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWF1","description":"ICD-PKWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI joint of lwr extr w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73722","description":"MRI joint of lwr extr w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prochlorperazine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0780","description":"Prochlorperazine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSF1","description":"ICD-DFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF0","description":"ICD-JHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA0","description":"ICD-CCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68760","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB1","description":"ICD-NKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTE1","description":"ICD-CDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX41","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA1","description":"ICD-NHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC126","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB1","description":"ICD-KHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixed patient lift system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0640","description":"Fixed patient lift system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide (ingenus)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9073","description":"Injection_ cyclophosphamide (ingenus)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice home care in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5010","description":"Hospice home care in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1289","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counselin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKA1","description":"ICD-GCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC31","description":"Medium Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear diagnostic exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78999","description":"Nuclear diagnostic exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0705T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Surveillance Center Technical Support Including Data Transmission With Analysis_ With A Minimum Of 18 Training Hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing care in home rn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9123","description":"Nursing care in home rn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pouch drainable w barrier at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5061","description":"Pouch drainable w barrier at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFB1","description":"ICD-NKFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE0","description":"ICD-KFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVB0","description":"ICD-CBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUF0","description":"ICD-NCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids quant 2-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82136","description":"Amino acids quant 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC115","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICC0","description":"ICD-CICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atten current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9165","description":"Atten current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone srgry cmptr CT/MRI imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055T","description":"Bone srgry cmptr CT/MRI imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERF1","description":"ICD-CERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Comprehensive Platelet Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274U","description":"Hematology (genetic platelet disorders)_ genomic sequence analysis of 43 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Comprehensive Platelet Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","description":"HCPCS-Q4391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFA0","description":"ICD-BBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC0","description":"ICD-CBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59320","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visualization adjunct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9968","description":"Visualization adjunct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces for trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84490","description":"Assay of feces for trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA1","description":"ICD-KCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA260","description":"Clinically Complex _ ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0B","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVA1","description":"ICD-GGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13C","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWB0","description":"ICD-HDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16075","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16075","description":"CPT-16075","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA1","description":"ICD-NAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37267","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","description":"CPT-37267","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJB0","description":"ICD-OGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53410","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFB1","description":"ICD-NIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","description":"CPT-01942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37650","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC1","description":"ICD-CIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18G","description":"Clinically Complex _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNC1","description":"ICD-CGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF1","description":"ICD-MHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMA0","description":"ICD-GHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA1","description":"ICD-JFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUB0","description":"ICD-OLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD0","description":"ICD-GHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC1","description":"ICD-KBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracran angioplsty w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61635","description":"Intracran angioplsty w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9031","description":"Lutetium Lu 177_ dotatate_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21720","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDC0","description":"ICD-OKDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE0","description":"ICD-GFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF1","description":"ICD-JIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMC1","description":"ICD-AIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fixd ht w/o mattres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0251","description":"Hosp bed fixd ht w/o mattres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES335","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0892","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0884_ 1 mg (for esrd on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME1","description":"ICD-GGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFA1","description":"ICD-FDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-84393","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","description":"CPT-84393","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHC1","description":"ICD-CFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB212","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWD1","description":"ICD-GHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove blood clot from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65930","description":"Remove blood clot from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPA0","description":"ICD-FDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0663T","description":"Scalp cooling_ mechanical; placement of device_ monitoring_ and removal of device (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBD0","description":"ICD-EDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB254","description":"Special Care High _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUD1","description":"ICD-EGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial amputation of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28825","description":"Partial amputation of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWB1","description":"ICD-PDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99310","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75842","description":"Vein x-ray adrenal glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23655","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1901","description":"HCPCS-A1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18C","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA0","description":"ICD-OACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92641","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","description":"CPT-92641","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE151","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE0","description":"ICD-FDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exchange nephrostomy cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50435","description":"Exchange nephrostomy cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bupivacaine (posimir)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9144","description":"Injection_ bupivacaine (posimir)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell count >= 500 cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3496F","description":"Cd4+ cell count >= 500 cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB0","description":"ICD-GDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11440","description":"Exc face-mm b9+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kne sing axis fric shin sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5200","description":"Kne sing axis fric shin sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4B","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infus pump statio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9006","description":"Parenteral infus pump statio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD0","description":"ICD-AEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4368","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","description":"HCPCS-Q4368","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFF0","description":"ICD-JDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDC0","description":"ICD-KHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Presc opiates >6 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9561","description":"Presc opiates >6 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYB0","description":"ICD-CDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMF1","description":"ICD-EEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90482","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","description":"CPT-90482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB1","description":"ICD-JGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intestine lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44110","description":"Excise intestine lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE0","description":"ICD-CFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc car modulj atr elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0410T","description":"Insj/rplc car modulj atr elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lanreotide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1930","description":"Lanreotide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86611","description":"Bartonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSF0","description":"ICD-GCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam drg >16<=48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6210","description":"Foam drg >16<=48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC0","description":"ICD-NFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40845","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA1","description":"ICD-OKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX40","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of impacted wax md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0268","description":"Removal of impacted wax md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telethx isodose plan cplx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77307","description":"Telethx isodose plan cplx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPC1","description":"ICD-NAPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35002","description":"Repair artery rupture neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB0","description":"ICD-GGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screen provided and if positive then documented mitigation recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9922","description":"Safety concerns screen provided and if positive then documented mitigation recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLC1","description":"ICD-CCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL42","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27332","description":"Removal of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ivig demo_ services/supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2052","description":"Ivig demo_ services/supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alt long-term cntrl med rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4144F","description":"Alt long-term cntrl med rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE0","description":"ICD-EDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTA1","description":"ICD-IHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOE1","description":"ICD-HCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1C","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foll-up eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9562","description":"Foll-up eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQE1","description":"ICD-OAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81000","description":"Urinalysis nonauto w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE0","description":"ICD-CHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWF0","description":"ICD-KEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub graft face/nk/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15275","description":"Skin sub graft face/nk/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE1","description":"ICD-ODGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE0","description":"ICD-BHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99421","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL45","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Buccal/labial frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7961","description":"Buccal/labial frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25A","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF1","description":"ICD-HIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA52","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEE1","description":"ICD-ICEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRE1","description":"ICD-ODRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA1","description":"ICD-IGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","description":"HCPCS-M1433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheal suction tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4624","description":"Tracheal suction tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE0","description":"ICD-GAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCC0","description":"ICD-MJCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28090","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78814","description":"Pet image w/ct lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude organ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37243","description":"Vasc embolize/occlude organ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0245U","description":"ThyGeNEXT® Thyroid Oncogene Panel_ Interpace Diagnostics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGF0","description":"ICD-BFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLE1","description":"ICD-BCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup body cast fiberglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4002","description":"Cast sup body cast fiberglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF0","description":"ICD-GFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVB0","description":"ICD-NJVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD0","description":"ICD-NJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB0","description":"ICD-ICDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0147U","description":"Drug assay_ definitive_ 85 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBF0","description":"ICD-GFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFB1","description":"ICD-KBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0097U","description":"Gastrointestinal pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 22 targets (Campylobacter [C. jejuni/C. coli/C.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBE1","description":"ICD-IDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of bladder tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51710","description":"Change of bladder tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC0","description":"ICD-CASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lenacapavir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1961","description":"Injection_ lenacapavir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee jnt ratchet lock ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2430","description":"Knee jnt ratchet lock ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited ankle motion ea jnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2200","description":"Limited ankle motion ea jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33840","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9321","description":"Doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFED0","description":"ICD-JFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUB0","description":"ICD-NFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNE1","description":"ICD-KHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","description":"HCPCS-Q4389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4209","description":"Surgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPC1","description":"ICD-JIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress disc rf lumbar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2348","description":"Decompress disc rf lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74018","description":"Radiologic examination_ abdomen; 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKB0","description":"ICD-JAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC0","description":"ICD-CHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0983T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","description":"CPT-0983T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNC0","description":"ICD-FFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTB1","description":"ICD-BDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad glove heavy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8426","description":"Custom grad glove heavy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shrinker upper limb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8465","description":"Shrinker upper limb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko w/0 joint rigid molded to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1834","description":"Ko w/0 joint rigid molded to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKE0","description":"ICD-KDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay total hydroxyproline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83505","description":"Assay total hydroxyproline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No rh-immunoglobulin order","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8811","description":"No rh-immunoglobulin order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coronary_ temporary_ with delivery system (propel)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1091","description":"Stent_ non-coronary_ temporary_ with delivery system (propel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF0","description":"ICD-KFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1165","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPD0","description":"ICD-JIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLF0","description":"ICD-JCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0313","description":"Imm counseling by a physician or other qualified health care prof when the vaccine(s) is not admin on the same date of service for ages under 21_ 16-30 min Medicaid only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAD1","description":"ICD-CGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATE0","description":"ICD-FATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF1","description":"ICD-BDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOA1","description":"ICD-DIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF0","description":"ICD-NKLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implnt/abut remov dent mand","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6111","description":"Implnt/abut remov dent mand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genetic test brugada","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3861","description":"Genetic test brugada","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELF1","description":"ICD-KELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Testosterone undecanoate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3145","description":"Testosterone undecanoate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAC1","description":"ICD-BGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGE1","description":"ICD-JIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLA1","description":"ICD-ICLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGED1","description":"ICD-BGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72130","description":"Ct chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF0","description":"ICD-NKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBC1","description":"ICD-GIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNB0","description":"ICD-NHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRD0","description":"ICD-HHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA0","description":"ICD-AGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl injectio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1200","description":"Diphenhydramine hcl injectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVA0","description":"ICD-GEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vertical shock reducing pylo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5988","description":"Vertical shock reducing pylo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8G","description":"Medium Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSD1","description":"ICD-OHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA206","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAE0","description":"ICD-ICAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl trans to lg bcell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9136","description":"Onc dx nhl trans to lg bcell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFB0","description":"ICD-CBFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth testis exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92451","description":"Anesth testis exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE0","description":"ICD-HEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel sach cushion type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3450","description":"Shoe heel sach cushion type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDE1","description":"ICD-AHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC1","description":"ICD-LBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX1C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lo flex l1-below l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0625","description":"Lo flex l1-below l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF1","description":"ICD-PFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8B","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB151","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRC1","description":"ICD-PKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF1","description":"ICD-CHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC1","description":"ICD-KHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID1","description":"ICD-JEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC1","description":"ICD-KHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9098","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells_ including leukapheresis and dose preparation procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTF0","description":"ICD-NFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0665","description":"Pneumatic appliance full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQA1","description":"ICD-OGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD1","description":"ICD-CBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD1","description":"ICD-CDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC1","description":"ICD-CDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB0","description":"ICD-FDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31780","description":"Reconstruct windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total hip arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27132","description":"Total hip arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB134","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC1","description":"ICD-OAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE0","description":"ICD-HERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA0","description":"ICD-OFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid colxn visc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49405","description":"Image cath fluid colxn visc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYC0","description":"ICD-OFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC11","description":"ICD-3CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93615","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0888T","description":"Histotripsy (ie_ non-thermal ablation via acoustic energy delivery) of malignant renal tissue_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB0","description":"ICD-AEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6023","description":"Sigmoidoscopy_ flexible; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB1","description":"ICD-EBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA213","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSA0","description":"ICD-PJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal fluid drainage w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59074","description":"Fetal fluid drainage w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA11","description":"ICD-2DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epsd bk pain for 12 wks/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1136F","description":"Epsd bk pain for 12 wks/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0414U","description":"Oncology (lung)_ augmentative algorithmic analysis of digitized whole slide imaging for 8 genes (ALK_ BRAF_ EGFR_ ERBB2_ MET_ NTRK1-3_ RET_ ROS1)_ and KRAS G12C and PD-L1_ if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9741","description":"Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery_ including any type of measur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB106","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBWC1","description":"ICD-GBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXA1","description":"ICD-JBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB1","description":"ICD-CIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3D","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB25D","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA1","description":"ICD-GIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB11","description":"ICD-4HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain open abdom abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49040","description":"Drain open abdom abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD12A","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNC1","description":"ICD-BHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGA1","description":"ICD-BAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","description":"CPT-00500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB1","description":"ICD-BHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA34","description":"Medium Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC1","description":"ICD-MFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1292","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD0","description":"ICD-NIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert xdrl bdy lmbr/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63303","description":"Remov vert xdrl bdy lmbr/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAED1","description":"ICD-MAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15793","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"H pylori (c-13) blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83009","description":"H pylori (c-13) blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery/speech prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31611","description":"Surgery/speech prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA1","description":"ICD-MALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95710","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ Each Increment Of 12-26 Hours; With Continuous_ Real-Time Monitoring And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98986","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","description":"CPT-98986","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTD0","description":"ICD-BCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKF0","description":"ICD-OGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJF0","description":"ICD-FBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27638","description":"Remove/graft leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5137","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ SC_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ehrlichia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86666","description":"Ehrlichia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72142","description":"MRI neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSE0","description":"ICD-GDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain image w/flow < 4 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78601","description":"Brain image w/flow < 4 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBF0","description":"ICD-CIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery-vein autograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36825","description":"Artery-vein autograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo spiral molded to pt plas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1950","description":"Afo spiral molded to pt plas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD0","description":"ICD-NILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB0","description":"ICD-CICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0872","description":"Injection_ daptomycin (Xellia)_ unrefrigerated_ not therapeutically equivalent to J0878 or J0873_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA104","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUA0","description":"ICD-KFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA0","description":"ICD-CFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA0","description":"ICD-BEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38500","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMB0","description":"ICD-MJMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0576U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","description":"CPT-0576U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBME1","description":"ICD-GBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl & rplcmt dfb gen mlt ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33264","description":"Rmvl & rplcmt dfb gen mlt ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC1","description":"ICD-GISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29887","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/drain eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67405","description":"Explore/drain eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24577","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49592","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans care mgmt 14 day disch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99495","description":"Trans care mgmt 14 day disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSA1","description":"ICD-HDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF0","description":"ICD-BFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA1","description":"ICD-DGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31645","description":"Bronchoscopy_ rigid or flexible_ including fluoroscopic guidance_ when performed; with therapeutic aspiration of tracheobronchial tree_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICE0","description":"ICD-JICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented within normal parameters and no follow-up plan is required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1296","description":"Bmi is documented within normal parameters and no follow-up plan is required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6007","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBC1","description":"ICD-KHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTE0","description":"ICD-NHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA1","description":"ICD-KDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1416","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","description":"HCPCS-M1416","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 40 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1030","description":"Methylprednisolone 40 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92542","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC1","description":"ICD-CDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3B","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54240","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVF0","description":"ICD-GDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24470","description":"Revision of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18E","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plumb/elec wk hm hemo equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4870","description":"Plumb/elec wk hm hemo equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC0","description":"ICD-BEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 17-18 test","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP18","description":"Auto test panel pricing code_ 17-18 test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMC1","description":"ICD-NAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD1","description":"ICD-OLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF1","description":"ICD-FDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVF0","description":"ICD-FCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUD0","description":"ICD-IIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB1","description":"ICD-KEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB1","description":"ICD-BHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary leg bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5112","description":"Urinary leg bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD131","description":"Clinically Complex _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID0","description":"ICD-IDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amphotericin b liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0289","description":"Amphotericin b liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTA0","description":"ICD-GBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNE1","description":"ICD-BFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF1","description":"ICD-JGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy tubal block","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58671","description":"Laparoscopy tubal block","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF1","description":"ICD-ABMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIF0","description":"ICD-NDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0403","description":"HCPCS-A0403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUF0","description":"ICD-KIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC1","description":"ICD-GDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55715","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","description":"CPT-55715","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement interface spsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1821","description":"Replacement interface spsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAF1","description":"ICD-FHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w/ supinator/pronator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3203","description":"Oxford w/ supinator/pronator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBE0","description":"ICD-GCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18I","description":"Clinically Complex _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169U","description":"NUDT15 (nudix hydrolase 15) and TPMT (thiopurine SCmethyltransferase) (eg drug metabolism) gene analysis common variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE0","description":"ICD-GHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA11","description":"ICD-1AA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1626","description":"Granisetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAF1","description":"ICD-FEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA1","description":"ICD-KCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC0","description":"ICD-MFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93595","description":"Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone_ Normal Or Abnormal Native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXD1","description":"ICD-JDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB0","description":"ICD-OGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01772","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","description":"CPT-01772","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA1","description":"ICD-MEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB0","description":"ICD-DGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency tracheotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7990","description":"Emergency tracheotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no scrn hcv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9452","description":"Doc med reas no scrn hcv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBED0","description":"ICD-CBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD1","description":"ICD-MCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC1","description":"ICD-KFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27240","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHC1","description":"ICD-FFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Core build-up incl any pins","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2950","description":"Core build-up incl any pins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25905","description":"Amputation of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKC1","description":"ICD-OAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC0","description":"ICD-FHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB0","description":"ICD-JBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFE1","description":"ICD-FBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE130","description":"Clinically Complex _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF0","description":"ICD-CHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUD0","description":"ICD-MEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBB0","description":"ICD-IEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelvis les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27047","description":"Exc hip/pelvis les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD1","description":"ICD-PDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD141","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9122","description":"Mometasone furoate sinus implant_ 10 mcg (Sinuva)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE0","description":"ICD-NEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF0","description":"ICD-ADAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCD1","description":"ICD-KCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUC0","description":"ICD-KAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24530","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE0","description":"ICD-GAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGA1","description":"ICD-CAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE0","description":"ICD-NBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE0","description":"ICD-NAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA1","description":"ICD-OHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE1","description":"ICD-LFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87626","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","description":"CPT-87626","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF1","description":"ICD-KHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID0","description":"ICD-EHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGF0","description":"ICD-JCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01933","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","description":"CPT-01933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAA1","description":"ICD-CHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQA1","description":"ICD-GCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topical anesthetic_ per gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4736","description":"Topical anesthetic_ per gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA1","description":"ICD-CGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert pacing lead & connect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33224","description":"Insert pacing lead & connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57240","description":"Anterior colporrhaphy_ repair of cystocele with or without repair of urethrocele_ including cystourethroscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVA1","description":"ICD-ODVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWC1","description":"ICD-LAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11442","description":"Exc face-mm b9+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13151","description":"Cmplx rpr e/n/e/l 1.1-2.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl leath cuff kafo-afo cal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4110","description":"Repl leath cuff kafo-afo cal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGND0","description":"ICD-CGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8500","description":"Hiv meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27246","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF1","description":"ICD-CDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHB1","description":"ICD-EEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE0","description":"ICD-JENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF0","description":"ICD-KCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEB1","description":"ICD-OGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUA0","description":"ICD-MKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE1","description":"ICD-KFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF1","description":"ICD-ECMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB0","description":"ICD-LHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE0","description":"ICD-GIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF0","description":"ICD-BHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76810","description":"Ob us >/= 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58578","description":"Laparo proc uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDA1","description":"ICD-IHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot c antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85302","description":"Clot inhibit prot c antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUE0","description":"ICD-FIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC1","description":"ICD-EEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIC1","description":"ICD-FCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB14C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCD0","description":"ICD-OLCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE0","description":"ICD-CFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/tr/ext >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12037","description":"Intmd rpr s/tr/ext >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDME1","description":"ICD-EDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC11","description":"ICD-1HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA0","description":"ICD-OCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBB1","description":"ICD-JDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote retinal imaging mgmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92228","description":"Remote retinal imaging mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","description":"HCPCS-M1479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0805","description":"HCPCS-A0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMD1","description":"ICD-MAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0077","description":"Injection_ clindamycin phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEED1","description":"ICD-FEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDC0","description":"ICD-FGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33953","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSB1","description":"ICD-HDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELD1","description":"ICD-GELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC0","description":"ICD-EIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63003","description":"Remove spine lamina 1/2 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB0","description":"ICD-FFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ruconest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0596","description":"Injection_ ruconest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUD0","description":"ICD-BFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA1","description":"ICD-JDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb not rxd; doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8474","description":"Ace/arb not rxd; doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJB0","description":"ICD-GAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWD1","description":"ICD-CIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC136","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0106","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0106","description":"HCPCS-B0106","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB1","description":"ICD-GCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA0","description":"ICD-MCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBC1","description":"ICD-ICBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disability examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99456","description":"Disability examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE250","description":"Clinically Complex _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28400","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adults who are not ambulatory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1068","description":"Adults who are not ambulatory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","description":"HCPCS-E0469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0777T","description":"Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intragastric hypothermia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0100","description":"Intragastric hypothermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up angiography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75898","description":"Follow-up angiography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flex/ext wrist w/wo friction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6621","description":"Flex/ext wrist w/wo friction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd spelling phys contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2508","description":"Sgd spelling phys contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAD0","description":"ICD-GCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculation tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87252","description":"Virus inoculation tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTA1","description":"ICD-AHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF0","description":"ICD-FHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCA0","description":"ICD-OHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHD1","description":"ICD-CFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQB0","description":"ICD-LBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0373U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ respiratory tract infection_ 17 bacteria_ 8 fungus_ 13 virus_ and 16 antibiotic-resistance genes_ multiplex amplified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tympanometry & reflex thresh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92550","description":"Tympanometry & reflex thresh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0724T","description":"Quantitative magnetic resonance cholangiopancreatography (QMRCP) including data preparation and transmission_ interpretation and report_ obtained with diagnostic magnetic reso","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE1","description":"ICD-PEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plt_ pher_ l/r cmv-neg_ irr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9053","description":"Plt_ pher_ l/r cmv-neg_ irr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18A","description":"Clinically Complex _ ADL Index 0-1/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home environment assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1028","description":"Home environment assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB0","description":"ICD-DESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE1","description":"ICD-BAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB1","description":"ICD-NBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASD1","description":"ICD-HASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pul art balloon repr percut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92998","description":"Pul art balloon repr percut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRC1","description":"ICD-OKRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ non-laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1894","description":"Intro/sheath_ non-laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWB0","description":"ICD-OJWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8692","description":"Replacement retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWA1","description":"ICD-PCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD221","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23174","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB0","description":"ICD-BBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDA0","description":"ICD-FHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWE0","description":"ICD-KGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPB0","description":"ICD-CBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol (ethanol); any specimen except breath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6040","description":"Alcohol (ethanol); any specimen except breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB1","description":"ICD-OKKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88272","description":"Cytogenetics 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE0","description":"ICD-ODEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF1","description":"ICD-GFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53605","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLE1","description":"ICD-GBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj vertbrl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35691","description":"Art trnsposj vertbrl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein_ direct measurement; small dense LDL cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83722","description":"Lipoprotein_ direct measurement; small dense LDL cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB1","description":"ICD-GCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair special seat heig","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1296","description":"Wheelchair special seat heig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB212","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC1","description":"ICD-KDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0304","description":"HCPCS-C0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTA1","description":"ICD-OLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90613","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","description":"CPT-90613","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIA0","description":"ICD-JHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMB1","description":"ICD-BEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE0","description":"ICD-KHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9331","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hygienic item or device_ disposable or non-disposable_ any type_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9286","description":"Hygienic item or device_ disposable or non-disposable_ any type_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOC0","description":"ICD-LEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE121","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA0","description":"ICD-OFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53854","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLA0","description":"ICD-OHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59120","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE0","description":"ICD-JCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32251","description":"Anesth biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8880","description":"Documentation of reason(s) sentinel lymph node biopsy not performed (e.g._ reasons could include but not limited to; non-invasive cancer_ incidental discovery of breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4411","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","description":"HCPCS-Q4411","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC1","description":"ICD-NHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF0","description":"ICD-MCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBE0","description":"ICD-NKBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99219","description":"Initial observation care_ per day_ for the evaluation and management of a patient_ which requires these 3 key components: A comprehensive history; A comprehensive examination;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45332","description":"Sigmoidoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA1","description":"ICD-KBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Belinostat_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9442","description":"Injection_ Belinostat_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESB1","description":"ICD-PESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANA1","description":"ICD-KANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC0","description":"ICD-NECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE0","description":"ICD-IDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFB0","description":"ICD-CDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA1","description":"ICD-HFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Malig tumor exc to 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7440","description":"Malig tumor exc to 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC1","description":"ICD-FCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB0","description":"ICD-MDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCB1","description":"ICD-KFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJB0","description":"ICD-OLJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36815","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXD1","description":"ICD-FGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1B","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPA1","description":"ICD-FIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE1","description":"ICD-JEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9247","description":"1 med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB0","description":"ICD-KFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","description":"HCPCS-J3374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Posterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8000","description":"Posterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD0","description":"ICD-MIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMD0","description":"ICD-CBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBE1","description":"ICD-IHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECA0","description":"ICD-NECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest wall manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94668","description":"Chest wall manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA53","description":"Medium Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient exhibits 2 or more risk factors for postoperative vomiting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9954","description":"Patient exhibits 2 or more risk factors for postoperative vomiting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEA0","description":"ICD-GFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRE1","description":"ICD-PFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam spinal canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76800","description":"Us exam spinal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSA0","description":"ICD-LFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"T cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86359","description":"T cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Jaw motion rehab system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1700","description":"Jaw motion rehab system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB31","description":"Very High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCD1","description":"ICD-NJCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQD1","description":"ICD-DDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTB0","description":"ICD-FFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafix Prime and GrafixPL Prime_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4133","description":"Grafix Prime and GrafixPL Prime_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBD1","description":"ICD-KGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA0","description":"ICD-CCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID0","description":"ICD-GHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKD0","description":"ICD-FBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood culture for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87040","description":"Blood culture for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient in hospice at any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9758","description":"Patient in hospice at any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB1","description":"ICD-NDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKC0","description":"ICD-GHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIE0","description":"ICD-ODIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF1","description":"ICD-JFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKA1","description":"ICD-CFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78205","description":"Liver imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHB1","description":"ICD-ICHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2A","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn no dicom format doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9329","description":"Norsn no dicom format doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARE1","description":"ICD-KARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQB1","description":"ICD-OHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluid pressure muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20950","description":"Fluid pressure muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8B","description":"Medium Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pump for water circulating p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0236","description":"Pump for water circulating p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC1","description":"ICD-OAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grad comp non-elastic bk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6545","description":"Grad comp non-elastic bk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDE1","description":"ICD-JCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWB1","description":"ICD-HBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1427","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","description":"HCPCS-M1427","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD131","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frenulectomy/frenulotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7960","description":"Frenulectomy/frenulotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant tricyclic 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80335","description":"Antidepressant tricyclic 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC0","description":"ICD-CESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audit/dast over 30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99409","description":"Audit/dast over 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33951","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE0","description":"ICD-BGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in w/border","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6219","description":"Gauze <= 16 sq in w/border","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCD0","description":"ICD-MGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9359","description":"Injection_ loncastuximab tesirine-lpyl_ 0.075 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWE0","description":"ICD-LGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26412","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35472","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC0","description":"ICD-MGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed fx ht w/o rails w/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0290","description":"Hosp bed fx ht w/o rails w/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm est 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99606","description":"Mtms by pharm est 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNA1","description":"ICD-CDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE126","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0890T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including target assessment_ initial motor threshold determination_ neuronavigati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJC0","description":"ICD-KHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF0","description":"ICD-HGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTA1","description":"ICD-EHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHD1","description":"ICD-CEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of heel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73650","description":"X-ray exam of heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Death occurring after discharge from the hospital but within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9816","description":"Death occurring after discharge from the hospital but within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10.1-30sqcm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14001","description":"Tis trnfr trunk 10.1-30sqcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA0","description":"ICD-JGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWB1","description":"ICD-CEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD1","description":"ICD-EHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx gastr intub w/asp specs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43755","description":"Dx gastr intub w/asp specs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0011","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp )to prevent human immunodeficiency virus (hiv)_ includes hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control nose/throat bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42970","description":"Control nose/throat bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open reduct compd mandble fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7730","description":"Open reduct compd mandble fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA0","description":"ICD-NHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted reprod med lab proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89398","description":"Unlisted reprod med lab proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE0","description":"ICD-GEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29880","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hpv low-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87623","description":"Hpv low-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62146","description":"Repair of skull with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE12A","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF0","description":"ICD-CIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIF0","description":"ICD-AGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUE1","description":"ICD-OLUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of digoxin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80162","description":"Assay of digoxin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFE0","description":"ICD-BAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC0","description":"ICD-PCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx planar_ p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2645","description":"Brachytx planar_ p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intervene hlth/behave group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96153","description":"Intervene hlth/behave group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB0","description":"ICD-GDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32940","description":"Revision of lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15778","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie_ external genitalia_ perineum_ abdominal wall) due to soft tissue infection or trauma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracostomy w/flap drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32036","description":"Thoracostomy w/flap drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21A","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA0","description":"ICD-KDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-svs of csw_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0155","description":"Hhcp-svs of csw_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sleep apnea assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8839","description":"Sleep apnea assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD1","description":"ICD-FEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUC0","description":"ICD-NGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOF1","description":"ICD-LBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGD1","description":"ICD-NJGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB0","description":"ICD-AEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB1","description":"ICD-FBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1102T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1102T","description":"CPT-1102T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1082T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1082T","description":"CPT-1082T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGD1","description":"ICD-OHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJF0","description":"ICD-CAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4500","description":"Below knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMD0","description":"ICD-KAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD0","description":"ICD-OLSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAD0","description":"ICD-OAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD1","description":"ICD-LBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF1","description":"ICD-OKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8E","description":"Medium Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vehicle mod waiver/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2039","description":"Vehicle mod waiver/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHB0","description":"ICD-AFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMB1","description":"ICD-ADMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE1","description":"ICD-CFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGC0","description":"ICD-FDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA0","description":"ICD-NGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE241","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDE1","description":"ICD-AGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Personalized_ anterior and lateral interbody cage (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1831","description":"Personalized_ anterior and lateral interbody cage (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair anal fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46288","description":"Repair anal fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAA1","description":"ICD-IGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no elig for bp assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8784","description":"Pt no elig for bp assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB0","description":"ICD-BFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOC1","description":"ICD-PAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0011M","description":"Oncology_ prostate cancer_ mRNA expression assay of 12 genes (10 content and 2 housekeeping)_ RT-PCR test utilizing blood plasma and/or urine_ algorithms to predict high-grade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial cervical torticollis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0113","description":"Cranial cervical torticollis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC30","description":"Ultra High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBB0","description":"ICD-FDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc pt maint ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0159","description":"Hhc pt maint ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23615","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE1","description":"ICD-OFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE1","description":"ICD-OJCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artificial insemination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58321","description":"Artificial insemination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB134","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microprcsr cu combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0482","description":"Microprcsr cu combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC0","description":"ICD-NEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dipropylacetic acid free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80165","description":"Dipropylacetic acid free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKD0","description":"ICD-KCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTE0","description":"ICD-FBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACE1","description":"ICD-JACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNA0","description":"ICD-JHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/sac drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32659","description":"Thoracoscopy w/sac drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD0","description":"ICD-MKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of elbow bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24105","description":"Removal of elbow bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD1","description":"ICD-KCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24D","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50972","description":"Ureter endoscopy & catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whfo w/o joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3809","description":"Whfo w/o joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amifostine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0207","description":"Amifostine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8535","description":"Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICF0","description":"ICD-BICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52000","description":"Cystoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMF1","description":"ICD-EBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCF0","description":"ICD-MGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE1","description":"ICD-KHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC1","description":"ICD-OHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB145","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBA0","description":"ICD-AHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X2061","description":"Hospital Special Treatment Room Support Component (Hstrsc) Hyperbaric Oxygen Treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special anesthesia service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99100","description":"Special anesthesia service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA250","description":"Clinically Complex _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEB0","description":"ICD-NIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of bone cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20615","description":"Treatment of bone cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9249","description":"Injection_ melphalan (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKB0","description":"ICD-NAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXC1","description":"ICD-KIXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKB0","description":"ICD-FGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analyze neurostim simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95971","description":"Analyze neurostim simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2108","description":"Patients Age 66 Or Older In Institutional Special Needs Plans (Snp) Or Residing In Long-Term Care With Pos Code 32_ 33_ 34_ 54 Or 56 For More Than 90 Days During The Measureme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl electrode for aed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0609","description":"Repl electrode for aed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg urin trac obstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2401","description":"Fetal surg urin trac obstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","description":"CPT-98015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFE0","description":"ICD-GAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB1","description":"ICD-NAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430U","description":"Gastroenterology_ malabsorption evaluation of alpha-1-antitrypsin_ calprotectin_ pancreatic elastase and reducing substances_ feces_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCF0","description":"ICD-IHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC1","description":"ICD-JCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF0","description":"ICD-ICMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJF1","description":"ICD-OLJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA1","description":"ICD-GDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDD1","description":"ICD-MLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLA1","description":"ICD-CFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01744","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","description":"CPT-01744","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLC0","description":"ICD-OHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPA1","description":"ICD-FHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNA1","description":"ICD-BHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD0","description":"ICD-AEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB106","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Idursulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1743","description":"Idursulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBE1","description":"ICD-CDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD0","description":"ICD-KBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEF0","description":"ICD-EIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99177","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLD1","description":"ICD-EHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA33","description":"High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD0","description":"ICD-AABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB1","description":"ICD-BDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUB0","description":"ICD-IGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUE0","description":"ICD-MLUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID0","description":"ICD-GAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAA0","description":"ICD-NCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97760","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported)_ upper extremity(ies)_ lower extremity(ies) and/or trunk_ initial orthotic(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51020","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69605","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0567","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB1","description":"ICD-EIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB0","description":"ICD-CAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLD1","description":"ICD-KGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC1","description":"ICD-JANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC1","description":"ICD-JGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00700","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","description":"CPT-00700","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA0","description":"ICD-FHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"corticotomy - one to three teeth or tooth spaces_ per quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7296","description":"corticotomy - one to three teeth or tooth spaces_ per quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIB1","description":"ICD-EGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0550","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","description":"HCPCS-G0550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth correct heart rhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41051","description":"Anesth correct heart rhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 hd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0879","description":"Pwc gp4 hd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGE1","description":"ICD-BAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAF0","description":"ICD-CIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemagglutination inhibition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86280","description":"Hemagglutination inhibition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESB1","description":"ICD-DESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVA1","description":"ICD-GBVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTF0","description":"ICD-CHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIIC1","description":"ICD-MIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMB0","description":"ICD-KHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCE1","description":"ICD-ODCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUB1","description":"ICD-EFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0786T","description":"Insertion or replacement of percutaneous electrode array_ sacral_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Silicone gel sheet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6025","description":"Silicone gel sheet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBA1","description":"ICD-MFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavior counsel obesity 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0447","description":"Behavior counsel obesity 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX50","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD1","description":"ICD-PEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27594","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0695T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB0","description":"ICD-GFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUD1","description":"ICD-FHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYF0","description":"ICD-PAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRA1","description":"ICD-OLRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Streptozocin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9320","description":"Streptozocin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDD1","description":"ICD-NLDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4239","description":"Supply allowance for non-adjunctive_ non-implanted continuous glucose monitor (cgm)_ includes all supplies and accessories_ 1 month supply = 1 unit of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBA1","description":"ICD-NLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pyruvate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84210","description":"Assay of pyruvate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye water bath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76513","description":"Echo exam of eye water bath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75726","description":"Artery x-rays abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE0","description":"ICD-PIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0914T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","description":"CPT-0914T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4361","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","description":"HCPCS-Q4361","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE1","description":"ICD-NCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25120","description":"Removal of forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD1","description":"ICD-LFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB0","description":"ICD-JANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93799","description":"Cardiovascular procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX41","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50900","description":"Repair of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAB1","description":"ICD-IHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63272","description":"Excise intrspinl lesion lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOA0","description":"ICD-HCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9816","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9816","description":"HCPCS-C9816","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Derm autograft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15131","description":"Derm autograft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Round caliper and plate atta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2240","description":"Round caliper and plate atta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0449U","description":"Carrier screening for severe inherited conditions (eg_ cystic fibrosis_ spinal muscular atrophy_ beta hemoglobinopathies [including sickle cell disease]_ alpha thalassemia)_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92632","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","description":"CPT-92632","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBB0","description":"ICD-OIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA11C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID1","description":"ICD-FEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24B","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF0","description":"ICD-LDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA1","description":"ICD-PJQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cessj therapy cath removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37214","description":"Cessj therapy cath removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Micro exam prep & report","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0473","description":"Micro exam prep & report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC0","description":"ICD-MJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWA0","description":"ICD-OAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF0","description":"ICD-GASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lev 2 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0381","description":"Lev 2 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB31","description":"ICD-2GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBED1","description":"ICD-MBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB0","description":"ICD-NDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ & train 1 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98960","description":"Self-mgmt educ & train 1 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALC1","description":"ICD-IALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj diagnostic arthroscopy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7872","description":"Tmj diagnostic arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF1","description":"ICD-NEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thrombin time plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85670","description":"Thrombin time plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLF0","description":"ICD-BDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX07","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE0","description":"ICD-GAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi-durometer symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5661","description":"Multi-durometer symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1326","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","description":"HCPCS-J1326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disease mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0317","description":"Disease mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB0","description":"ICD-EHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVC0","description":"ICD-CEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUE0","description":"ICD-JAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0516","description":"Insertion of non-biodegradable drug delivery implants_ 4 or more (services for subdermal rod implant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of erythropoietin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82668","description":"Assay of erythropoietin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC1","description":"ICD-KATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60225","description":"Partial removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHF1","description":"ICD-OHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJD0","description":"ICD-NEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert subq exten to ip cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49435","description":"Insert subq exten to ip cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE0","description":"ICD-CCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGB0","description":"ICD-OHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-imaging heart function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78414","description":"Non-imaging heart function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF0","description":"ICD-CBDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2698","description":"Brachytx_ stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB0","description":"ICD-FBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Depo-estradiol cypionate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1000","description":"Depo-estradiol cypionate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01210","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","description":"CPT-01210","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rotary wing air transport","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0431","description":"Rotary wing air transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB1","description":"ICD-KGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of primidone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80188","description":"Assay of primidone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental case management - addressing appointment compliance barriers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9991","description":"Dental case management - addressing appointment compliance barriers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43860","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA1","description":"ICD-EFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUC0","description":"ICD-IGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB111","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNB1","description":"ICD-OGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay 2 srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6602","description":"Cst hgh nble mtl inlay 2 srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20694","description":"Remove bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILA1","description":"ICD-KILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9034","description":"Injection_ bendamustine HCl (Bendeka)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECE0","description":"ICD-MECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOF1","description":"ICD-DHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetrics/Gynecology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4018","description":"Obstetrics/Gynecology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBF1","description":"ICD-GIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD0","description":"ICD-CGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVB1","description":"ICD-FAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAC1","description":"ICD-OFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYC0","description":"ICD-HAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise diaphragm nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64746","description":"Incise diaphragm nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA0","description":"ICD-KESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLC1","description":"ICD-ABLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92992","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA1","description":"ICD-CDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB1","description":"ICD-FHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27000","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOA0","description":"ICD-DHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unite biomatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4129","description":"Unite biomatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJC0","description":"ICD-GBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64866","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF1","description":"ICD-NDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC1","description":"ICD-GGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB104","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE1","description":"ICD-MIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF0","description":"ICD-GCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF1","description":"ICD-BEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB0","description":"ICD-AFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0491T","description":"Ablative laser treatment_ non-contact_ full field and fractional ablation_ open wound_ per day_ total treatment surface area; first 20 sq cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABC0","description":"ICD-GABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDD1","description":"ICD-KGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARE0","description":"ICD-CARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUF1","description":"ICD-NIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBD1","description":"ICD-KHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCB0","description":"ICD-GCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth ear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12451","description":"Anesth ear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC1","description":"ICD-JFKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-fetoprotein amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82106","description":"Alpha-fetoprotein amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA0","description":"ICD-GCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rprt bone scint xref w xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3570F","description":"Rprt bone scint xref w xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA1","description":"ICD-GIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYC1","description":"ICD-CIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0686T","description":"Histotripsy (Ie_ Non-Thermal Ablation Via Acoustic Energy Delivery) Of Malignant Hepatocellular Tissue_ Including Image Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remis 12m not phq-9 score <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9510","description":"Remis 12m not phq-9 score <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27780","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Homemaker service nos /diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5131","description":"Homemaker service nos /diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo cap desgn w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3977","description":"Sewhfo cap desgn w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext line w easy lock connect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4673","description":"Ext line w easy lock connect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close tear duct opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68761","description":"Close tear duct opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFD1","description":"ICD-BIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec childcare waiver 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2027","description":"Spec childcare waiver 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA0","description":"ICD-CBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE113","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVA0","description":"ICD-FEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTF1","description":"ICD-CFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB0","description":"ICD-FAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFE0","description":"ICD-CDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt care icu&vent w/in 24hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4168F","description":"Pt care icu&vent w/in 24hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0463","description":"Pressure support ventilator with volume control mode_ may include pressure control mode_ used with invasive interface (e.g. tracheostomy tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLC1","description":"ICD-KGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAE1","description":"ICD-KEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUD0","description":"ICD-OIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUB1","description":"ICD-MBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ratchet assembly","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0050","description":"Ratchet assembly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJC0","description":"ICD-JCJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB0","description":"ICD-FCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFE1","description":"ICD-OJFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker wheel attachment_pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0155","description":"Walker wheel attachment_pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N.gonorrhoeae dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87592","description":"N.gonorrhoeae dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg/ankle surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27899","description":"Leg/ankle surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXC1","description":"ICD-NBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOE0","description":"ICD-HIOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXA0","description":"ICD-KCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy intracavitary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96440","description":"Chemotherapy intracavitary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9293","description":"Fertility cycle (contraception & conception) tracking software application_ fda cleared_ per month_ includes accessories (e.g._ thermometer)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE0","description":"ICD-GAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAA0","description":"ICD-MFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"repair resin partial denture base_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5611","description":"repair resin partial denture base_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22614","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBE1","description":"ICD-OLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA31","description":"ICD-4IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB1","description":"ICD-KGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86807","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD1","description":"ICD-KDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD0","description":"ICD-OLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPA1","description":"ICD-OEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj potassium chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3480","description":"Inj potassium chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/4.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2309","description":"Lens sphc trifocal 4.25-7/4.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86318","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semiquantitative_ single-step method (eg_ reagent strip);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald neck_ loop ind receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5283","description":"Ald neck_ loop ind receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRA1","description":"ICD-HIRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE0","description":"ICD-JCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE0","description":"ICD-EHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD1","description":"ICD-CASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOA1","description":"ICD-CDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA1","description":"ICD-FFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFF0","description":"ICD-GCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGD1","description":"ICD-NCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAE1","description":"ICD-IBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2c9 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81227","description":"Cyp2c9 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMA0","description":"ICD-AEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 1-2 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP02","description":"Auto.test pane pricing code_ 1-2 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTF0","description":"ICD-CDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB0","description":"ICD-NGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA0","description":"ICD-FEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIA0","description":"ICD-AHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYA1","description":"ICD-GDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2025F","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWD0","description":"ICD-PJWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOA1","description":"ICD-CFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF0","description":"ICD-NHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81462","description":"Solid organ neoplasm_ genomic sequence analysis panel_ cell-free nucleic acid (eg_ plasma)_ interrogation for sequence variants; DNA analysis or combined DNA and RNA analysis_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC41","description":"High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUE1","description":"ICD-KHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHD0","description":"ICD-OGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/over 6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2110","description":"Spherocylinder 4.25d/over 6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0459","description":"Chest wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA0","description":"ICD-CIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36465","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate_ inclusive of all imaging guidance and monitoring; singl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Singl prscrp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0504","description":"Singl prscrp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8F","description":"Very High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0569T","description":"Transcatheter Tricuspid Valve Repair_ Percutaneous Approach; Initial Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNB0","description":"ICD-OFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC221","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB0","description":"ICD-OFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng periton dialysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4055F","description":"Pt rcvng periton dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF0","description":"ICD-KBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC1","description":"ICD-KBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF1","description":"ICD-MCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE0","description":"ICD-FHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6584","description":"Elbow fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Birthing class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9442","description":"Birthing class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial open end","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5585","description":"Prep ak ischial open end","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2 flow reg pos inspir press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1352","description":"O2 flow reg pos inspir press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWF1","description":"ICD-GFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF0","description":"ICD-CIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2520","description":"Th/wght bear quad-lat brim c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acute pvd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1337","description":"Acute pvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWA0","description":"ICD-CBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPA0","description":"ICD-JAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC1","description":"ICD-KDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98972","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA116","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81248","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANA1","description":"ICD-BANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYD0","description":"ICD-OEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB140","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD0","description":"ICD-JELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATC1","description":"ICD-EATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14851","description":"Anesth eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA0","description":"ICD-FEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate pulm tumors extnsn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340T","description":"Ablate pulm tumors extnsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD0","description":"ICD-JBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGE1","description":"ICD-JDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl relapse/refractor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9137","description":"Onc dx nhl relapse/refractor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQE0","description":"ICD-KAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICC1","description":"ICD-JICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26432","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pvc intravenous administ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1016","description":"Non-pvc intravenous administ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AJCC stage at breast cancer diagnosis = II or III","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9831","description":"AJCC stage at breast cancer diagnosis = II or III","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEA0","description":"ICD-IDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0649U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0649U","description":"CPT-0649U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBME0","description":"ICD-FBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB0","description":"ICD-OGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNA1","description":"ICD-OHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1086T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1086T","description":"CPT-1086T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRD1","description":"ICD-KCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB0","description":"ICD-LIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety concerns screening not provided_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9925","description":"Safety concerns screening not provided_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB0","description":"ICD-PHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome count additional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88285","description":"Chromosome count additional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx transantral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21385","description":"Opn tx orbit fx transantral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8I","description":"High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Truss single w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8300","description":"Truss single w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC0","description":"ICD-BHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18B","description":"Special Care High _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVE1","description":"ICD-BGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJD1","description":"ICD-JEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_autosys and md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0141","description":"Scr c/v cyto_autosys and md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0490T","description":"Autologous adipose-derived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28F","description":"Extensive Services _ ADL Index 2-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4395","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","description":"HCPCS-Q4395","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat larynx fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31584","description":"Treat larynx fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BA31","description":"ICD-1BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBC0","description":"ICD-NCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1280","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQB1","description":"ICD-OIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXB1","description":"ICD-OKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSB1","description":"ICD-PLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXA1","description":"ICD-GFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX55","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNA1","description":"ICD-NJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam abdominl aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75625","description":"Contrast exam abdominl aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage ext line_ dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4672","description":"Drainage ext line_ dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPB1","description":"ICD-NCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrnd hgh-risk sex behav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4293F","description":"Pt scrnd hgh-risk sex behav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC1","description":"ICD-EFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUE1","description":"ICD-GFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tempr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0278T","description":"Tempr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC0","description":"ICD-NEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27197","description":"Closed treatment of posterior pelvic ring fracture(s)_ dislocation(s)_ diastasis or subluxation of the ilium_ sacroiliac joint_ and/or sacrum_ with or without anterior pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Octagam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1568","description":"Octagam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFC1","description":"ICD-GHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMC0","description":"ICD-GAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL06","description":"High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA0","description":"ICD-JEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE0","description":"ICD-CFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSC1","description":"ICD-GGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE1","description":"ICD-GHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMA1","description":"ICD-IFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYC1","description":"ICD-HHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDA0","description":"ICD-GHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOE0","description":"ICD-OFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22D","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXC0","description":"ICD-JGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial angioplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61630","description":"Intracranial angioplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBF0","description":"ICD-BDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6557","description":"Gradient compression stocking_ thigh length_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHC1","description":"ICD-NAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQC1","description":"ICD-PEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0790T","description":"Revision (eg_ augmentation_ division of tether)_ replacement_ or removal of thoracolumbar or lumbar vertebral body tethering_ including thoracoscopy_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB21B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBA0","description":"ICD-JIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALF0","description":"ICD-NALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlorambucil 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0172","description":"Chlorambucil 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44140","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD1","description":"ICD-NDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90671","description":"Pneumococcal conjugate vaccine_ 15 valent (PCV15)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB1","description":"ICD-BGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg arterial two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33534","description":"Cabg arterial two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF1","description":"ICD-IGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0234","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0234","description":"HCPCS-Q0234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL3A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50600","description":"Exploration of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILA1","description":"ICD-AILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSF1","description":"ICD-PFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWE0","description":"ICD-OKWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRA1","description":"ICD-KHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75827","description":"Vein x-ray chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy snare les remv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43217","description":"Esophagoscopy snare les remv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodobenguate_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9508","description":"I131 iodobenguate_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC0","description":"ICD-GBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDD1","description":"ICD-KFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of facial/other nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64868","description":"Fusion of facial/other nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI for tissue ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77022","description":"MRI for tissue ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L7406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","description":"HCPCS-L7406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETE0","description":"ICD-BETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEB1","description":"ICD-IGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried prkns complic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4324F","description":"Pt queried prkns complic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No follow up pulm nod norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9347","description":"No follow up pulm nod norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE23A","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWC0","description":"ICD-OAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJC1","description":"ICD-OEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt cath w/ventriclgrphy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93453","description":"R&l hrt cath w/ventriclgrphy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID1","description":"ICD-KGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1085","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTE0","description":"ICD-CFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYE1","description":"ICD-DBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3C","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPF0","description":"ICD-ODPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC144","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0566","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","description":"HCPCS-G0566","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAC1","description":"ICD-ABAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE1","description":"ICD-MEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBA0","description":"ICD-OIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA31","description":"Very High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97022","description":"Whirlpool therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo pwr shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1008","description":"Pwr seat combo pwr shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft t/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15150","description":"Cult skin grft t/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01931","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","description":"CPT-01931","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ortho dvc repair per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4205","description":"Ortho dvc repair per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5156","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","description":"HCPCS-Q5156","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull (press relief)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61343","description":"Incise skull (press relief)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB0","description":"ICD-EGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMB0","description":"ICD-NDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXF1","description":"ICD-BFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9161","description":"Lang comp d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCED1","description":"ICD-FCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens pmma-toric/prism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2501","description":"Cntct lens pmma-toric/prism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJB0","description":"ICD-GHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plastic surgery neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15819","description":"Plastic surgery neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1170","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXB0","description":"ICD-KCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytherapy needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1715","description":"Brachytherapy needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUF0","description":"ICD-ABUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF0","description":"ICD-JEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NeoPatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4176","description":"NeoPatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFE0","description":"ICD-CHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diazoxide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1730","description":"Diazoxide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXE0","description":"ICD-NIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERF1","description":"ICD-KERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9760","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infusion addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96415","description":"Chemo iv infusion addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part lumbar vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22102","description":"Remove part lumbar vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC0","description":"ICD-NCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00836","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","description":"CPT-00836","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJE1","description":"ICD-GGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB0","description":"ICD-ACDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc prosth taa add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33884","description":"Endovasc prosth taa add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFC1","description":"ICD-GBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnioband_ guardian 1 sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4151","description":"Amnioband_ guardian 1 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release middle ear bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69650","description":"Release middle ear bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB1","description":"ICD-FAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC1","description":"ICD-KBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB0","description":"ICD-CBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC244","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETB0","description":"ICD-KETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE1","description":"ICD-LASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place breast rad tube/caths","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19298","description":"Place breast rad tube/caths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF0","description":"ICD-NGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUF1","description":"ICD-OIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath impl vasc access portal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4300","description":"Cath impl vasc access portal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11300","description":"Shave skin lesion 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES140","description":"Extensive Services _ ADL Index 2-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADA1","description":"ICD-EADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5226","description":"Mandibular part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB1","description":"ICD-HBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AC11","description":"ICD-3AC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy w/tumor excise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31640","description":"Bronchoscopy w/tumor excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLB1","description":"ICD-OFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF1","description":"ICD-CHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75968","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMA0","description":"ICD-MDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0405","description":"HCPCS-A0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1119","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKE0","description":"ICD-NJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACF0","description":"ICD-MACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDD1","description":"ICD-FCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grps w/fist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46262","description":"Remove in/ex hem grps w/fist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ver doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8565","description":"Ver doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMA0","description":"ICD-NFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33426","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ravulizumab-cwvz_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1303","description":"Injection_ ravulizumab-cwvz_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0103","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0103","description":"HCPCS-B0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic implant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8699","description":"Prosthetic implant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGC1","description":"ICD-JBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMA1","description":"ICD-MKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93575","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary angiography of major aortopulmonary colla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF1","description":"ICD-JDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20525","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYE0","description":"ICD-OAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq&ic allg test drugs/biol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95018","description":"Perq&ic allg test drugs/biol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genet virus isolate hsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87255","description":"Genet virus isolate hsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF1","description":"ICD-PKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Node neg inv brst cncr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8879","description":"Node neg inv brst cncr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72127","description":"Ct neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of middle ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69440","description":"Exploration of middle ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB1","description":"ICD-CGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPB1","description":"ICD-BFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA1","description":"ICD-FGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGF1","description":"ICD-CCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE217","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNF1","description":"ICD-NFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF0","description":"ICD-CIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post op service lvrs min 6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0305","description":"Post op service lvrs min 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKE1","description":"ICD-GIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLE0","description":"ICD-CFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC1","description":"ICD-NGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD110","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEC0","description":"ICD-OKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.0/.12-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2303","description":"Lens sphcy trifocal 4.0/.12-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas cyst and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48540","description":"Fuse pancreas cyst and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMF0","description":"ICD-MKMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE1","description":"ICD-OEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE115","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6721","description":"Hook/hand_ hvy dty_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAA0","description":"ICD-JGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAA1","description":"ICD-NEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE0","description":"ICD-KBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE1","description":"ICD-NCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Work hardening add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97546","description":"Work hardening add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF0","description":"ICD-NBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin long acting 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5553","description":"Insulin long acting 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no ref otolo no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8568","description":"Pt no ref otolo no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add metal substructure to acrylic full denture (per arch)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5876","description":"Add metal substructure to acrylic full denture (per arch)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIE0","description":"ICD-OKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB55","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMB0","description":"ICD-ICMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMB1","description":"ICD-MHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA0","description":"ICD-KDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCD0","description":"ICD-OHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB1","description":"ICD-FBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL06","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA1","description":"ICD-JHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","description":"HCPCS-Q4341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITB0","description":"ICD-AITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55821","description":"Removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC0","description":"ICD-CFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA1","description":"ICD-BEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral nutrition additiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4216","description":"Parenteral nutrition additiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC0","description":"ICD-GDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC42","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft sclp/arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15220","description":"Skin full graft sclp/arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos pain assess no f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8509","description":"Pos pain assess no f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33368","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Free/remove chest lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32320","description":"Free/remove chest lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Path rpt malig cancer docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3318F","description":"Path rpt malig cancer docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB0","description":"ICD-KFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","description":"CPT-64656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEF0","description":"ICD-BBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroplasty duodenal switch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43845","description":"Gastroplasty duodenal switch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF1","description":"ICD-OFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of serum potassium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84132","description":"Assay of serum potassium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB0","description":"ICD-KILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87532","description":"Hhv-6 dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA151","description":"Clinically Complex _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTF1","description":"ICD-AGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2221","description":"Lenticular lens_ bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNF0","description":"ICD-GGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQA0","description":"ICD-KAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA1","description":"ICD-IEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9361","description":"Injection_ efbemalenograstim alfa-vuxw_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal vol/count/mot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89320","description":"Semen anal vol/count/mot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMC0","description":"ICD-OKMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXC1","description":"ICD-KGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Didanosine_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0137","description":"Didanosine_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cbt 1st hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94644","description":"Cbt 1st hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guide nerv destr elec stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95873","description":"Guide nerv destr elec stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC1","description":"ICD-BDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom fabricate w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2609","description":"Custom fabricate w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93314","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ldh enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83625","description":"Assay of ldh enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF0","description":"ICD-BIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB11","description":"ICD-2KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCID0","description":"ICD-GCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIF1","description":"ICD-KDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEE1","description":"ICD-GIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAND0","description":"ICD-KAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0468U","description":"Hepatology (nonalcoholic steatohepatitis [NASH])_ miR-34a-5p_ alpha 2-macroglobulin_ YKL40_ HbA1c_ serum and whole blood_ algorithm reported as a single score for NASH activit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWC0","description":"ICD-GIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ torso and shoulder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6568","description":"Gradient compression garment_ torso and shoulder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWB0","description":"ICD-CHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE0","description":"ICD-BHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1442","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","description":"HCPCS-M1442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAB0","description":"ICD-BIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ secukinumab_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9166","description":"Injection_ secukinumab_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB1","description":"ICD-KIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSD0","description":"ICD-ODSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC0","description":"ICD-IHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-hep b-ipv vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90723","description":"Dtap-hep b-ipv vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCE0","description":"ICD-NCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43287","description":"Esophagectomy_ distal two-thirds_ with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy_ with laparoscopic pyloric drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWE0","description":"ICD-DAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA1","description":"ICD-KDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLF0","description":"ICD-NCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLB1","description":"ICD-OCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF0","description":"ICD-GBGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME1","description":"ICD-MJME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFC1","description":"ICD-KAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUF1","description":"ICD-IFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUC1","description":"ICD-KIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD0","description":"ICD-DGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGF0","description":"ICD-JAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF0","description":"ICD-GGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF0","description":"ICD-FHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99473","description":"Self-Measured Blood Pressure Using A Device Validated For Clinical Accuracy; Patient Education/Training And Device Calibration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL05","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic shoe with wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5504","description":"Diabetic shoe with wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1465","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","description":"HCPCS-M1465","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9032","description":"Injection_ voretigene neparvovec-rzyl_ 1 billion vector genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87594","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","description":"CPT-87594","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIE0","description":"ICD-MDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv no prsv increased ag im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90662","description":"Iiv no prsv increased ag im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0642T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMD0","description":"ICD-OKMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33A","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0570U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","description":"CPT-0570U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUF1","description":"ICD-JDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repos nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432T","description":"Repos nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC31","description":"ICD-4LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1016","description":"Clinical decision support mechanism Speed of Care_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUE0","description":"ICD-CIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing Of Paired Malignant And Normal Dna Specimens_ Fresh Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Blood Or Bone Marrow_ Comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB0","description":"ICD-FFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 11-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99447","description":"Interprof phone/online 11-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nipple exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19110","description":"Nipple exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c shoulder harness/straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0960","description":"W/c shoulder harness/straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0595","description":"Spu Or Asc Patient Transferred To The Hospital Or Discharged From The Sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/congen repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52400","description":"Cystouretero w/congen repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBE1","description":"ICD-MFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB245","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant mandible for augment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7996","description":"Implant mandible for augment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWC1","description":"ICD-LEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release/revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50725","description":"Release/revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anal/urinary muscle study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51785","description":"Anal/urinary muscle study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB1","description":"ICD-BICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5995","description":"Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIA0","description":"ICD-OEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denervation of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27035","description":"Denervation of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELE1","description":"ICD-FELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE1","description":"ICD-JEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No improve visual funct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0915","description":"No improve visual funct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0539T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAD0","description":"ICD-ECAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open wedge/bx lung infiltr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32096","description":"Open wedge/bx lung infiltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cavopulmonary shunting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33768","description":"Cavopulmonary shunting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL01","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE0","description":"ICD-ECHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMF0","description":"ICD-BAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1021","description":"Clinical decision support mechanism ehealthline clinical decision support mechanism_ as defined by the medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93152","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1196","description":"Initial (index visit) numeric rating scale (nrs)_ visual rating scale (vrs)_ or itchyquant assessment score of greater than or equal to 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHF0","description":"ICD-IBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD0","description":"ICD-PBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYE0","description":"ICD-PGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0702","description":"HCPCS-C0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHF1","description":"ICD-EHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrocardiogram tracing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93005","description":"Electrocardiogram tracing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA0","description":"ICD-CHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWA1","description":"ICD-LCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable plstic pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4377","description":"Drainable plstic pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCC1","description":"ICD-FHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDB0","description":"ICD-CBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta-2 glycoprotein antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86146","description":"Beta-2 glycoprotein antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE0","description":"ICD-GENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF1","description":"ICD-PDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAF0","description":"ICD-MKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOF1","description":"ICD-KBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech audiom thresh & recog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211T","description":"Speech audiom thresh & recog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA1","description":"ICD-NDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLF1","description":"ICD-NKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert cath pleura w/o image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32556","description":"Insert cath pleura w/o image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDE1","description":"ICD-OJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB1","description":"ICD-PFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDB0","description":"ICD-IDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC1","description":"ICD-NKTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE0","description":"ICD-JHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB1","description":"ICD-KHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal non-stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59025","description":"Fetal non-stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBC1","description":"ICD-CHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCA1","description":"ICD-MKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0568T","description":"Introduction Of Mixture Of Saline And Air For Sonosalpingography To Confirm Occlusion Of Fallopian Tubes_ Transcervical Approach_ Including Transvaginal Ultrasound And Pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWF1","description":"ICD-OGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Type location activityassess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1052F","description":"Type location activityassess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMB0","description":"ICD-MBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX33","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF0","description":"ICD-JBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF0","description":"ICD-BHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk fork strap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5684","description":"Bk fork strap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPB0","description":"ICD-GHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPB1","description":"ICD-KCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepc mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8549","description":"Hepc mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGB1","description":"ICD-NHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo drain lymphocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49323","description":"Laparo drain lymphocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA0","description":"ICD-EEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fld ped wc adjstabl w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1238","description":"Fld ped wc adjstabl w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthoped ladies shoes dpth i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3216","description":"Orthoped ladies shoes dpth i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEE0","description":"ICD-JFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg press ventilation cnp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94662","description":"Neg press ventilation cnp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0666","description":"Pneumatic appliance half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rails bed side half length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0305","description":"Rails bed side half length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GC31","description":"ICD-4GC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20816","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alkaloids nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80323","description":"Alkaloids nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAD0","description":"ICD-BGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47350","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6008","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special pump services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99190","description":"Special pump services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat lordotc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71021","description":"Chest x-ray frnt lat lordotc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF1","description":"ICD-CCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant tcat pulm vlv perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33477","description":"Implant tcat pulm vlv perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF1","description":"ICD-BGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEB1","description":"ICD-BDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1006T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","description":"CPT-1006T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETE0","description":"ICD-IETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXE1","description":"ICD-NLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE1","description":"ICD-KHWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEC1","description":"ICD-OLEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA1","description":"ICD-OCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME1","description":"ICD-IIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA0","description":"ICD-OEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13D","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL52","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNA1","description":"ICD-CBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth genitalia surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92051","description":"Anesth genitalia surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC0","description":"ICD-CFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE240","description":"Clinically Complex _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVD1","description":"ICD-GAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tsi globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84445","description":"Assay of tsi globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cidofovir injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0740","description":"Cidofovir injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB0","description":"ICD-JDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33710","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE0","description":"ICD-OAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze > 48 sq in water/salne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6230","description":"Gauze > 48 sq in water/salne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remv&replc pm gen mult leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33229","description":"Remv&replc pm gen mult leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLE0","description":"ICD-IBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKWA1","description":"ICD-OKWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00950","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","description":"CPT-00950","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA1","description":"ICD-KCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of arm bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24140","description":"Partial removal of arm bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko dbl upright w/air pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1847","description":"Ko dbl upright w/air pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHD1","description":"ICD-IHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrinsic factor antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86340","description":"Intrinsic factor antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYD0","description":"ICD-CHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB0","description":"ICD-GDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumo imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1022F","description":"Pneumo imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA36","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC0","description":"ICD-AFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVC0","description":"ICD-NLVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC0","description":"ICD-EDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNF0","description":"ICD-OKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics 25-99","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88274","description":"Cytogenetics 25-99","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBID0","description":"ICD-OBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD1","description":"ICD-FIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLC0","description":"ICD-JHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVE1","description":"ICD-BFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35256","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJD1","description":"ICD-KHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA0","description":"ICD-OHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECE1","description":"ICD-KECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQA1","description":"ICD-OKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compressor nondispos filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7014","description":"Compressor nondispos filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26410","description":"Repair hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1322","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injecte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHF1","description":"ICD-MCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA11","description":"ICD-1JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot inhibit prot s free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85306","description":"Clot inhibit prot s free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6752","description":"Crown porcelain noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMC0","description":"ICD-FHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPE0","description":"ICD-OFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB30","description":"Low Rehab_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28570","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28G","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYF0","description":"ICD-GGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Care Practitioners Rendering Treatment In Place (Tip)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2021","description":"Health Care Practitioners Rendering Treatment In Place (Tip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise hip/thigh nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64766","description":"Incise hip/thigh nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk12.6-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12005","description":"Rpr s/n/a/gen/trk12.6-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCB1","description":"ICD-NHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nontherm electromgntc device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0761","description":"Nontherm electromgntc device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRD0","description":"ICD-OKRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMD0","description":"ICD-GAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Posturography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92548","description":"Posturography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop image confirm excise","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8872","description":"Intraop image confirm excise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy tube collar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7526","description":"Tracheostomy tube collar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod sed diff phys/qhp add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99150","description":"Mod sed diff phys/qhp add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMA1","description":"ICD-KEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD0","description":"ICD-MBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIB0","description":"ICD-GBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose fx uncomplicatd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21325","description":"Open tx nose fx uncomplicatd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special base curve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2730","description":"Special base curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDA0","description":"ICD-GDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand tum deep < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26116","description":"Exc hand tum deep < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9164","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inlay composite/resin one su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2650","description":"Inlay composite/resin one su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATD0","description":"ICD-GATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15940","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKC1","description":"ICD-CIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart pacing mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93631","description":"Heart pacing mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVA1","description":"ICD-FDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7505","description":"Percutaneous vertebroplasties (bone biopsies included when performed)_ first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies_ unilateral or bila","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB44","description":"Low Rehab_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDE1","description":"ICD-IHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUE1","description":"ICD-MJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1336","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFFE0","description":"ICD-JFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAME0","description":"ICD-OAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0107U","description":"Oncology (colorectal)_ quantitative assessment of three urine metabolites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme cell activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82657","description":"Enzyme cell activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCF0","description":"ICD-MKCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJID0","description":"ICD-NJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj plantar digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64455","description":"N block inj plantar digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA25","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cultr bacteria except blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87075","description":"Cultr bacteria except blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA1","description":"ICD-IFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILD0","description":"ICD-KILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99252","description":"Inpatient consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE14A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phq-scr >9 doc in 12m time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9572","description":"Phq-scr >9 doc in 12m time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient died at any time during the 24-month measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9751","description":"Patient died at any time during the 24-month measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0704T","description":"Remote Treatment Of Amblyopia Using An Eye Tracking Device; Device Supply With Initial Set-Up And Patient Education On Use Of Equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAE0","description":"ICD-GIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWD1","description":"ICD-OBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial hospitalization serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0201","description":"Partial hospitalization serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA45","description":"Medium Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED0","description":"ICD-MLED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mandibular denture prosth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5935","description":"Mandibular denture prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnanetriol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84138","description":"Assay of pregnanetriol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8G","description":"High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES331","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA1","description":"ICD-AGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurosurgical Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4016","description":"Neurosurgical Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDC0","description":"ICD-OEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18X","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy inner cannula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4623","description":"Tracheostomy inner cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levamisole 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0177","description":"Levamisole 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67340","description":"Revise eye muscle add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNC0","description":"ICD-GGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA1","description":"ICD-CFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINA1","description":"ICD-KINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96377","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHB0","description":"ICD-OEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84155","description":"Assay of protein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA1","description":"ICD-KHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2001","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2001","description":"CDT-D2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAD0","description":"ICD-MAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYD0","description":"ICD-HFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC42","description":"Very High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7329","description":"Hyaluronan or derivative_ Trivisc_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTE1","description":"ICD-ODTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA1","description":"ICD-ODUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGD0","description":"ICD-GAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1459","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","description":"HCPCS-M1459","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAB1","description":"ICD-NJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPE1","description":"ICD-JFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAC0","description":"ICD-JGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJF0","description":"ICD-NKJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB0","description":"ICD-CBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA0","description":"ICD-IACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOF0","description":"ICD-PDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAC0","description":"ICD-JDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMD1","description":"ICD-GDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBD0","description":"ICD-KBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE1","description":"ICD-KGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8713","description":"Spkt/v greater than or equal to 1. 2 (single-pool clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Signs of melanoma absent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8749","description":"Signs of melanoma absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC0","description":"ICD-BBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATB0","description":"ICD-EATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22852","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32663","description":"Thoracoscopy w/lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pressure treatment esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43460","description":"Pressure treatment esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCB1","description":"ICD-KDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54200","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSC1","description":"ICD-ODSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAB0","description":"ICD-MAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTB1","description":"ICD-FCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49617","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36011","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0552T","description":"Low-level laser therapy_ dynamic photonic and dynamic thermokinetic energies_ provided by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEA1","description":"ICD-KAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Memory current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9168","description":"Memory current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76989","description":"Intraoperative epicardial cardiac ultrasound (ie_ echocardiography) for congenital heart disease_ diagnostic; interpretation and report only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB0","description":"ICD-DFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8B","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAID1","description":"ICD-NAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker crutch attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0157","description":"Walker crutch attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60281","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone mineral single photon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78350","description":"Bone mineral single photon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 1 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34841","description":"Endovasc visc aorta 1 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUA0","description":"ICD-AAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL02","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus endoscopy/ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43205","description":"Esophagus endoscopy/ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IC21","description":"ICD-2IC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1000T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","description":"CPT-1000T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assessment Of Salivary Flow By Measurement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0419","description":"Assessment Of Salivary Flow By Measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDD0","description":"ICD-FFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57135","description":"Remove vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWD1","description":"ICD-LIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAF0","description":"ICD-KCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICC1","description":"ICD-GICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE0","description":"ICD-JINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol > 100gm prote","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4199","description":"Parenteral sol > 100gm prote","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD1","description":"ICD-KASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arm/leg nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64857","description":"Repair arm/leg nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB41","description":"Medium Rehab _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEE1","description":"ICD-NBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0704","description":"HCPCS-C0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPD1","description":"ICD-JDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0575","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0575","description":"HCPCS-G0575","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE1","description":"ICD-PJWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKF0","description":"ICD-CEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant zonisamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80203","description":"Drug screen quant zonisamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8648","description":"Fun stat score knee < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91451","description":"Anesth removal of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC0","description":"ICD-GBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBE1","description":"ICD-CFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEB1","description":"ICD-FDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EB11","description":"ICD-4EB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBF1","description":"ICD-NGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy wbx sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32604","description":"Thoracoscopy wbx sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA11","description":"ICD-2FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXA1","description":"ICD-JEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0338U","description":"Oncology (solid tumor)_ circulating tumor cell selection_ identification_ morphological characterization_ detection and enumeration based on differential EpCAM_ cytokeratins 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj enoxaparin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1650","description":"Inj enoxaparin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92606","description":"Non-speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis test procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81099","description":"Urinalysis test procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYE1","description":"ICD-PKYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA1","description":"ICD-CFUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad exp time w/fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9500","description":"Rad exp time w/fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE0","description":"ICD-NEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF1","description":"ICD-KGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE1","description":"ICD-NIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18I","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8I","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE0","description":"ICD-JGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combination sit to stand sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0637","description":"Combination sit to stand sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0612","description":"Injection_ calcium gluconate (fresenius kabi)_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Graft_ vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1768","description":"Graft_ vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB22","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1080","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC0","description":"ICD-KIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEC1","description":"ICD-EBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJF1","description":"ICD-OAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX42","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w>=5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6444","description":"Conform band n/s w>=5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA0","description":"ICD-EABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg>20min <=40min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2504","description":"Sgd prerec msg>20min <=40min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB0","description":"ICD-KFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5916","description":"Ocular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAB1","description":"ICD-CCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB21A","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct maxilla segment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7947","description":"Reconstruct maxilla segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC0","description":"ICD-CHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA0","description":"ICD-CEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDE1","description":"ICD-OHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD0","description":"ICD-ABLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLF1","description":"ICD-NGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anal sp inf pmp w/reprg&fill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62369","description":"Anal sp inf pmp w/reprg&fill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE0","description":"ICD-CDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVE1","description":"ICD-NDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOA0","description":"ICD-GDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21208","description":"Augmentation of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSD0","description":"ICD-HDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin respon genetic test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9143","description":"Warfarin respon genetic test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preorthodontic tx visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8660","description":"Preorthodontic tx visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0551","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","description":"HCPCS-G0551","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert epicard eltrd endo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33203","description":"Insert epicard eltrd endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD1","description":"ICD-BAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHE1","description":"ICD-BAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61692","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWB0","description":"ICD-GFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Halo repl liner/interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0861","description":"Halo repl liner/interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB0","description":"ICD-JEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCB0","description":"ICD-KGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gjb6 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81254","description":"Gjb6 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral function therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92526","description":"Oral function therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC0B","description":"High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE1","description":"ICD-OKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEF0","description":"ICD-GBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1302","description":"HCPCS-A1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF0","description":"ICD-HBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna amp prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87541","description":"Legion pneumo dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smear wet mount saline/ink","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87210","description":"Smear wet mount saline/ink","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWA1","description":"ICD-DAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD1","description":"ICD-NLPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC1","description":"ICD-FHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIB0","description":"ICD-MHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15A","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBB1","description":"ICD-ABBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCE0","description":"ICD-MJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB1","description":"ICD-OIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIC1","description":"ICD-GHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIF0","description":"ICD-KEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC1","description":"ICD-JIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADA0","description":"ICD-IADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXD1","description":"ICD-KCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA34","description":"Low Rehab_ ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE105","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAA1","description":"ICD-BGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB31","description":"ICD-4CB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLC1","description":"ICD-OBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC21","description":"High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7547","description":"Convert nephrostomy catheter to nephroureteral catheter_ percutaneous via pre-existing nephrostomy tract_ with ureteral stricture balloon dialation_ including diagnostic nephr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND1","description":"ICD-KEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients receiving rrt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1199","description":"Patients receiving rrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87552","description":"Mycobacteria dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF0","description":"ICD-NBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair detachable a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1084","description":"Hemi-wheelchair detachable a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCME0","description":"ICD-CCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPA0","description":"ICD-NGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psych svcs provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4060F","description":"Psych svcs provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIC0","description":"ICD-EFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB24A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATE1","description":"ICD-AATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37271","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","description":"CPT-37271","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC20","description":"Medium Rehab _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB101","description":"Clinically Complex _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year reprod tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89344","description":"Storage/year reprod tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD0","description":"ICD-FGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBA0","description":"ICD-NDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99422","description":"Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Days; 11-20 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQB0","description":"ICD-OAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF0","description":"ICD-EEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iv oct for proc addl vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292T","description":"Iv oct for proc addl vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA1","description":"ICD-JAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Port_ indwelling_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1788","description":"Port_ indwelling_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCC0","description":"ICD-IBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHMF1","description":"ICD-IHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE1","description":"ICD-OCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD14D","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37278","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","description":"CPT-37278","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mohs addl stage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17312","description":"Mohs addl stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF0","description":"ICD-BBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHD1","description":"ICD-NBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDE1","description":"ICD-ICDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEC0","description":"ICD-IIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"remove erupted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7210","description":"remove erupted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBE0","description":"ICD-NEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRC1","description":"ICD-KCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUD1","description":"ICD-EIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF1","description":"ICD-JEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth blood vessel repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77051","description":"Anesth blood vessel repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE216","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair solid seat insert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0992","description":"Wheelchair solid seat insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA141","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545T","description":"Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device_ percutaneous approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD0","description":"ICD-GGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB1","description":"ICD-NFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic subs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2740","description":"Crown porcelain/ceramic subs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0664T","description":"Donor hysterectomy (including cold preservation); open_ from cadaver donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVC0","description":"ICD-CIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0D","description":"High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk removable medial brim sus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5672","description":"Bk removable medial brim sus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA1","description":"ICD-LDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOA1","description":"ICD-OCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinic service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1015","description":"Clinic service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGC1","description":"ICD-FEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAC0","description":"ICD-KEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1001T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","description":"CPT-1001T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50060","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDC0","description":"ICD-CDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC115","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup hip spica ped fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4028","description":"Cast sup hip spica ped fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHB0","description":"ICD-NBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE1","description":"ICD-CEOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXB0","description":"ICD-CCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0716","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0716","description":"HCPCS-E0716","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAB1","description":"ICD-GCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUC1","description":"ICD-ODUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shlder disart int lock elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6300","description":"Shlder disart int lock elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No abd imag w/o reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9457","description":"No abd imag w/o reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC1","description":"ICD-OLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPF1","description":"ICD-GBPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal Endo Surg; Balln Dilat Eust T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9745","description":"Nasal Endo Surg; Balln Dilat Eust T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE0","description":"ICD-FCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSC1","description":"ICD-GBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1B","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHD1","description":"ICD-EIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl measr scales jaw motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1702","description":"Repl measr scales jaw motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA1","description":"ICD-NFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRF1","description":"ICD-GGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trigeminal block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9212","description":"Trigeminal block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE1","description":"ICD-GFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBC1","description":"ICD-IHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA0","description":"ICD-ODWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQF0","description":"ICD-DEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB0","description":"ICD-KHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telavancin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3095","description":"Telavancin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00120","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","description":"CPT-00120","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE0","description":"ICD-FCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOE0","description":"ICD-PDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise wrist tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25118","description":"Excise wrist tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX1C","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1492","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","description":"HCPCS-M1492","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX16","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWE0","description":"ICD-PAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FA11","description":"ICD-1FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUC0","description":"ICD-OBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc pract mgmt differs trial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9057","description":"Onc pract mgmt differs trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23552","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMF0","description":"ICD-GBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified periodontal proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4999","description":"Unspecified periodontal proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14D","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser tx skin 250-500 sq cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96921","description":"Laser tx skin 250-500 sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD0","description":"ICD-CEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIB1","description":"ICD-GDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gas system stationary compre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0425","description":"Gas system stationary compre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBD1","description":"ICD-NIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQA1","description":"ICD-DGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF0","description":"ICD-OLPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serv asmnt/care plan waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2024","description":"Serv asmnt/care plan waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQB1","description":"ICD-DDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB1","description":"ICD-MGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQE0","description":"ICD-PJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenovirus ag if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87260","description":"Adenovirus ag if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB53","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHE1","description":"ICD-MIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth tubal ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85151","description":"Anesth tubal ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC1","description":"ICD-LAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE0","description":"ICD-KEVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRB0","description":"ICD-HCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGF0","description":"ICD-OKGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam pelvic complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76856","description":"Us exam pelvic complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spinal orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1499","description":"Spinal orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24000","description":"Exploratory elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNB0","description":"ICD-FDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMF0","description":"ICD-KAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB220","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54840","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA0","description":"ICD-OHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt dischg <=2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9255","description":"Doc pt dischg <=2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral hygiene instruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1330","description":"Oral hygiene instruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Terbutaline sulf comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7681","description":"Terbutaline sulf comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJD1","description":"ICD-BEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLA0","description":"ICD-CGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCB0","description":"ICD-MHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans bench w/wo comm open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0247","description":"Trans bench w/wo comm open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUF1","description":"ICD-JFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tymp memb motion examd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2035F","description":"Tymp memb motion examd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystoenterostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47570","description":"Laparo cholecystoenterostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay carbamazepine free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80157","description":"Assay carbamazepine free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surg reduct osseoustuberosit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7485","description":"Surg reduct osseoustuberosit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXA0","description":"ICD-KHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telethx isodose plan simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77306","description":"Telethx isodose plan simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB0","description":"ICD-OCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD1","description":"ICD-OBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33478","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intend rpt card prev msr grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9673","description":"Intend rpt card prev msr grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXB1","description":"ICD-FAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33984","description":"Ecmo/ecls rmvl prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVD1","description":"ICD-KIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95250","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professiona","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA0","description":"ICD-MBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0501","description":"HCPCS-A0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine osmolality","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83935","description":"Assay of urine osmolality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC1","description":"ICD-FBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUC1","description":"ICD-GFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF0","description":"ICD-GCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25D","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA1","description":"ICD-JAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYF0","description":"ICD-KEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD0","description":"ICD-GIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB1","description":"ICD-KBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDD0","description":"ICD-ABDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLF1","description":"ICD-GBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8C","description":"Very High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA53","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC15C","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD0","description":"ICD-DAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA0","description":"ICD-MDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB1","description":"ICD-PLQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD144","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBD0","description":"ICD-BCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMC1","description":"ICD-GGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2178","description":"Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure_ for example patient bilateral amputee; patient has condition tha","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBF1","description":"ICD-OBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77062","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4A","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPE0","description":"ICD-GBPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31800","description":"Repair of windpipe injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA0","description":"ICD-GHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA1","description":"ICD-MFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKD1","description":"ICD-CGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAA1","description":"ICD-JHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSF0","description":"ICD-HFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50722","description":"Release of ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAD0","description":"ICD-AEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBA0","description":"ICD-MGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA0","description":"ICD-MGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0824","description":"Pwc gp 2 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXC0","description":"ICD-CFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25375","description":"Revise radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID1","description":"ICD-NLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00635","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","description":"CPT-00635","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD25A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME0","description":"ICD-NCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC1","description":"ICD-IATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHD1","description":"ICD-GIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNA0","description":"ICD-GDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE22B","description":"Special Care High _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC21","description":"ICD-2DC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1120","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIE1","description":"ICD-MGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC0","description":"ICD-NEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHC0","description":"ICD-FBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB0","description":"ICD-NLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDB0","description":"ICD-CIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDA1","description":"ICD-FFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4172F","description":"Pt not rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDE0","description":"ICD-ODDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29530","description":"Strapping of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd pneum dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87487","description":"Chylmd pneum dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGF1","description":"ICD-JGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHED1","description":"ICD-CHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD0","description":"ICD-GCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC1","description":"ICD-OIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE1","description":"ICD-HDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIB1","description":"ICD-EIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB1","description":"ICD-HGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No filt remov w/in 3mos plcm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9544","description":"No filt remov w/in 3mos plcm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUA1","description":"ICD-EEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic aneurysm<5cm diam ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9001F","description":"Aortic aneurysm<5cm diam ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0634T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; With Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFD1","description":"ICD-FCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0501","description":"Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables_ patient lift_ and adjustabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXE0","description":"ICD-NDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97169","description":"Athletic training evaluation_ low complexity_ requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An exami","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMC1","description":"ICD-MIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26060","description":"Incision of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYB1","description":"ICD-DHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKC0","description":"ICD-JIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enamel microabrasion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9970","description":"Enamel microabrasion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD1","description":"ICD-IGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTE0","description":"ICD-AFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINF0","description":"ICD-BINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA0","description":"ICD-CFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF1","description":"ICD-EATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQA0","description":"ICD-KFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINF1","description":"ICD-FINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE0","description":"ICD-FACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA0","description":"ICD-GIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB0","description":"ICD-OAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 4 dose immunsup im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90747","description":"Hepb vacc 4 dose immunsup im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37700","description":"Revise leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE0","description":"ICD-KESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init nb em per day non-fac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99461","description":"Init nb em per day non-fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB0","description":"ICD-GCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID0","description":"ICD-KFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96164","description":"Health Behavior Intervention_ Group (2 Or More Patients)_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD0","description":"ICD-JEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92310","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0464U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification_ methylated DNA markers_ including LASS4_ LRRC4 and PPP2R5C_ a reference marker ZDHHC1_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7526","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7526","description":"HCPCS-J7526","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA1","description":"ICD-LBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEND0","description":"ICD-KEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef not performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8396","description":"Lvef not performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD140","description":"Clinically Complex _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB1","description":"ICD-CIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKC0","description":"ICD-BFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93243","description":"External Electrocardiographic Recording For More Than 48 Hours Up To 7 Days By Continuous Rhythm Recording And Storage; Scanning Analysis With Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOE1","description":"ICD-HDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE1","description":"ICD-CCDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNA1","description":"ICD-OFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit periorbtl implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21390","description":"Opn tx orbit periorbtl implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified diagnostic proce","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0999","description":"Unspecified diagnostic proce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA1","description":"ICD-GASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0616","description":"Hospital Special Treatment Room Support Component (Hstrsc) Endoscopic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99379","description":"Nursing fac care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine specimen collect mult","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9615","description":"Urine specimen collect mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8010","description":"Mastectomy sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair anti-tipping devi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0971","description":"Wheelchair anti-tipping devi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of rectal prolapse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45900","description":"Reduction of rectal prolapse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GB21","description":"ICD-4GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF1","description":"ICD-FBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUF1","description":"ICD-EIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGC0","description":"ICD-NFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEED0","description":"ICD-NEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9691","description":"Patient had hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSB1","description":"ICD-OFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD112","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTB1","description":"ICD-JFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 2 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34846","description":"Visc & infraren abd 2 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERD0","description":"ICD-GERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0919T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","description":"CPT-0919T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECD0","description":"ICD-EECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9780","description":"Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g._ inside-out technique)_ including imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAD0","description":"ICD-NDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB121","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSE0","description":"ICD-PLSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33745","description":"Transcatheter Intracardiac Shunt (Tis) Creation By Stent Placement For Congenital Cardiac Anomalies To Establish Effective Intracardiac Flow_ Including All Imaging Guidance By","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD1","description":"ICD-JGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray female genital tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74740","description":"X-ray female genital tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE0","description":"ICD-KIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0517","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 60-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chron care mgmt srvc 20 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99490","description":"Chron care mgmt srvc 20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA1","description":"ICD-CBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATD0","description":"ICD-JATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMA0","description":"ICD-FDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of tongue lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41112","description":"Excision of tongue lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNC0","description":"ICD-NGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFD0","description":"ICD-GEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0747T","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy_ arrhythmia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 10 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP10","description":"Auto.test pane pricing code_ 10 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQB0","description":"ICD-PLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD1","description":"ICD-AIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHF1","description":"ICD-OLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC1","description":"ICD-GAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82681","description":"Estradiol; Free_ Direct Measurement (Eg_ Equilibrium Dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD1","description":"ICD-NLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0403U","description":"Oncology (prostate)_ mRNA_ gene expression profiling of 18 genes_ first-catch post-digital rectal examination urine (or processed first-catch urine)_ algorithm reported as per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25670","description":"Treat wrist dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83655","description":"Assay of lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1826","description":"Generator_ neurostimulator (implantable)_ includes closed feedback loop leads and all implantable components_ with rechargeable battery and charging system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med nutrition indiv subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97803","description":"Med nutrition indiv subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQF1","description":"ICD-KEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6516","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","description":"HCPCS-A6516","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMD0","description":"ICD-FEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92512","description":"Nasal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED0","description":"ICD-BAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0219","description":"Injection_ avalglucosidase alfa-ngpt_ 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUC1","description":"ICD-NKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28B","description":"Special Care Low _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTD0","description":"ICD-CHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cran surg hemotoma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21151","description":"Anesth cran surg hemotoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF1","description":"ICD-MJEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB0","description":"ICD-NFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86941","description":"Hemolysins/agglutinins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGF0","description":"ICD-OGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery chrgr 12 volt utah/e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7366","description":"Battery chrgr 12 volt utah/e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITC1","description":"ICD-JITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20D","description":"Clinically Complex _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92549","description":"Computerized Dynamic Posturography Sensory Organization Test (Cdp-Sot)_ 6 Conditions (Ie_ Eyes Open_ Eyes Closed_ Visual Sway_ Platform Sway_ Eyes Closed Platform Sway_ Platfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF0","description":"ICD-OIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOD0","description":"ICD-LAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levofloxacin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1956","description":"Levofloxacin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laetrile amygdalin vit b17","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3570","description":"Laetrile amygdalin vit b17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF1","description":"ICD-KHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBB1","description":"ICD-GDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD1","description":"ICD-PKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of finger(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73140","description":"X-ray exam of finger(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJE0","description":"ICD-OGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of great vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33916","description":"Surgery of great vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB1","description":"ICD-PHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC1","description":"ICD-FAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKF1","description":"ICD-KFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In morphine preservativ free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2274","description":"In morphine preservativ free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9011","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","description":"HCPCS-J9011","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteot hum xtrnl lngth dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0594T","description":"Osteot hum xtrnl lngth dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUB1","description":"ICD-MEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDF1","description":"ICD-KFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD1","description":"ICD-MFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE0","description":"ICD-CAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0643","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0643","description":"HCPCS-J0643","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 200-249mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9960","description":"Hocm 200-249mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSC0","description":"ICD-PCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermapure 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4152","description":"Dermapure 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB54","description":"High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20C","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUA0","description":"ICD-GFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plan caremng angnl symptdocd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0557F","description":"Plan caremng angnl symptdocd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1295","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin test candida","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86485","description":"Skin test candida","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA1","description":"ICD-DAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC235","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEND1","description":"ICD-NEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1200","description":"Wheelchair amputee fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9161","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","description":"HCPCS-J9161","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9291","description":"Prescription digital behavioral therapy_ FDA-cleared_ per course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6554","description":"Gradient compression stocking_ below knee_ 40 mmhg or greater_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5169","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5169","description":"HCPCS-Q5169","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINE0","description":"ICD-NINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXA1","description":"ICD-CDXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic rem appliance tx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8210","description":"Orthodontic rem appliance tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD0","description":"ICD-OBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE1","description":"ICD-GDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-prxd rsk et al docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3018F","description":"Pre-prxd rsk et al docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no abx therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9559","description":"Doc med reas no abx therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA234","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3630","description":"Trans shoe solid stirrup new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC0","description":"ICD-AHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA1","description":"ICD-KCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAB1","description":"ICD-AHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATE0","description":"ICD-GATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE1","description":"ICD-CAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE1","description":"ICD-JIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX20","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC156","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBD0","description":"ICD-EHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc order cefazolin/cefurox","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4041F","description":"Doc order cefazolin/cefurox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQE0","description":"ICD-OHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53405","description":"Revise urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Discography cerv/thor spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72285","description":"Discography cerv/thor spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In-home respite care_ 4-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0529","description":"In-home respite care_ 4-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJD1","description":"ICD-KEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDA1","description":"ICD-ODDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCB0","description":"ICD-JBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIC0","description":"ICD-CEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA0","description":"ICD-NCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB1","description":"ICD-CDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9507","description":"Fresh frozen plasma_ high titer COVID-19 convalescent_ frozen within 8 hours of collection_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","description":"CPT-00866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIA1","description":"ICD-KFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0492","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ controlled by phone application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor viii vw antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85246","description":"Clot factor viii vw antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBD0","description":"ICD-NKBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration; with imaging guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10022","description":"Fine needle aspiration; with imaging guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYC0","description":"ICD-LHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINF0","description":"ICD-CINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVF0","description":"ICD-GBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25927","description":"Amputation of hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36660","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVF1","description":"ICD-OJVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA1","description":"ICD-BCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD0","description":"ICD-EHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC245","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38780","description":"Remove abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 249cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4720","description":"Dialysat sol fld vol > 249cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69730","description":"Replacement (including removal of existing device)_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside the mastoid a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1155","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81298","description":"Msh6 gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCA1","description":"ICD-GBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of heart lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33130","description":"Removal of heart lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Musculoskeletal nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78399","description":"Musculoskeletal nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methadone oral 5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0109","description":"Methadone oral 5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC1","description":"ICD-CDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25250","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8G","description":"Low Rehab_ ADL Index 0-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF1","description":"ICD-OABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3424","description":"Injection_ hydroxocobalamin_ intravenous_ 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Activation device for intraurethral drainage device with valve_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1011","description":"Activation device for intraurethral drainage device with valve_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78816","description":"Pet image w/ct full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB21","description":"ICD-2CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/ mattr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0294","description":"Hosp bed semi-elect w/ mattr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla or mandible resectio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7490","description":"Maxilla or mandible resectio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCF1","description":"ICD-EGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXA1","description":"ICD-CCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9764","description":"Patient has been treated with an oral systemic or biologic medication for psoriasis vulgaris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYE0","description":"ICD-OGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3C","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF0","description":"ICD-GHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67923","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSD0","description":"ICD-LGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB1","description":"ICD-CDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEA0","description":"ICD-NBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67025","description":"Replace eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE225","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52277","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart symp image plnr spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0332T","description":"Heart symp image plnr spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLC0","description":"ICD-IDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calcitrol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0169","description":"Calcitrol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 std up to 300lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0806","description":"Pov group 2 std up to 300lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket brim cust fit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4030","description":"Replace socket brim cust fit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD0","description":"ICD-CCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB1","description":"ICD-JDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXE1","description":"ICD-NCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFC0","description":"ICD-NHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB1","description":"ICD-CFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFD0","description":"ICD-OEFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF1","description":"ICD-FCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortoiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35537","description":"Art byp grft aortoiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB1","description":"ICD-MHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0728T","description":"Diagnostic analysis of vestibular implant_ unilateral; with initial programming","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB1","description":"ICD-CEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen skin test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3031","description":"Collagen skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trnscth renal symp denrv bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339T","description":"Trnscth renal symp denrv bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC1","description":"ICD-NACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABA1","description":"ICD-KABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAID0","description":"ICD-OAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEB0","description":"ICD-CDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELC0","description":"ICD-AELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0402","description":"HCPCS-A0402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1001","description":"Clinical Decision Support Mechanism Evicore_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRF1","description":"ICD-KIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6525","description":"Gradient compression garment_ lower leg and foot_ padded_ for nighttime use_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPF0","description":"ICD-FCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC0","description":"ICD-CAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMD1","description":"ICD-EHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE0","description":"ICD-EHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITD1","description":"ICD-JITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9310","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9310","description":"HCPCS-C9310","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB1","description":"ICD-KCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD0","description":"ICD-MCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24516","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA0","description":"ICD-CBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGC1","description":"ICD-ODGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYD1","description":"ICD-OAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA1","description":"ICD-BAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC113","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEB1","description":"ICD-OAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273U","description":"Hematology (genetic hyperfibrinolysis_ delayed bleeding)_ genomic sequence analysis of 8 genes (F13A1_ F13B_ FGA_ FGB_ FGG_ SERPINA1_ SERPINE1_ SERPINF2_ PLAU)_ blood_ buccal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECB0","description":"ICD-GECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28G","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous rf 1st vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36475","description":"Endovenous rf 1st vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA0D","description":"Ultra High Rehab _ ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE0","description":"ICD-EBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0957T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","description":"CPT-0957T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED0","description":"ICD-CIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit tpn 2 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9366","description":"Hit tpn 2 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red cell mass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78121","description":"Red cell mass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2783","description":"Crown 3/4 porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFB0","description":"ICD-CGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMB1","description":"ICD-OHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser inc for pkp/lkp donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289T","description":"Laser inc for pkp/lkp donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD1","description":"ICD-NCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBA0","description":"ICD-FDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXA1","description":"ICD-CHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGA1","description":"ICD-GGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436U","description":"Oncology (lung)_ plasma analysis of 388 proteins_ using aptamer-based proteomics technology_ predictive algorithm reported as clinical benefit from immune checkpoint inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD1","description":"ICD-KFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0615","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","description":"HCPCS-J0615","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC1","description":"ICD-JGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repr per/vag pouch dbl proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46712","description":"Repr per/vag pouch dbl proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB21","description":"ICD-4AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC1","description":"ICD-AFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2C","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWA0","description":"ICD-KFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERE0","description":"ICD-LERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPA0","description":"ICD-OAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTE1","description":"ICD-NBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1822","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","description":"HCPCS-E1822","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAC0","description":"ICD-ADAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGF0","description":"ICD-OEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES111","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8878","description":"Sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEF1","description":"ICD-GDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lever-activated wheel drive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0988","description":"Lever-activated wheel drive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYB0","description":"ICD-GFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Critical care first hour","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99291","description":"Critical care first hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Normal blood pressure reading documented_ follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1294","description":"Normal blood pressure reading documented_ follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1002","description":"Cranial Electrotherapy Stimulation (Ces) System_ Includes All Supplies And Accessories_ Any Type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQC0","description":"ICD-PHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain lower leg bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27604","description":"Drain lower leg bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore parathyroid glands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60505","description":"Explore parathyroid glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of imperforated anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46742","description":"Repair of imperforated anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64555","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC0","description":"ICD-NAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mtms by pharm np 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99605","description":"Mtms by pharm np 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAC1","description":"ICD-AIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGC0","description":"ICD-BHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILB1","description":"ICD-IILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appliance removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7997","description":"Appliance removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD0","description":"ICD-JHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 1 space","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25020","description":"Decompress forearm 1 space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATA1","description":"ICD-OATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQE0","description":"ICD-PGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC1","description":"ICD-JIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCC0","description":"ICD-NLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD1","description":"ICD-CHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of ureter tube/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50688","description":"Change of ureter tube/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDA0","description":"ICD-IFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Not Referred_ Reason Not Otherwise Specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0039","description":"Patient Not Referred_ Reason Not Otherwise Specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EB21","description":"ICD-3EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJC1","description":"ICD-FHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFD1","description":"ICD-OLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHF1","description":"ICD-FEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDA0","description":"ICD-AEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC220","description":"Special Care Low _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triptorelin pamoate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3315","description":"Triptorelin pamoate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJE0","description":"ICD-GEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC0","description":"ICD-NGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iron binding test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83550","description":"Iron binding test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0412U","description":"Beta amyloid_ AB42/40 ratio_ immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD0","description":"ICD-PLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB0","description":"ICD-FIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release knuckle contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26520","description":"Release knuckle contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALD0","description":"ICD-EALD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUE0","description":"ICD-NBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB0","description":"ICD-DBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBD1","description":"ICD-MIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap place gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43770","description":"Lap place gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA02","description":"Default_ /Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31575","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC1","description":"ICD-OABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITB0","description":"ICD-CITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA17","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22847","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lsh uterus above 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58543","description":"Lsh uterus above 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","description":"CPT-01636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB0","description":"ICD-BGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD1","description":"ICD-JADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISC0","description":"ICD-GISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB1","description":"ICD-CFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXC1","description":"ICD-KFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLA0","description":"ICD-FFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular flow imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78445","description":"Vascular flow imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA1","description":"ICD-NHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMD1","description":"ICD-NAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOA1","description":"ICD-KGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVF1","description":"ICD-JFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mohs 1 stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17313","description":"Mohs 1 stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE1","description":"ICD-CIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ipratropium bromide comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7645","description":"Ipratropium bromide comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tb ag response t-cell susp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86481","description":"Tb ag response t-cell susp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens extended wear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2513","description":"Contact lens extended wear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIB1","description":"ICD-NEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAD1","description":"ICD-NFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESA1","description":"ICD-DESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81457","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA116","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0743T","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (BMD)_ with concurrent vertebral fracture assessment_ utilizing data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB0","description":"ICD-OHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB0","description":"ICD-CFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0599T","description":"Ncntc r-t fluor wnd img ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE1","description":"ICD-JEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJF1","description":"ICD-FGJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME0","description":"ICD-NIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc drug-el cor stent bran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9601","description":"Perc drug-el cor stent bran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9755","description":"Creation of arteriovenous fistula_ percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLC0","description":"ICD-MLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF1","description":"ICD-CICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0352U","description":"Infectious disease (bacterial vaginosis and vaginitis)_ multiplex amplified probe technique_ for detection of bacterial vaginosis-associated bacteria (BVAB-2_ Atopobium vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA1","description":"ICD-JIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp4 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0880","description":"Pwc gp4 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDD0","description":"ICD-MCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRF0","description":"ICD-CGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AC21","description":"ICD-1AC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDA0","description":"ICD-GFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTD1","description":"ICD-GGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTA0","description":"ICD-BBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA0","description":"ICD-OLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97007","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","description":"CPT-97007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61608","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA0","description":"ICD-PFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA0","description":"ICD-OHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine process addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172T","description":"Lumbar spine process addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA11","description":"ICD-4HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRD1","description":"ICD-ODRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRB0","description":"ICD-CCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARF0","description":"ICD-LARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro/pos wc cus>=22","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2625","description":"Adj skin pro/pos wc cus>=22","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Same day nb discharge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99463","description":"Same day nb discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF0","description":"ICD-PLOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIB1","description":"ICD-OFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE1","description":"ICD-KFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERD0","description":"ICD-DERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2216","description":"Take-home supply of injectable naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXE0","description":"ICD-JDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnt pain noted none prsnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1126F","description":"Amnt pain noted none prsnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD1","description":"ICD-IFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83521","description":"Immunoglobulin Light Chains (Ie_ Kappa_ Lambda)_ Free_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB0","description":"ICD-FFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy into cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96450","description":"Chemotherapy into cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1473","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","description":"HCPCS-M1473","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUD0","description":"ICD-KHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVC1","description":"ICD-CBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF1","description":"ICD-NFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD217","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE0","description":"ICD-NKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGE0","description":"ICD-FEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJE0","description":"ICD-CFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD1","description":"ICD-JEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-explore parathyroids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60502","description":"Re-explore parathyroids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB160","description":"Clinically Complex _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96132","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAD1","description":"ICD-FCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj tendon origin/insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20551","description":"Inj tendon origin/insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE1","description":"ICD-NITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB0","description":"ICD-FINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC0","description":"ICD-OICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx infiltrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32607","description":"Thoracoscopy w/bx infiltrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB1","description":"ICD-OIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA1A","description":"Default_ /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE1","description":"ICD-FBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSD1","description":"ICD-OLSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abd paracentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49082","description":"Abd paracentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOA0","description":"ICD-GEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0153U","description":"Oncology (breast)_ mRNA_ gene expression profiling by next-generation sequencing of 101 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as a tripl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID1","description":"ICD-FAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97153","description":"Adaptive behavior treatment by protocol_ administered by technician under the direction of a physician or other qualified health care professional_ face-to-face with one patie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHA0","description":"ICD-EFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disease modif pharmacothxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4540F","description":"Disease modif pharmacothxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70210","description":"X-ray exam of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1553","description":"Re-Cement Or Re-Bond Unilateral Space Maintainer - Per Quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE0","description":"ICD-IBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSF0","description":"ICD-PJSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee w/ foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1180","description":"Wheelchair amputee w/ foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLC0","description":"ICD-OCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCMF0","description":"ICD-NCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1321","description":"Counseling for the control and prevention of adverse oral_ behavioral_ and systemic health effects associated with high-risk substance use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"7 field photo interp doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2024F","description":"7 field photo interp doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lamina/facets lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63012","description":"Remove lamina/facets lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alysishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88369","description":"M/phmtrc alysishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2179","description":"Clinician documented that patient had medical reason for not performing lower extremity neurological exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0317","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB0","description":"ICD-GGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99491","description":"Chronic care management services_ provided personally by a physician or other qualified health care professional_ at least 30 minutes of physician or other qualified health ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82671","description":"Assay of estrogens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOE0","description":"ICD-DEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE160","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBOC1","description":"ICD-DBOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYF0","description":"ICD-GAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAD1","description":"ICD-AGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBF1","description":"ICD-EEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC1","description":"ICD-MFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB121","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construction of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57291","description":"Construction of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE0","description":"ICD-NFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65420","description":"Removal of eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA43","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAF1","description":"ICD-ICAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF1","description":"ICD-EFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIID0","description":"ICD-EIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wcd device interrogate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93292","description":"Wcd device interrogate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDF0","description":"ICD-OIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9775","description":"Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"P32 chromic phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9564","description":"P32 chromic phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWA1","description":"ICD-OLWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove coronoid process","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21070","description":"Remove coronoid process","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening proctoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0601","description":"Screening proctoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00192","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","description":"CPT-00192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB1","description":"ICD-OBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428T","description":"Rmvl nstim apnea pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA1","description":"ICD-GCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med record copy admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9981","description":"Med record copy admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE226","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC0","description":"ICD-GCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49606","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1001","description":"Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAC1","description":"ICD-CCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDND1","description":"ICD-BDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDA1","description":"ICD-BDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIF0","description":"ICD-MKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA110","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney imaging morphol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78700","description":"Kidney imaging morphol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPD1","description":"ICD-JFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX44","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81165","description":"BRCA1 (BRCA1_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0863T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; transmitter component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA07","description":"High Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Misc integral lens serv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0590","description":"Misc integral lens serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevat proximal arm support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2631","description":"Elevat proximal arm support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nocardia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86744","description":"Nocardia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score shdl < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8664","description":"Fun stat score shdl < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBE1","description":"ICD-IBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD1","description":"ICD-AILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney & ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50236","description":"Removal of kidney & ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBC1","description":"ICD-NKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD0","description":"ICD-OIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20A","description":"Extensive Services _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD1","description":"ICD-ICCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo intralesional over 7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96406","description":"Chemo intralesional over 7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9311","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9311","description":"HCPCS-C9311","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC0","description":"ICD-MCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYF1","description":"ICD-HBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor X_ (human)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7175","description":"Injection_ Factor X_ (human)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC0","description":"ICD-PFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0601","description":"HCPCS-A0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEA1","description":"ICD-KHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB0","description":"ICD-CBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21315","description":"Closed tx nose fx w/o stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF0","description":"ICD-IGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXA1","description":"ICD-NFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEB1","description":"ICD-AIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB0","description":"ICD-GDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRF1","description":"ICD-OKRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED1","description":"ICD-MJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0461","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0461","description":"CDT-D0461","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemophilia clot factor noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7199","description":"Hemophilia clot factor noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gel pressure mattress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0196","description":"Gel pressure mattress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUB1","description":"ICD-GBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE0","description":"ICD-BADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC0","description":"ICD-JALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEA0","description":"ICD-NIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1089U","description":"Red Cell Antigen (Mns Blood Group) Genotyping (Gypa)_ Gene Analysis_ Gypa (Glycophorin A [Mns Blood Group]) Introns 1_ 5_ Exon 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified drugs or biolog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9399","description":"Unclassified drugs or biolog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE1","description":"ICD-NEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0501","description":"HCPCS-C0501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye thickness","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76514","description":"Echo exam of eye thickness","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elevat legrst up hangr brack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0047","description":"Elevat legrst up hangr brack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA216","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral hiv-1/hiv-2 screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0435","description":"Oral hiv-1/hiv-2 screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB1","description":"ICD-HDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fee covid-19 vac 2 res","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0014A","description":"Fee covid-19 vac 2 res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Embedded ip cath exit-site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49436","description":"Embedded ip cath exit-site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rh ig full-dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90384","description":"Rh ig full-dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33370","description":"Transcatheter Placement And Subsequent Removal Of Cerebral Embolic Protection Device(S)_ Including Arterial Access_ Catheterization_ Imaging_ And Radiological Supervision And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4041","description":"Cast sup lng leg splnt plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rt heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93530","description":"Rt heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient receives hcv antibody test with reactive result","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1232","description":"Patient receives hcv antibody test with reactive result","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0602","description":"HCPCS-C0602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0B","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE212","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-131 iodide cap_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9528","description":"Iodine i-131 iodide cap_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28470","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD225","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIED1","description":"ICD-JIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pinworm exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87172","description":"Pinworm exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lat retinacular release open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27425","description":"Lat retinacular release open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22610","description":"Thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPB0","description":"ICD-KIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF0","description":"ICD-CGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEF0","description":"ICD-IFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD0","description":"ICD-BABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg press wound therapy pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2402","description":"Neg press wound therapy pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No eval activity clin symp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3119F","description":"No eval activity clin symp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNB1","description":"ICD-GFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86036","description":"Antineutrophil Cytoplasmic Antibody (Anca); Screen_ Each Antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA1","description":"ICD-OGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVC1","description":"ICD-OGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD1","description":"ICD-GAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID0","description":"ICD-JHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTD1","description":"ICD-CFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methocarbamol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2800","description":"Methocarbamol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0749T","description":"Bone strength and fracture-risk assessment using digital X-ray radiogrammetry-bone mineral density (DXR-BMD) analysis of bone mineral density (BMD) utilizing data from a digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PEANUT ALLG ASMT EPI CLIN RX","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178U","description":"PEANUT ALLG ASMT EPI CLIN RX","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2252","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","description":"HCPCS-J2252","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"GYPB GNOTYP NTRNS 1 5 SEUX 3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190U","description":"GYPB GNOTYP NTRNS 1 5 SEUX 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCC1","description":"ICD-EDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD0","description":"ICD-OFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA1","description":"ICD-HBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50075","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spinal disk surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63035","description":"Spinal disk surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAME0","description":"ICD-IAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE0","description":"ICD-JCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy diagnostic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32601","description":"Thoracoscopy diagnostic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC0","description":"ICD-MAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHC0","description":"ICD-NBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB1","description":"ICD-KCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUC0","description":"ICD-MKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUB1","description":"ICD-EGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lo rig pos pnl l1-l5 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0641","description":"Lo rig pos pnl l1-l5 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID0","description":"ICD-ADID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPD0","description":"ICD-NEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA0","description":"ICD-CAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC0","description":"ICD-LIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHF0","description":"ICD-OIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTF1","description":"ICD-BDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE1","description":"ICD-CGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmp22 gene known fam variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81326","description":"Pmp22 gene known fam variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC0","description":"ICD-NHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert temp bladder cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51702","description":"Insert temp bladder cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain fused base m","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2751","description":"Crown porcelain fused base m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB0","description":"ICD-GGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPF0","description":"ICD-KHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPB1","description":"ICD-GDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Jaw arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29800","description":"Jaw arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","description":"HCPCS-M1380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12A","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92650","description":"Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli_ Automated Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBE1","description":"ICD-CGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA0","description":"ICD-CBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIA1","description":"ICD-MBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKF1","description":"ICD-GIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELB1","description":"ICD-BELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87110","description":"Chlamydia culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCB1","description":"ICD-MCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF1","description":"ICD-IETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol or peroxide per pint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4244","description":"Alcohol or peroxide per pint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guidance radiotherapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6001","description":"Echo guidance radiotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor x stuart-power","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85260","description":"Clot factor x stuart-power","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODID1","description":"ICD-ODID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace non-molded thigh lac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4045","description":"Replace non-molded thigh lac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHB0","description":"ICD-JDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF1","description":"ICD-FFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/revise tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51595","description":"Remove bladder/revise tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27842","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPE1","description":"ICD-BBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHF1","description":"ICD-NCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA0","description":"ICD-AACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYC0","description":"ICD-DEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 3/> node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31653","description":"Bronch ebus samplng 3/> node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97156","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (with or without the patient present)_ face-to-face with gua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNB1","description":"ICD-OCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGB0","description":"ICD-NEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBC0","description":"ICD-BHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILE1","description":"ICD-JILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Portable 02 contents_ liquid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0444","description":"Portable 02 contents_ liquid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB210","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB17","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEF0","description":"ICD-AIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rect/bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45800","description":"Repair rect/bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHA1","description":"ICD-NCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKC0","description":"ICD-JFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doxorubicin inj 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2050","description":"Doxorubicin inj 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBC0","description":"ICD-KEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAB1","description":"ICD-ACAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0496","description":"Battery elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s)_ with endoscopic cannulation of papilla with direct visual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7544","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s)_ with endoscopic cannulation of papilla with direct visual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAE0","description":"ICD-GBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHC0","description":"ICD-MCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFA1","description":"ICD-KBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autogenous Av Fistula Received","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8530","description":"Autogenous Av Fistula Received","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gammaplex injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1557","description":"Gammaplex injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee cushion socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5648","description":"Above knee cushion socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTA0","description":"ICD-OGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB0","description":"ICD-OLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA0","description":"ICD-BFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRA0","description":"ICD-GIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy head&neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15876","description":"Suction lipectomy head&neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1061T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1061T","description":"CPT-1061T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIC1","description":"ICD-IGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMC0","description":"ICD-NDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXF0","description":"ICD-OFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10C","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWE0","description":"ICD-KAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA0","description":"ICD-MEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31256","description":"Exploration maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF0","description":"ICD-NICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF0","description":"ICD-ACMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF0","description":"ICD-LAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD1","description":"ICD-GFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHE0","description":"ICD-EIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial direct form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5570","description":"Prep ak ischial direct form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADE1","description":"ICD-KADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj trimetrexate glucoronate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3305","description":"Inj trimetrexate glucoronate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNA0","description":"ICD-JBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD1","description":"ICD-KHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA1","description":"ICD-DBYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1391","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","description":"HCPCS-M1391","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bupropion hcl sr 60 tablets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0106","description":"Bupropion hcl sr 60 tablets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB1","description":"ICD-ODTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87534","description":"Hiv-1 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBD1","description":"ICD-AGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKF0","description":"ICD-CGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5657","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","description":"HCPCS-L5657","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE135","description":"Special Care High _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5658","description":"Socket insert above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAF0","description":"ICD-GHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99348","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDD0","description":"ICD-NEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intestine transplant live","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44136","description":"Intestine transplant live","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Veritas collagen matrix_ cm2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9354","description":"Veritas collagen matrix_ cm2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34715","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision_ unilateral (List separately in addition to cod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXC1","description":"ICD-CHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGC1","description":"ICD-OCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible mlc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87187","description":"Microbe susceptible mlc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronidase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3473","description":"Hyaluronidase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLB0","description":"ICD-BHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVA0","description":"ICD-CBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq lamot/lam crv/thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0274T","description":"Perq lamot/lam crv/thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9250","description":"Methotrexate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC225","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3213","description":"Benesch boot pair child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA255","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vivaglobin_ inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1562","description":"Vivaglobin_ inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0504","description":"HCPCS-C0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42310","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home vent mgmt supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94005","description":"Home vent mgmt supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us >/= 14 wks sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76805","description":"Ob us >/= 14 wks sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIE0","description":"ICD-IHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Localized delivery antimicro","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4381","description":"Localized delivery antimicro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9886","description":"Behavioral counseling for diabetes prevention_ in-person_ group_ 60 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAB1","description":"ICD-OJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE0","description":"ICD-JGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF0","description":"ICD-AATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICF1","description":"ICD-NICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCA1","description":"ICD-OKCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJE0","description":"ICD-KGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3A","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE126","description":"Special Care Low _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISD0","description":"ICD-KISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ gadopiclenol_ 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9573","description":"Injection_ gadopiclenol_ 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIB0","description":"ICD-EEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrpulmnry percuss vent sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0481","description":"Intrpulmnry percuss vent sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66850","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit hydra 1 liter diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9374","description":"Hit hydra 1 liter diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF0","description":"ICD-FHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE0","description":"ICD-BGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetoscop laser ther ttts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2411","description":"Fetoscop laser ther ttts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA0","description":"ICD-OAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68110","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tpa initi w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8600","description":"Tpa initi w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1832","description":"Ko adj jnt pos r sup pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9041","description":"Injection_ coagulation Factor Xa (recombinant)_ inactivated (Andexxa)_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPB0","description":"ICD-BCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc cryo ablate renal tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50593","description":"Perc cryo ablate renal tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB0","description":"ICD-NGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE1","description":"ICD-FCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detach non-adjus hght armrst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0015","description":"Detach non-adjus hght armrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTC0","description":"ICD-AGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA1","description":"ICD-GDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52354","description":"Cystouretero w/biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETD1","description":"ICD-GETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0431","description":"Drug screen_ qualitative; single drug class method (e.g._ immunoassay_ enzyme assay)_ each drug class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC1","description":"ICD-FCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Access av dial grft for eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36147","description":"Access av dial grft for eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00218","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","description":"CPT-00218","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED1","description":"ICD-MFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of urethra gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53250","description":"Removal of urethra gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEA1","description":"ICD-BHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWA1","description":"ICD-OIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35102","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm phone r-strip device eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93293","description":"Pm phone r-strip device eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9484","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21490","description":"Repair dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CA21","description":"ICD-4CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLD1","description":"ICD-NBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parathyrd planar w/wo subtrj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78071","description":"Parathyrd planar w/wo subtrj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Team evaluation & management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1024","description":"Team evaluation & management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ca tx e-stim electr/transduc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4555","description":"Ca tx e-stim electr/transduc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXA0","description":"ICD-FDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXD1","description":"ICD-CBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVB0","description":"ICD-FFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEB1","description":"ICD-KAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE1","description":"ICD-JIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod compres band w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6451","description":"Mod compres band w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0015","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC0","description":"ICD-FHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diskectomy_ anterior_ with d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2350","description":"Diskectomy_ anterior_ with d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMA0","description":"ICD-JIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provisional pontic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6253","description":"Provisional pontic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWA0","description":"ICD-DGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNE1","description":"ICD-GDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED1","description":"ICD-FFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9996","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","description":"HCPCS-Q9996","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB0","description":"ICD-MFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB0","description":"ICD-CHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo fluid swing ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5724","description":"Knee-shin exo fluid swing ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOE0","description":"ICD-OEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0383U","description":"Tyrosinemia type I monitoring by patient-collected blood card sample_ quantitative measurement of tyrosine_ phenylalanine_ methionine_ succinylacetone_ nitisinone_ liquid chro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSC1","description":"ICD-DHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA1","description":"ICD-CINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC210","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Belatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0485","description":"Belatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHND0","description":"ICD-NHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFF1","description":"ICD-KGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test hemidiaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95866","description":"Muscle test hemidiaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy w/biopsy(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52204","description":"Cystoscopy w/biopsy(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUE1","description":"ICD-BHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephropathy doc tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3066F","description":"Nephropathy doc tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES245","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xe133 xenon 10mci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9558","description":"Xe133 xenon 10mci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagenase_ clost hist inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0775","description":"Collagenase_ clost hist inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54861","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNE1","description":"ICD-JCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIC0","description":"ICD-CDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES305","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIE0","description":"ICD-KHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERB0","description":"ICD-LERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF1","description":"ICD-NBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9504","description":"Documented reason for not assessing hepatitis B virus (HBV) status (e.g._ patient not initiating anti-TNF therapy_ patient declined) prior to initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOB1","description":"ICD-GBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye service or procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92499","description":"Eye service or procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBE1","description":"ICD-JCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0751","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg_ oral_ fda approved prescription_ only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFE0","description":"ICD-JCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUD1","description":"ICD-BAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSE1","description":"ICD-LFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic laryngoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31579","description":"Diagnostic laryngoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE0","description":"ICD-MFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9355","description":"No early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27392","description":"Incision of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo pla sin up w/wo k/a cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2034","description":"Kafo pla sin up w/wo k/a cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA0","description":"ICD-ODFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSD0","description":"ICD-OKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyclophosphamide 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9070","description":"Cyclophosphamide 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML07","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total hip resurfacing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2118","description":"Total hip resurfacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAF0","description":"ICD-AFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUF0","description":"ICD-KBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1021","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMB1","description":"ICD-JCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50045","description":"Exploration of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKA0","description":"ICD-BEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA0","description":"ICD-GAGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB0","description":"ICD-EDHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADF1","description":"ICD-GADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME0","description":"ICD-IGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIB0","description":"ICD-GFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27724","description":"Repair/graft of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5245","description":"Hearing aid_ prog_ mon_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE0","description":"ICD-GGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cpm device_ other than knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0936","description":"Cpm device_ other than knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0020U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ with specimen verification including DNA authentication in comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA1","description":"ICD-NGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNC0","description":"ICD-BBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWC0","description":"ICD-GAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLC0","description":"ICD-GDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC0","description":"ICD-KENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rib and nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21616","description":"Removal of rib and nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPC0","description":"ICD-CEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFC0","description":"ICD-CGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80343","description":"Antipsychotics nos 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"LW GNOTYP ICAM4 EXON 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0197U","description":"LW GNOTYP ICAM4 EXON 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCA0","description":"ICD-EFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0958T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","description":"CPT-0958T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF1","description":"ICD-OERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0906T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","description":"CPT-0906T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC0","description":"ICD-JCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE0","description":"ICD-HAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAD0","description":"ICD-ADAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB0","description":"ICD-FCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA0","description":"ICD-NFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGA1","description":"ICD-KCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90999","description":"Dialysis procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDD0","description":"ICD-MIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"EpiFix or Epicord_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4131","description":"EpiFix or Epicord_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6553","description":"Gradient compression stocking_ below knee_ 30-40 mmhg_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4350","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","description":"HCPCS-Q4350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKC0","description":"ICD-FIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35082","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA214","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVB0","description":"ICD-CHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRC1","description":"ICD-DFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB0","description":"ICD-ODFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2C","description":"Medium Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mis sup/acc imp vad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0508","description":"Mis sup/acc imp vad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spacer bag/reservoir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4627","description":"Spacer bag/reservoir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD0","description":"ICD-OJFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0707T","description":"Injection(S)_ Bone-Substitute Material (Eg_ Calcium Phosphate) Into Subchondral Bone Defect (Ie_ Bone Marrow Lesion_ Bone Bruise_ Stress Injury_ Microtrabecular Fracture)_ Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUE1","description":"ICD-JIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97550","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9884","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 19-21 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt reas not rec hcv srn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9385","description":"Doc pt reas not rec hcv srn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYF1","description":"ICD-PBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86363","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Flow Cytometry (Ie_ Fluorescence-Activated Cell Sorting [Facs])_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0063U","description":"Neurology autism_ 32 amines by LC-MS/MS_ using plasma_ algorithm reported as metabolic signature associated with autism spectrum disorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26860","description":"Fusion of finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth < 22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2601","description":"Gen w/c cushion wdth < 22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYF0","description":"ICD-PDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9783","description":"Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control_ including vascular access and closure_ right heart catherization_ venou","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFND1","description":"ICD-GFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1220","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of reti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIB0","description":"ICD-GEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHE0","description":"ICD-EDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKB1","description":"ICD-GFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD1","description":"ICD-HESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supplies for maintenance of insulin infusion catheter_ per week","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4224","description":"Supplies for maintenance of insulin infusion catheter_ per week","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA154","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of lip fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40806","description":"Incision of lip fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rhophylac injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2791","description":"Rhophylac injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size brief/diaper med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4522","description":"Adult size brief/diaper med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81239","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE1","description":"ICD-BEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facial moulage complete","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5912","description":"Facial moulage complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psych disorders assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3700F","description":"Psych disorders assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASD0","description":"ICD-PASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fistula cannulation set_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4730","description":"Fistula cannulation set_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB214","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTD1","description":"ICD-OFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB1","description":"ICD-FGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of fascia for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20922","description":"Removal of fascia for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac discharge day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99316","description":"Nursing fac discharge day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCE1","description":"ICD-GDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy contrl bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32654","description":"Thoracoscopy contrl bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84251","description":"Anesth amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dis site tele svcs RHC/FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2025","description":"Dis site tele svcs RHC/FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftrst lower extension tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0043","description":"Ftrst lower extension tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETD1","description":"ICD-JETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTE1","description":"ICD-IHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25624","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC1","description":"ICD-NEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83719","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUC0","description":"ICD-IAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68135","description":"Remove eyelid lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD1","description":"ICD-KFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67318","description":"Revise eye muscle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early ind/delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9356","description":"Early ind/delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD1","description":"ICD-OESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF1","description":"ICD-MHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF0","description":"ICD-BAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1747","description":"Endoscope_ single-use (i.e. disposable)_ urinary tract_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGC1","description":"ICD-OGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1086","description":"Radiation Therapy For Colorectal Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admission to mccm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9480","description":"Admission to mccm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA0","description":"ICD-GFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC0","description":"ICD-CGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB0","description":"ICD-AIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCF0","description":"ICD-ACCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35512","description":"Art byp grft subclav-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED0","description":"ICD-IBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15D","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB0","description":"ICD-NIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pacemaker insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53051","description":"Anesth pacemaker insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0977T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","description":"CPT-0977T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial preventive exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0402","description":"Initial preventive exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB0","description":"ICD-NGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3B","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprt fees/laryngeal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92617","description":"Interprt fees/laryngeal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUD0","description":"ICD-MFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Graftjacket xpress","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4113","description":"Graftjacket xpress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPF0","description":"ICD-JCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-2 spine 4/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72110","description":"X-ray exam l-2 spine 4/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTD0","description":"ICD-OHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tibial arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29855","description":"Tibial arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXC0","description":"ICD-JEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF0","description":"ICD-CFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB120","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYF0","description":"ICD-OCYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy lumb/sac facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64635","description":"Destroy lumb/sac facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0739","description":"Injection_ cabotegravir_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD235","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUB1","description":"ICD-JFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FY GNOTYP ACKR1 EXONS 1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0187U","description":"FY GNOTYP ACKR1 EXONS 1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33736","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC0","description":"ICD-MILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD0","description":"ICD-GGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA0","description":"ICD-OKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38X","description":"Extensive Services _ ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC0","description":"ICD-GCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD1","description":"ICD-HCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1029","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE0","description":"ICD-AHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAB0","description":"ICD-FDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRB0","description":"ICD-KDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96912","description":"Photochemotherapy with uv-a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC1","description":"ICD-JEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXF1","description":"ICD-BGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBD1","description":"ICD-AEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Particle agglut antbdy titr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86406","description":"Particle agglut antbdy titr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit stoma care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99505","description":"Home visit stoma care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSC0","description":"ICD-KFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF1","description":"ICD-PJOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JC11","description":"ICD-4JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay test for blood fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82274","description":"Assay test for blood fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estrogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82672","description":"Assay of estrogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB25B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYA0","description":"ICD-PCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED1","description":"ICD-OBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ingest challenge ini 120 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95076","description":"Ingest challenge ini 120 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62551","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver elastography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91200","description":"Liver elastography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45123","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF0","description":"ICD-KCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB1","description":"ICD-KDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHF1","description":"ICD-ICHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPF0","description":"ICD-BAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXF0","description":"ICD-JEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE0","description":"ICD-MCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE216","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysate solution_ non-dex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4728","description":"Dialysate solution_ non-dex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6448","description":"Lt compres band <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBD0","description":"ICD-GGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bath tub rail floor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0242","description":"Bath tub rail floor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Umbilical artery echo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76820","description":"Umbilical artery echo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIA1","description":"ICD-FEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUC0","description":"ICD-KFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBB0","description":"ICD-AGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBC1","description":"ICD-CFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIA1","description":"ICD-EBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLF0","description":"ICD-EHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC1","description":"ICD-PLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIA1","description":"ICD-GGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADB0","description":"ICD-OADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGE1","description":"ICD-NBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHE1","description":"ICD-MDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMA1","description":"ICD-MJMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least one well-child visit with PCP during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9965","description":"Patient did not receive at least one well-child visit with PCP during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9283","description":"Hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0720T","description":"Percutaneous electrical nerve field stimulation_ cranial nerves_ without implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUA0","description":"ICD-NCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC151","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21251","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnicore pro+_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4299","description":"Amnicore pro+_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx spine process fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22305","description":"Closed tx spine process fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB0","description":"ICD-JBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7529","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7529","description":"HCPCS-J7529","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7008","description":"Pediatric electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJE0","description":"ICD-JAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47147","description":"Prep donor liver/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr rdncl ntrstl/icav brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77771","description":"Hdr rdncl ntrstl/icav brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mrs disc pain acquisj data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0609T","description":"Mrs disc pain acquisj data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA0","description":"ICD-JGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect prox finger tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26260","description":"Resect prox finger tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGE1","description":"ICD-GBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray urethra/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74450","description":"X-ray urethra/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA1","description":"ICD-EGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBD0","description":"ICD-NHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE246","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXA0","description":"ICD-OAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCE1","description":"ICD-MKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITC0","description":"ICD-OITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX36","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIB0","description":"ICD-KFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYF0","description":"ICD-OAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim not spine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0747","description":"Elec osteogen stim not spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL5C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"S&i stent/chest vert art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0076T","description":"S&i stent/chest vert art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXC0","description":"ICD-OCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27253","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD210","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Azithromycin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0456","description":"Azithromycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPC1","description":"ICD-OHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Botulism ig iv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90288","description":"Botulism ig iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB1","description":"ICD-PIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCE0","description":"ICD-GCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA0","description":"ICD-BGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect mediastinal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39200","description":"Resect mediastinal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIF0","description":"ICD-EHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE135","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIF0","description":"ICD-NLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7290","description":"Repositioning of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81357","description":"U2Af1 (U2 Small Nuclear Rna Auxiliary Factor 1) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ S34F_ S34Y_ Q157R_ Q157P)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5141","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","description":"HCPCS-Q5141","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUA1","description":"ICD-ICUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD1","description":"ICD-GDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27238","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80333","description":"Antidepressants class 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC1","description":"ICD-GDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD1","description":"ICD-IFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC0","description":"ICD-BELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIDC0","description":"ICD-MIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28070","description":"Removal of foot joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal 3.1 to 6mg bupren","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0573","description":"Bupren/nal 3.1 to 6mg bupren","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0615U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","description":"CPT-0615U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC11","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLJA0","description":"ICD-OLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD1","description":"ICD-NGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest cultured skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15040","description":"Harvest cultured skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPF1","description":"ICD-JIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special stains group 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88312","description":"Special stains group 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUC1","description":"ICD-FGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF0","description":"ICD-NKEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluorine-18 fluorodeoxygluco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8085","description":"Fluorine-18 fluorodeoxygluco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYF0","description":"ICD-OFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIB1","description":"ICD-MAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0316U","description":"Borrelia burgdorferi (Lyme disease)_ OspA protein evaluation_ urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cetuximab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9055","description":"Cetuximab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB0","description":"ICD-EGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE246","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGE0","description":"ICD-OGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl soft interface_ helmet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8004","description":"Repl soft interface_ helmet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hemorrhoid clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46320","description":"Removal of hemorrhoid clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40520","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81546","description":"Oncology (Thyroid)_ Mrna_ Gene Expression Analysis Of 10_196 Genes_ Utilizing Fine Needle Aspirate_ Algorithm Reported As A Categorical Result (Eg_ Benign Or Suspicious)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0661U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0661U","description":"CPT-0661U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24800","description":"Fusion of elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c wdth 20-23 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2340","description":"W/c wdth 20-23 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73520","description":"Radiologic examination_ hips_ bilateral_ minimum of two views of each hip_ including anteroposterior view of pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIE1","description":"ICD-KFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug/substance nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80375","description":"Drug/substance nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gemcitabine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9201","description":"Gemcitabine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0804","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0804","description":"CDT-D0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxillofacial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5999","description":"Maxillofacial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEE1","description":"ICD-BCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip core decompression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2325","description":"Hip core decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMB1","description":"ICD-GEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE1","description":"ICD-NJNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97530","description":"Therapeutic activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61891","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow socket ins use w/o lck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6695","description":"Elbow socket ins use w/o lck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXC0","description":"ICD-OJXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62180","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tebentafusp-tebn_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9274","description":"Injection_ tebentafusp-tebn_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0368","description":"Cone beam ct interprete tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01991","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","description":"CPT-01991","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Col chromotography qual/quan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82542","description":"Col chromotography qual/quan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain w/ noble met","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2752","description":"Crown porcelain w/ noble met","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOB1","description":"ICD-DDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee bicros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5240","description":"Dispensing fee bicros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAD1","description":"ICD-OEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB0","description":"ICD-JDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip clevis/thrust bearing lo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2610","description":"Hip clevis/thrust bearing lo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNE0","description":"ICD-NDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBA1","description":"ICD-FHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF0","description":"ICD-LGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78104","description":"Bone marrow imaging body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMA1","description":"ICD-IGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc ref upper gi endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3132F","description":"Doc ref upper gi endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1813","description":"Insulin (lyumjev) for administration through dme (i.e._ insulin pump) per 50 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0346T","description":"Ultrasound_ elastography (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLA0","description":"ICD-OBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA0","description":"ICD-CBKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA1","description":"ICD-GGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNB1","description":"ICD-KCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKE0","description":"ICD-KGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx paravert w/us cer/thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214T","description":"Njx paravert w/us cer/thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of nephrostomy or pyelostomy tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50398","description":"Change of nephrostomy or pyelostomy tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA131","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXB0","description":"ICD-FEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGA1","description":"ICD-KEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9707","description":"Patient received hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Matristem wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4119","description":"Matristem wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ankle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27840","description":"Treat ankle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJA1","description":"ICD-FGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug confirmation_ each procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6058","description":"Drug confirmation_ each procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB1","description":"ICD-DHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAA1","description":"ICD-NHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96138","description":"Psychological or neuropsychological test administration and scoring by technician_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9783","description":"Documentation of patients with diabetes who have a most recent fasting or direct LDL- C laboratory test result < 70 mg/dl and are not taking statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE0","description":"ICD-BFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA1","description":"ICD-GCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray arms/legs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75822","description":"Vein x-ray arms/legs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQA0","description":"ICD-DFQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFME1","description":"ICD-KFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefotetan disodiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0074","description":"Injection_ cefotetan disodiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKC1","description":"ICD-FEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQB0","description":"ICD-OLQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF1","description":"ICD-BDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9232","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9232","description":"HCPCS-J9232","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit est patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99349","description":"Home visit est patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB1","description":"ICD-NJGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTB1","description":"ICD-OLTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4438","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0849","description":"Pwc gp 3 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTE0","description":"ICD-ACTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOE0","description":"ICD-CGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF1","description":"ICD-OEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQC1","description":"ICD-CCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTD0","description":"ICD-BDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7668","description":"Metaproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF0","description":"ICD-ACHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt serv p day 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90970","description":"Esrd home pt serv p day 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHD1","description":"ICD-CAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29365","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anastomosis/artery-aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33606","description":"Anastomosis/artery-aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of estradiol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82670","description":"Assay of estradiol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22101","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical procedures that included the use of silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9756","description":"Surgical procedures that included the use of silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSA0","description":"ICD-GGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/.25-","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2311","description":"Lens sphc trifo 7.25-12/.25-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDF1","description":"ICD-CFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJB1","description":"ICD-KIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67800","description":"Remove eyelid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD0","description":"ICD-NCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC54","description":"High Rehab _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVE0","description":"ICD-KFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4D","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB15B","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33475","description":"Replacement pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF1","description":"ICD-BCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB24","description":"Low Rehab_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYA1","description":"ICD-LGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC1","description":"ICD-KGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELD0","description":"ICD-AELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRB0","description":"ICD-LCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEE1","description":"ICD-CGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF1","description":"ICD-BEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD0","description":"ICD-KHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC50","description":"Ultra High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enfuvirtide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1324","description":"Enfuvirtide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQA0","description":"ICD-PEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3D","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC1","description":"ICD-CBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD0","description":"ICD-NGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB31","description":"ICD-1KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical Therapy/Occupational Therapy Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4026","description":"Physical Therapy/Occupational Therapy Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28290","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ abdomen; 3 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74021","description":"Radiologic examination_ abdomen; 3 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAB0","description":"ICD-AAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUA0","description":"ICD-GDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLE0","description":"ICD-EHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSA1","description":"ICD-DBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43635","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73701","description":"Ct lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEF1","description":"ICD-FCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKA1","description":"ICD-OFKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC21","description":"ICD-3JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITB0","description":"ICD-NITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAF0","description":"ICD-MJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAED0","description":"ICD-JAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lip surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40799","description":"Lip surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-t9 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0455","description":"Tlso flex trnk sj-t9 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC0","description":"ICD-HFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analgesics non-opioid 3-5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80330","description":"Analgesics non-opioid 3-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD0","description":"ICD-KGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair spinal fluid leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63707","description":"Repair spinal fluid leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB0","description":"ICD-AGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTE1","description":"ICD-FGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9416","description":"Tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin reuse pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5560","description":"Insulin reuse pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDE0","description":"ICD-MEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDA1","description":"ICD-KCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE1","description":"ICD-CAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compounded drug not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9977","description":"Compounded drug not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX43","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF0","description":"ICD-KFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOA0","description":"ICD-KIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Who w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3906","description":"Who w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0929T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","description":"CPT-0929T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDE1","description":"ICD-CBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUD1","description":"ICD-GIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA1","description":"ICD-KGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBF1","description":"ICD-GBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUF0","description":"ICD-GEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADD1","description":"ICD-AADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTE1","description":"ICD-KFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA0","description":"ICD-KCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supp maint employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2026","description":"Supp maint employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66020","description":"Injection treatment of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENC0","description":"ICD-BENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF0","description":"ICD-ADEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap jejunostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44186","description":"Lap jejunostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical placement: zygomatic implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7994","description":"Surgical placement: zygomatic implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMD1","description":"ICD-BBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE0","description":"ICD-OCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF0","description":"ICD-OKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUE1","description":"ICD-FBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRC0","description":"ICD-CIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exam synovial fluid crystals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89060","description":"Exam synovial fluid crystals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal orthotic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7880","description":"Occlusal orthotic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8I","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD1","description":"ICD-JBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHA1","description":"ICD-NFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56632","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC0","description":"ICD-GFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26542","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0739","description":"Rehab system with interactive interface providing active assistance in rehabilitation therapy_ includes all components and accessories_ motors_ microprocessors_ sensors","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTA0","description":"ICD-EFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32408","description":"Core Needle Biopsy_ Lung Or Mediastinum_ Percutaneous_ Including Imaging Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD0","description":"ICD-GDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL51","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine nrv half segmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63185","description":"Incise spine nrv half segmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVC1","description":"ICD-GGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADA1","description":"ICD-GADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE0","description":"ICD-FBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPA1","description":"ICD-KCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASF1","description":"ICD-HASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB246","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD1","description":"ICD-KARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAA0","description":"ICD-BEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33251","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBME0","description":"ICD-IBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc esrd dia trans preg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9231","description":"Doc esrd dia trans preg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us transrectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76872","description":"Us transrectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0442U","description":"Infectious disease (respiratory infection)_ Myxovirus resistance protein A (MxA) and C-reactive protein (CRP)_ fingerstick whole blood specimen_ each biomarker reported as pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC0","description":"ICD-NCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB0","description":"ICD-GCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDB1","description":"ICD-JDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd red simpl mandible fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7640","description":"Clsd red simpl mandible fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAC1","description":"ICD-MEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA1","description":"ICD-NEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01620","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","description":"CPT-01620","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHB0","description":"ICD-CGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB0","description":"ICD-KBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLA0","description":"ICD-OGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vehicle Modifications","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0139","description":"Vehicle Modifications","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB0","description":"ICD-OJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0047U","description":"Oncology (prostate)_ mRNA_ gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1268","description":"Patients on active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8I","description":"Medium Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIE0","description":"ICD-CGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE155","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 5-8 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98962","description":"Self-mgmt educ/train 5-8 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disconnect insert locking wr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6616","description":"Disconnect insert locking wr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0145","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2053","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIID0","description":"ICD-AIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYF0","description":"ICD-CHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOE0","description":"ICD-KBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA31","description":"ICD-1AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37291","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","description":"CPT-37291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31375","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr e/n/e/l 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14060","description":"Tis trnfr e/n/e/l 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conversion ext bil drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47535","description":"Conversion ext bil drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPD0","description":"ICD-FFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPC0","description":"ICD-KHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxillary part denture flex","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5225","description":"Maxillary part denture flex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cat scan follow-up study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76380","description":"Cat scan follow-up study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDA0","description":"ICD-GBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF0","description":"ICD-DERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVA1","description":"ICD-CGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92019","description":"Eye exam & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semen analysis w/count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89310","description":"Semen analysis w/count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal axial rotation u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5982","description":"Exoskeletal axial rotation u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXF0","description":"ICD-BDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2209","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67915","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0701","description":"HCPCS-A0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8941","description":"Elder maltreatment screen documented as positive_ follow-up plan not documented_ documentation the patient is not eligible for follow-up plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF0","description":"ICD-NKNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUC1","description":"ICD-AAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTA1","description":"ICD-NKTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul revise","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0284T","description":"Periph field stimul revise","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83721","description":"Assay of blood lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA1","description":"ICD-ICBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg strap each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0038","description":"Leg strap each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adalimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0135","description":"Adalimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE0","description":"ICD-NLKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA0","description":"ICD-JATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACC1","description":"ICD-OACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc stnt & ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37235","description":"Tib/per revasc stnt & ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUA0","description":"ICD-MJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUD0","description":"ICD-AFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay carboxyhb quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82375","description":"Assay carboxyhb quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC0","description":"ICD-FDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECA0","description":"ICD-BECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatric service/therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90899","description":"Psychiatric service/therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eyelid foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67938","description":"Remove eyelid foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCF1","description":"ICD-NJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD105","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93598","description":"Cardiac Output Measurement(S)_ Thermodilution Or Other Indicator Dilution Method_ Performed During Cardiac Catheterization For The Evaluation Of Congenital Heart Defects (List","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61556","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8H","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78835","description":"Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRC0","description":"ICD-LCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYA1","description":"ICD-HCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPF1","description":"ICD-NAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD0","description":"ICD-AAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUA0","description":"ICD-EIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF1","description":"ICD-KHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB0","description":"ICD-DGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAD1","description":"ICD-CAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE1","description":"ICD-OKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0844T","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg_ touch preparation_ squash preparation)_ each additional site (Lis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCB1","description":"ICD-EHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25405","description":"Repair/graft radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD1","description":"ICD-KBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB0","description":"ICD-MGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95706","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Intermittent Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLA0","description":"ICD-FHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elotuzumab_ 1mg (Empliciti)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9477","description":"Injection_ elotuzumab_ 1mg (Empliciti)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alkalin batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4233","description":"Alkalin batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9366","description":"1high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LA21","description":"ICD-3LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB1","description":"ICD-JHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25C","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4426","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","description":"HCPCS-Q4426","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC1","description":"ICD-KAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of leg veins/lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37735","description":"Removal of leg veins/lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWA0","description":"ICD-GHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Matristem micromatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4118","description":"Matristem micromatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINA1","description":"ICD-FINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1152","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Variable asphericity lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2499","description":"Variable asphericity lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUF0","description":"ICD-OGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special med equip_ noswaiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2029","description":"Special med equip_ noswaiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB0","description":"ICD-GDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUC1","description":"ICD-AEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBE0","description":"ICD-JBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBF0","description":"ICD-NBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD0","description":"ICD-NELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOF0","description":"ICD-HGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11444","description":"Exc face-mm b9+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPB1","description":"ICD-JCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA05","description":"Ultra High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15012","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","description":"CPT-15012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of foot infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28003","description":"Treatment of foot infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJC0","description":"ICD-NBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDE0","description":"ICD-JDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1814","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","description":"HCPCS-E1814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96202","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis_ administered by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53515","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone 20-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83499","description":"Assay of progesterone 20-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX07","description":"High Rehab plus Extensive _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sincalide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2805","description":"Sincalide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMF1","description":"ICD-NKMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3A","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEB1","description":"ICD-ECEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIE0","description":"ICD-BBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEB1","description":"ICD-OFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0018U","description":"Oncology (thyroid)_ microRNA profiling by RT-PCR of 10 microRNA sequences_ utilizing fine needle aspirate_ algorithm reported as a positive or negative result for moderate to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skills train and dev_ 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2014","description":"Skills train and dev_ 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carry d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8986","description":"Carry d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBPD0","description":"ICD-BBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVB0","description":"ICD-CAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25800","description":"Fusion of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous prp for ulcers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0460","description":"Autologous prp for ulcers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIF0","description":"ICD-JEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0653U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0653U","description":"CPT-0653U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE0","description":"ICD-CAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92978","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJB0","description":"ICD-JCJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1019","description":"Replacement supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447T","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUA0","description":"ICD-ADUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALF1","description":"ICD-JALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFD1","description":"ICD-JIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep a vac injxn admin/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4148F","description":"Hep a vac injxn admin/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","description":"HCPCS-E1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAD1","description":"ICD-MBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITD1","description":"ICD-CITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD0","description":"ICD-ICLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix complex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7194","description":"Factor ix complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVC1","description":"ICD-CDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ligate spermatic vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55550","description":"Laparo ligate spermatic vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB0","description":"ICD-HIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEE1","description":"ICD-MCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_ nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2699","description":"Brachytx_ non-stranded_ nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUC1","description":"ICD-OJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE104","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKE1","description":"ICD-JFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tigecycline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3243","description":"Tigecycline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem nonodonto cyst to 1.25cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7460","description":"Rem nonodonto cyst to 1.25cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJD1","description":"ICD-GBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOF0","description":"ICD-OAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso a-p-l control molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0700","description":"Ctlso a-p-l control molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mitochondrial gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81440","description":"Mitochondrial gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove unilat space maintain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1520","description":"Remove unilat space maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEA0","description":"ICD-JEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB120","description":"Special Care High _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWF1","description":"ICD-DBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze >16<=48 no w/sal w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6223","description":"Gauze >16<=48 no w/sal w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA1","description":"ICD-FGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0190T","description":"Placement of intraocular radiation source applicator (List separately in addition to primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBD0","description":"ICD-NCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVC1","description":"ICD-CFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAA1","description":"ICD-OHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIE1","description":"ICD-MFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOD1","description":"ICD-LFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRB0","description":"ICD-PHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2095","description":"Documentation Of System Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Other System Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES131","description":"Extensive Services _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEE1","description":"ICD-BBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJC1","description":"ICD-BGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHC0","description":"ICD-CDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy submucous njx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45381","description":"Colonoscopy submucous njx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELD0","description":"ICD-CELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0320U","description":"Nephrology (renal transplant)_ RNA expression by select transcriptome sequencing_ using posttransplant peripheral blood_ algorithm reported as a risk score for acute cellular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32151","description":"Remove lung foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/con_stres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8928","description":"Tte w or w/o fol w/con_stres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pectin based ostomy paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4406","description":"Pectin based ostomy paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJC0","description":"ICD-FIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile eye pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6410","description":"Sterile eye pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0857","description":"Pwc gp3 std sing pow opt cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC0","description":"ICD-OAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vancomycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80202","description":"Assay of vancomycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB1","description":"ICD-MCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE0","description":"ICD-ODAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHF0","description":"ICD-BEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47490","description":"Incision of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8701","description":"Repair Of Fixed Retainer_ Includes Reattachment - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE1","description":"ICD-OFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiesse injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2026","description":"Radiesse injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE1","description":"ICD-OAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUA1","description":"ICD-NKUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ewho w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3764","description":"Ewho w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraction of lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66930","description":"Extraction of lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immune globulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90399","description":"Immune globulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJA1","description":"ICD-FEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGC0","description":"ICD-BIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99236","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA0","description":"ICD-HHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHF1","description":"ICD-BIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMC1","description":"ICD-NKMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54348","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl smear w/diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85007","description":"Bl smear w/diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27535","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap ins device for rt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49327","description":"Lap ins device for rt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMA1","description":"ICD-OHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENA0","description":"ICD-FENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNB1","description":"ICD-BBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscope procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58579","description":"Hysteroscope procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert electrd/pm cath sngl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33210","description":"Insert electrd/pm cath sngl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIA0","description":"ICD-BFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA21","description":"ICD-1JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD0","description":"ICD-NEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSB0","description":"ICD-GFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQD1","description":"ICD-KAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFB1","description":"ICD-JEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB0","description":"ICD-OBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVF1","description":"ICD-CCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic circulation assist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33971","description":"Aortic circulation assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAD1","description":"ICD-GDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQD1","description":"ICD-OCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES31C","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUA1","description":"ICD-CCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFUD1","description":"ICD-GFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA5B","description":"Medium Rehab _ ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose intermed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77317","description":"Brachytx isodose intermed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSF0","description":"ICD-OBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPB1","description":"ICD-NHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth abdominal wall surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82077","description":"Anesth abdominal wall surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9999","description":"Documentation Of System Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Unable To Locate Previous Colonoscopy Report_ Previous Colonoscopy Rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNB0","description":"ICD-CHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB130","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEND1","description":"ICD-GEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA1","description":"ICD-KGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA1","description":"ICD-GFYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0880T","description":"Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0080","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKB0","description":"ICD-CAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC1","description":"ICD-GDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB0","description":"ICD-IFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27006","description":"Incision of hip tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA0","description":"ICD-CDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUB1","description":"ICD-NBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPB1","description":"ICD-BIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2013","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ omacetaxine mep_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9262","description":"Inj_ omacetaxine mep_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLC1","description":"ICD-ODLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDE1","description":"ICD-IIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE0","description":"ICD-BFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOF0","description":"ICD-LHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLE1","description":"ICD-CCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKE0","description":"ICD-NKKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQE1","description":"ICD-CFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 5 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP05","description":"Auto.test pane pricing code_ 5 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF1","description":"ICD-NLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90705","description":"Measles virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sys<140 and dia<90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9273","description":"Sys<140 and dia<90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF0","description":"ICD-BGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip wall fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27226","description":"Treat hip wall fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-electr w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0261","description":"Hosp bed semi-electr w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95926","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES13D","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEA1","description":"ICD-FCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11103","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); each separate/additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inr measurement performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3555F","description":"Pt inr measurement performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD0","description":"ICD-PHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXE0","description":"ICD-JBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8A","description":"Low Rehab_ ADL Index 0-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC12","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEID0","description":"ICD-AEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topographic brain mapping","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8040","description":"Topographic brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUF1","description":"ICD-BAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA21A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE1","description":"ICD-GCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD0","description":"ICD-IAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with no clinical indications for imaging of the head","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1031","description":"Patients with no clinical indications for imaging of the head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOE0","description":"ICD-CEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride skin at fx site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11010","description":"Debride skin at fx site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46761","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF1","description":"ICD-JHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31530","description":"Laryngoscopy w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVB0","description":"ICD-JHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hx injec drug use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9450","description":"Hx injec drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0196T","description":"Arthrodesis_ pre-sacral interbody technique_ disc space preparation_ discectomy_ without instrumentation_ with image guidance_ includes bone graft when performed; L4-L5 inters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWF1","description":"ICD-OCWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDD0","description":"ICD-BCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28250","description":"Revision of foot fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUF1","description":"ICD-GCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVE0","description":"ICD-NIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28297","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifocal 4.25-7/2.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2308","description":"Lens sphc trifocal 4.25-7/2.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES101","description":"Extensive Services _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92083","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATC1","description":"ICD-FATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED1","description":"ICD-ECED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IC31","description":"ICD-3IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIE1","description":"ICD-OLIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC07","description":"Very High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJME0","description":"ICD-MJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2471","description":"Injection_ pantoprazole (Hikma)_ not therapeutically equivalent to J2470_ 40 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28I","description":"Special Care High _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUB1","description":"ICD-KBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC1","description":"ICD-JEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISF1","description":"ICD-LISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIRE1","description":"ICD-GIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAF0","description":"ICD-JEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB1","description":"ICD-OJQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29886","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit im injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99506","description":"Home visit im injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333U","description":"Oncology (liver)_ surveillance for hepatocellular carcinoma (HCC) in high-risk patients_ analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHF1","description":"ICD-EAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE1","description":"ICD-OHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64468","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","description":"CPT-64468","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRD1","description":"ICD-KGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8012","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8012","description":"HCPCS-C8012","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0813","description":"Pwc gp 1 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB0","description":"ICD-DFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11470","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPE1","description":"ICD-CFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1304","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1304","description":"CDT-D1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB34","description":"High Rehab _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add pwr leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1010","description":"Add pwr leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0387U","description":"Oncology (melanoma)_ autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry_ formalin-fixed paraffin-embedded (FFPE) tissue_ report for risk o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECB0","description":"ICD-EECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB1","description":"ICD-NAFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md document visit by npp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0454","description":"Md document visit by npp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWB0","description":"ICD-GDWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1101","description":"HCPCS-B1101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF1","description":"ICD-EEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF0","description":"ICD-NBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8F","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEE0","description":"ICD-MBEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJC1","description":"ICD-JHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92518","description":"Vestibular Evoked Myogenic Potential (Vemp) Testing_ With Interpretation And Report; Ocular (Ovemp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt access bil tree sm bwl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47541","description":"Plmt access bil tree sm bwl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHED1","description":"ICD-KHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10080","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc back les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21930","description":"Exc back les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQB0","description":"ICD-GGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge porcelain high noble","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6240","description":"Bridge porcelain high noble","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLF0","description":"ICD-EBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF0","description":"ICD-KAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drop lock retainer each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2785","description":"Drop lock retainer each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5118","description":"Injection_ bevacizumab-bvzr_ biosimilar_ (Zirabev)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho abduction hip adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1650","description":"Ho abduction hip adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ caplacizumab-yhdp_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9047","description":"Injection_ caplacizumab-yhdp_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETD1","description":"ICD-FETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD1","description":"ICD-JCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1104","description":"Radiation Therapy For Uterine Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB0","description":"ICD-BIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC0","description":"ICD-IFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNB1","description":"ICD-GDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43820","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE1","description":"ICD-FHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8E","description":"Low Rehab_ ADL Index 0-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPA0","description":"ICD-KBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC0","description":"ICD-JAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ behind the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5220","description":"Hearing aid_ BICROS_ behind the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB156","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0874T","description":"Removal of a peritoneal ascites pump system_ including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC1","description":"ICD-KHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB07","description":"Very High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE1","description":"ICD-FCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 max 100uci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9531","description":"I131 max 100uci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm pair wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0112","description":"Crutch underarm pair wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES130","description":"Extensive Services _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF0","description":"ICD-JBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA1","description":"ICD-OCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICB1","description":"ICD-KICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq cervicothoracic inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22510","description":"Perq cervicothoracic inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8I","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC155","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF0","description":"ICD-KGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair hvy duty detach a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1290","description":"Wheelchair hvy duty detach a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy lymph node exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32674","description":"Thoracoscopy lymph node exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB1","description":"ICD-MDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBF0","description":"ICD-EBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUF1","description":"ICD-JGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFC1","description":"ICD-BGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB211","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8F","description":"Very High Rehab _ ADL Index 0-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBF0","description":"ICD-MKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1013","description":"Clinical decision support mechanism EvidenceCare imaging advisor_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB0","description":"ICD-CAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Up ext fx orthos humeral nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3980","description":"Up ext fx orthos humeral nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC0","description":"ICD-NKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental house call","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9410","description":"Dental house call","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNC0","description":"ICD-KFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE0","description":"ICD-OJUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82543","description":"Column chromatography/mass spectrometry (eg_ gc/ms_ or hplc/ms)_ analyte not elsewhere specified; stable isotope dilution_ single analyte_ quantitative_ single st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPD0","description":"ICD-BEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAED0","description":"ICD-FAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00908","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","description":"CPT-00908","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97813","description":"Acupunct w/stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC0","description":"ICD-DFSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE1","description":"ICD-PHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab and hyaluronidase_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9467","description":"Injection_ rituximab and hyaluronidase_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERB0","description":"ICD-OERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","description":"CPT-00882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC1C","description":"Medium Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stgi no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9063","description":"Onc dx nsclc stgi no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD1","description":"ICD-GFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF1","description":"ICD-GBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJVA0","description":"ICD-NJVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA124","description":"Clinically Complex _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA155","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARA1","description":"ICD-KARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect apical lung tum/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32504","description":"Resect apical lung tum/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA0","description":"ICD-PFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95724","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ceftazidime and avibactam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0714","description":"Ceftazidime and avibactam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","description":"CPT-00670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHC0","description":"ICD-BFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC1","description":"ICD-NIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aud rehab pre-ling hear loss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92630","description":"Aud rehab pre-ling hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQE1","description":"ICD-DIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDC1","description":"ICD-BFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC0","description":"ICD-BAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE1","description":"ICD-GFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQB1","description":"ICD-PAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME0","description":"ICD-BDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0330U","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ vaginal pathogen panel_ identification of 27 organisms_ amplified probe technique_ vaginal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETE0","description":"ICD-JETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHA1","description":"ICD-MCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC21","description":"ICD-3BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb no presc no reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8698","description":"Antithromb no presc no reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"School-based iep ser bundled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1018","description":"School-based iep ser bundled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB1","description":"ICD-ADUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardioversion electric ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92960","description":"Cardioversion electric ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4354","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","description":"HCPCS-Q4354","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDF1","description":"ICD-MHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOC0","description":"ICD-PBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aor/carot/innom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35526","description":"Art byp grft aor/carot/innom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9750","description":"Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAC0","description":"ICD-EEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legg perthes patten bottom t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1755","description":"Legg perthes patten bottom t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOB0","description":"ICD-CGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fungi identification mold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87107","description":"Fungi identification mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ olipudase alfa-rpcp_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0218","description":"Injection_ olipudase alfa-rpcp_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA1","description":"ICD-NKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRD1","description":"ICD-OLRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx complx malar fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21365","description":"Opn tx complx malar fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD0","description":"ICD-KGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA1","description":"ICD-NDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sho insert w arch toe filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5000","description":"Sho insert w arch toe filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGB0","description":"ICD-OKGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis one evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90945","description":"Dialysis one evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Range of motion measurements","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95851","description":"Range of motion measurements","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD224","description":"Special Care Low _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av dialysis shunt imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75791","description":"Av dialysis shunt imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOE0","description":"ICD-HAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNB0","description":"ICD-JGNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPF0","description":"ICD-OGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC1","description":"ICD-ABEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impression casting ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0395","description":"Impression casting ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXD0","description":"ICD-BCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF0","description":"ICD-BGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABD0","description":"ICD-EABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFA1","description":"ICD-OEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHB0","description":"ICD-FBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIA0","description":"ICD-GHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 ioflupane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9584","description":"Iodine i-123 ioflupane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD0","description":"ICD-IDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1065","description":"Shingrix vaccine was not administered for reasons documented by clinician (e.g._ patient administered vaccine other than Shingr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ziprasidone mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3486","description":"Ziprasidone mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIF0","description":"ICD-OEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE113","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTD0","description":"ICD-FGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF1","description":"ICD-HHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEF1","description":"ICD-GAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRA1","description":"ICD-PHRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9994","description":"Patient Is Using Palliative Care Services Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC0","description":"ICD-KGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTF0","description":"ICD-IFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB0","description":"ICD-MILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRE0","description":"ICD-HDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACC0","description":"ICD-CACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mast rad urban type","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19306","description":"Mast rad urban type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB1","description":"ICD-NCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC1","description":"ICD-JHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHE0","description":"ICD-NJHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare sperm duct x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55300","description":"Prepare sperm duct x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB1","description":"ICD-OLRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic anrysm 6/> cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9004F","description":"Aortic anrysm 6/> cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXD0","description":"ICD-FHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9812","description":"Patient died including all deaths occurring during the hospitalization in which the operation was performed_ even if after 30 days_ and those deaths occurring after discharge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0013","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFID1","description":"ICD-CFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLIC0","description":"ICD-NLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special stains group 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88313","description":"Special stains group 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0501U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","description":"CPT-0501U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJE0","description":"ICD-FFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0631","description":"Lso sag r an/pos pnl pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE21A","description":"Special Care High _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYD1","description":"ICD-PHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine bending","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72114","description":"X-ray exam l-s spine bending","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Axillary crutch extension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0978","description":"Axillary crutch extension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0128U","description":"Oncology_ RNA_ gene expression by whole transcriptome sequencing_ formalin-","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8627","description":"Surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/staple esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43405","description":"Ligate/staple esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trac stand free stand extrem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0880","description":"Trac stand free stand extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC0","description":"ICD-EEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq device breast 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19281","description":"Perq device breast 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67516","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOE1","description":"ICD-PLOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKF0","description":"ICD-FFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOC0","description":"ICD-OAOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt surv improv bsline tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9603","description":"Pt surv improv bsline tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0301U","description":"Infectious Agent Detection By Nucleic Acid (Dna Or Rna)_ Bartonella Henselae And Bartonella Quintana_ Droplet Digital Pcr (Ddpcr);","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24120","description":"Remove elbow lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00404","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","description":"CPT-00404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHF0","description":"ICD-MFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEA1","description":"ICD-IEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMB0","description":"ICD-NEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAE0","description":"ICD-GCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYB1","description":"ICD-HBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-vag hyst w/t/o compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58554","description":"Laparo-vag hyst w/t/o compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE0","description":"ICD-EIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92229","description":"Imaging Of Retina For Detection Or Monitoring Of Disease; Point-Of-Care Automated Analysis And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSB0","description":"ICD-OBSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOD1","description":"ICD-HIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF0","description":"ICD-GEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4A","description":"Default_ /PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ring flange plastic/leather","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1100","description":"Ring flange plastic/leather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBD0","description":"ICD-ODBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE1","description":"ICD-FDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv adrenrg inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95922","description":"Autonomic nrv adrenrg inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithromb no presc doc reas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8697","description":"Antithromb no presc doc reas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNE1","description":"ICD-CBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGB0","description":"ICD-NIGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA0","description":"ICD-ABIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPC1","description":"ICD-GFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin each add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90472","description":"Immunization admin each add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBF0","description":"ICD-NDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOA1","description":"ICD-CEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJC1","description":"ICD-JIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88309","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD0","description":"ICD-JGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01990","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","description":"CPT-01990","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLC1","description":"ICD-BHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUB0","description":"ICD-BAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJC0","description":"ICD-CFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUB0","description":"ICD-CCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0533U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","description":"CPT-0533U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRE1","description":"ICD-GHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54505","description":"Biopsy of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear quad-lat brim m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2510","description":"Th/wght bear quad-lat brim m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert/place heart catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93503","description":"Insert/place heart catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0873T","description":"Revision of a subcutaneously implanted peritoneal ascites pump system_ any component (ascites pump_ associated peritoneal catheter_ associated bladder catheter)_ including ima","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDC1","description":"ICD-BHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTF1","description":"ICD-JFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA1","description":"ICD-BIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCE1","description":"ICD-BFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE1","description":"ICD-IEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carry goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8985","description":"Carry goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1159","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNC1","description":"ICD-KCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0703","description":"Injection_ cefepime hydrochloride (b braun)_ not therapeutically equivalent to maxipime_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENC1","description":"ICD-NENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC1","description":"ICD-OELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1034T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1034T","description":"CPT-1034T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9220","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","description":"HCPCS-J9220","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj tedizolid phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3090","description":"Inj tedizolid phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFF1","description":"ICD-NDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27280","description":"Fusion of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF0","description":"ICD-FIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA0","description":"ICD-GCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAE1","description":"ICD-NHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB56","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGF0","description":"ICD-BEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQA1","description":"ICD-LBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ emicizumab-kxwh_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9995","description":"Injection_ emicizumab-kxwh_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF0","description":"ICD-BHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respite not-in-home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0045","description":"Respite not-in-home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBD0","description":"ICD-FHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF0","description":"ICD-OJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 4th stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0342","description":"Lifestyle mod 4th stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWE0","description":"ICD-PBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable pch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4388","description":"Drainable pch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKE1","description":"ICD-FDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSF0","description":"ICD-GBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF1","description":"ICD-ODMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHD0","description":"ICD-JCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27156","description":"Revision of hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE1","description":"ICD-GBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEC0","description":"ICD-NKEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10B","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC0","description":"ICD-KGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE1","description":"ICD-LAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam propulsion tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2218","description":"Foam propulsion tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy excl nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31525","description":"Dx laryngoscopy excl nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9929","description":"Patient with transient or reversible cause of AF (e.g._ pneumonia_ hyperthyroidism_ pregnancy_ cardiac surgery)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE1","description":"ICD-FIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUD1","description":"ICD-CIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGA0","description":"ICD-OGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGE0","description":"ICD-JAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJB1","description":"ICD-BAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0628T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; Each Add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA1","description":"ICD-MKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXE0","description":"ICD-NEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE1","description":"ICD-EBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of citrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82507","description":"Assay of citrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic catheter for biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47510","description":"Introduction of percutaneous transhepatic catheter for biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDD0","description":"ICD-OJDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAB0","description":"ICD-NCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIF0","description":"ICD-FAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA16","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTC1","description":"ICD-MJTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID1","description":"ICD-BEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc glutathione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82979","description":"Assay rbc glutathione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD105","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA1","description":"ICD-KEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no lipid profile","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8726","description":"Doc reas no lipid profile","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFF0","description":"ICD-GEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytotoxic antibody screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86808","description":"Cytotoxic antibody screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA1","description":"ICD-KBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME1","description":"ICD-GCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9700","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50437","description":"Dilation of existing tract_ percutaneous_ for an endourologic procedure including imaging guidance (eg_ ultrasound and/or fluoroscopy) and all associated radiological supervis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator jun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3207","description":"Hightop w/ supp/pronator jun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF1","description":"ICD-KAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1402","description":"HCPCS-B1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHD1","description":"ICD-IGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA1","description":"ICD-ODQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYA1","description":"ICD-CIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam establish patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92012","description":"Eye exam establish patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOC1","description":"ICD-PHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA1","description":"ICD-OJNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF1","description":"ICD-GCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift sling or seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0621","description":"Patient lift sling or seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF1","description":"ICD-NCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABB1","description":"ICD-IABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8001","description":"HCPCS-C8001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC1","description":"ICD-GERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC53","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUA0","description":"ICD-AIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKD0","description":"ICD-KGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD0","description":"ICD-JHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29046","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD0","description":"ICD-ODVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLE1","description":"ICD-BFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3401","description":"Beremagene geperpavec-svdt for topical administration_ containing nominal 5 x 10^9 pfu/ml vector genomes_ per 0.1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thorabd diaphr hern repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43337","description":"Thorabd diaphr hern repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35246","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUC1","description":"ICD-JHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAB1","description":"ICD-FGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPD1","description":"ICD-NBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF1","description":"ICD-DIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXB1","description":"ICD-GAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ureter & kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50750","description":"Fusion of ureter & kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA60","description":"High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the followin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37298","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","description":"CPT-37298","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFD0","description":"ICD-OAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachy linear_ non-str_p-103","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2636","description":"Brachy linear_ non-str_p-103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA13","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALE0","description":"ICD-AALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC0","description":"ICD-NBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD0","description":"ICD-GFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEME1","description":"ICD-GEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25449","description":"Remove wrist joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHA1","description":"ICD-JGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF0","description":"ICD-JAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOA0","description":"ICD-KDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9810","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9810","description":"HCPCS-C9810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0680","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","description":"HCPCS-G0680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL60","description":"Very High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCB1","description":"ICD-CGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML1B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pres/absn urine incon assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1090F","description":"Pres/absn urine incon assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAA0","description":"ICD-OEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2291","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","description":"HCPCS-J2291","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker monitr audible/vis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0610","description":"Pacemaker monitr audible/vis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOB0","description":"ICD-KGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF1","description":"ICD-JCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFE0","description":"ICD-FFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4B","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED0","description":"ICD-BEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC1","description":"ICD-GFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-surg tx root canal obs","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3331","description":"Non-surg tx root canal obs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEC1","description":"ICD-MAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE1","description":"ICD-FBBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEC0","description":"ICD-NDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA0","description":"ICD-KAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUD1","description":"ICD-MIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIOD1","description":"ICD-GIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC0","description":"ICD-PLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB1","description":"ICD-JBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB1","description":"ICD-ODXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC0","description":"ICD-AEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD1","description":"ICD-GFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLB1","description":"ICD-FDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate ic vasospasm add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61642","description":"Dilate ic vasospasm add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMA0","description":"ICD-MAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHE1","description":"ICD-MAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILA0","description":"ICD-FILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical medicine procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97139","description":"Physical medicine procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC0","description":"ICD-BCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parkinsons disease mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8903","description":"Parkinsons disease mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33702","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE1","description":"ICD-IAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep bk ptb thermopls molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5530","description":"Prep bk ptb thermopls molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7040","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med rsn no scr etoh use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9623","description":"Doc med rsn no scr etoh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241U","description":"NFCT DS RNA 4 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDB1","description":"ICD-BBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGA1","description":"ICD-OHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESD0","description":"ICD-LESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHA0","description":"ICD-BEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1132","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFE1","description":"ICD-CAFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0815","description":"Pwc gp 1 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1349","description":"Patients who did not have a net increase in pam score of at least 3 points within 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reptilase test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85635","description":"Reptilase test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEC0","description":"ICD-NHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA0","description":"ICD-CIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bed pan standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0275","description":"Bed pan standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKE0","description":"ICD-GDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC1","description":"ICD-CCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD1","description":"ICD-GBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD1","description":"ICD-IGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nitroblue tetrazolium dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86384","description":"Nitroblue tetrazolium dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB05","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1084","description":"Radiation Therapy For Cns Tumors Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38212","description":"Rbc depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE0","description":"ICD-KEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart vessel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33501","description":"Repair heart vessel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable nebulizer prefill","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7008","description":"Disposable nebulizer prefill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No ster wd ifx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8572","description":"No ster wd ifx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHD0","description":"ICD-NKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBC1","description":"ICD-ACBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv musc neck dyston","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64616","description":"Chemodenerv musc neck dyston","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSA0","description":"ICD-LDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX34","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHB1","description":"ICD-JIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEA0","description":"ICD-OFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9990","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Janssen Covid-19 Vaccine Administration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0031A","description":"Janssen Covid-19 Vaccine Administration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","description":"HCPCS-J0168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine nrv >2 segmnts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63190","description":"Incise spine nrv >2 segmnts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC BRST CA AI ASSMT 12 FEAT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220U","description":"ONC BRST CA AI ASSMT 12 FEAT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGD0","description":"ICD-OLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Panitumumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9303","description":"Panitumumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of miscarriage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59821","description":"Treatment of miscarriage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit diuretic infus diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9361","description":"Hit diuretic infus diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQF0","description":"ICD-HAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLA1","description":"ICD-KCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASF1","description":"ICD-GASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","description":"HCPCS-M1431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CC21","description":"ICD-1CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKF1","description":"ICD-JHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0763T","description":"Digitization of glass microscope slides for morphometric analysis_ tumor immunohistochemistry (eg_ Her-2/neu_ estrogen receptor/progesterone receptor)_ quantitative or semiqua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYB1","description":"ICD-DFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANF0","description":"ICD-GANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXB1","description":"ICD-JAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inlay repair","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2981","description":"Inlay repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31573","description":"Laryngoscopy_ flexible; with therapeutic injection(s) (eg_ chemodenervation agent or corticosteroid_ injected percutaneous_ transoral_ or via endoscope channel)_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso corset front","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0972","description":"Lso corset front","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL53","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0821T","description":"Continuous in-person monitoring and intervention (eg_ psychotherapy_ crisis intervention)_ as needed_ during psychedelic medication therapy; second physician or other qualifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES260","description":"Extensive Services _ ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIA0","description":"ICD-NIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostatectomy (turp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52601","description":"Prostatectomy (turp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSA1","description":"ICD-GFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0803","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0803","description":"CDT-D0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKC1","description":"ICD-CAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB1","description":"ICD-CFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6004","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSB1","description":"ICD-CCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC0","description":"ICD-GAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28047","description":"Resect foot/toe tumor 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC1","description":"ICD-CCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipid profile perf doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8725","description":"Lipid profile perf doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDA0","description":"ICD-EFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant headset replace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8615","description":"Coch implant headset replace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_5%_ 50ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9041","description":"Albumin (human)_5%_ 50ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEB1","description":"ICD-GIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTC0","description":"ICD-NLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28296","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICE0","description":"ICD-IICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJE0","description":"ICD-NKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1128","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef mod/sever deprs syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3021F","description":"Lvef mod/sever deprs syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove impacted ear wax uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69209","description":"Remove impacted ear wax uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253U","description":"Reproductive Medicine (Endometrial Receptivity Analysis)_ Rna Gene Expression Profile_ 238 Genes By Next-Generation Sequencing_ Endometrial Tissue_ Predictive Algorithm Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD0","description":"ICD-JHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43611","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25215","description":"Removal of wrist bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB0","description":"ICD-HIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQB0","description":"ICD-CAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2789","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2789","description":"HCPCS-J2789","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITF1","description":"ICD-KITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0822","description":"Pwc gp 2 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBB0","description":"ICD-EIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSB1","description":"ICD-HBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVA0","description":"ICD-KBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lens surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14251","description":"Anesth lens surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEC0","description":"ICD-BCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35190","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGC1","description":"ICD-OLGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMC0","description":"ICD-NLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA52","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant auditory brain imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2235","description":"Implant auditory brain imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC0","description":"ICD-PKWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE0","description":"ICD-JHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD0","description":"ICD-ODUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFC0","description":"ICD-OJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15015","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","description":"CPT-15015","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","description":"HCPCS-M1422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86023","description":"Immunoglobulin assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26415","description":"Excision hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGC0","description":"ICD-OJGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9941","description":"Back pain was measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA0","description":"ICD-OFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70490","description":"Ct soft tissue neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD0","description":"ICD-BBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perc d-e cor revasc t cabg b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9605","description":"Perc d-e cor revasc t cabg b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L ventric pacing lead add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33225","description":"L ventric pacing lead add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84157","description":"Assay of protein other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRA0","description":"ICD-PIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hern premie blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49492","description":"Rpr ing hern premie blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF0","description":"ICD-CESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKB1","description":"ICD-GEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA0","description":"ICD-MCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQF0","description":"ICD-HIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKE1","description":"ICD-JIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310U","description":"Pediatrics (vasculitis_ Kawasaki disease [KD])_ analysis of 3 biomarkers (NT-proBNP_ C-reactive protein_ and T-uptake)_ plasma_ algorithm reported as a risk score for KD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF1","description":"ICD-CGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE0","description":"ICD-OKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIME1","description":"ICD-NIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRC1","description":"ICD-PBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28024","description":"Exploration of toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC205","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerevise eye muscles add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67332","description":"Rerevise eye muscles add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63266","description":"Excise intrspinl lesion thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPD1","description":"ICD-BDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD235","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX43","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTF1","description":"ICD-CGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monit store cryo embryo 30 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4040","description":"Monit store cryo embryo 30 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICC0","description":"ICD-KICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12045","description":"Intmd rpr n-hf/genit12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27405","description":"Repair of knee ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee acrylic socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5629","description":"Below knee acrylic socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF0","description":"ICD-BFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAC0","description":"ICD-IFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUC1","description":"ICD-EIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGVC1","description":"ICD-CGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33694","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYF1","description":"ICD-DFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMA1","description":"ICD-NBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF1","description":"ICD-FGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHF1","description":"ICD-BBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAA1","description":"ICD-AGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECD0","description":"ICD-BECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDF1","description":"ICD-KBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5654","description":"Socket insert symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE131","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF0","description":"ICD-LDSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC0","description":"ICD-JCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA0","description":"ICD-FCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLB0","description":"ICD-MDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anthrax vaccine sc or im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90581","description":"Anthrax vaccine sc or im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gold sodium thiomaleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1600","description":"Gold sodium thiomaleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMA0","description":"ICD-KIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAD0","description":"ICD-ABAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius/ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25575","description":"Treat fracture radius/ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0891","description":"Injection_ argatroban (accord)_ not therapeutically equivalent to j0883_ 1 mg (for non-esrd use)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9656","description":"Patient transferred directly from anesthetizing location to PACE or other non-ICU location","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA0","description":"ICD-NKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUD1","description":"ICD-MBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no hx act drain 90 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8562","description":"Pt no hx act drain 90 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB1","description":"ICD-AACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx multple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21347","description":"Opn tx nasomax fx multple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12C","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77090","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Preparation And Transmission Of Data For Analysis To Be Performed Elsewhere","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAE1","description":"ICD-CGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special radiation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77470","description":"Special radiation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRD0","description":"ICD-DDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd shck absrber for hd powwc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1018","description":"Hd shck absrber for hd powwc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hrdtry brst ca-rlatd dsordrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81433","description":"Hrdtry brst ca-rlatd dsordrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4035","description":"Thoracic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKF1","description":"ICD-JEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDB0","description":"ICD-AEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25426","description":"Repair/graft radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLA0","description":"ICD-IBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1025","description":"Nonpneumatic sequential compression garment_ full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF1","description":"ICD-OGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPE0","description":"ICD-BHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMB0","description":"ICD-JFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Redo endovas vena cava filtr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37192","description":"Redo endovas vena cava filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCD0","description":"ICD-CHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for vulva lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56440","description":"Surgery for vulva lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegcetacoplan_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9151","description":"Injection_ pegcetacoplan_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Child fostercare th per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5145","description":"Child fostercare th per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVB1","description":"ICD-FGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHF0","description":"ICD-OJHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12020","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETF0","description":"ICD-IETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARC1","description":"ICD-DARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES236","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHE1","description":"ICD-OAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCC0","description":"ICD-NHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA1","description":"ICD-HESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB0","description":"ICD-ECCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB1","description":"ICD-KEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE1","description":"ICD-BFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVD1","description":"ICD-NIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC1","description":"ICD-HIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHE1","description":"ICD-BFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUD1","description":"ICD-GAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1481","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","description":"HCPCS-M1481","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVB0","description":"ICD-GHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place gastrostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49440","description":"Place gastrostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB11A","description":"Special Care High _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36837","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ separate access sites of the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated leukocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85048","description":"Automated leukocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57455","description":"Biopsy of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gr 34 nonsealed leadacid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2358","description":"Gr 34 nonsealed leadacid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLD1","description":"ICD-ICLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED1","description":"ICD-CGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc antibio given b/4 surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4048F","description":"Doc antibio given b/4 surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","description":"CPT-01732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB1","description":"ICD-GIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neox 100 or Clarix 100_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4156","description":"Neox 100 or Clarix 100_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDB1","description":"ICD-KBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUE1","description":"ICD-OEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASD0","description":"ICD-KASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB0","description":"ICD-DAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent w/angio addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92929","description":"Prq card stent w/angio addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIB1","description":"ICD-FCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILB1","description":"ICD-KILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA0","description":"ICD-NJJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heel leather reinforced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3440","description":"Heel leather reinforced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMC0","description":"ICD-ODMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCC1","description":"ICD-OCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28302","description":"Incision of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA0","description":"ICD-KEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA112","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKF0","description":"ICD-NJKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB0","description":"ICD-JDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF0","description":"ICD-AACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preparation for bladder xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51605","description":"Preparation for bladder xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93246","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF1","description":"ICD-MEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sip and puff interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2325","description":"Sip and puff interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQC1","description":"ICD-OLQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0140","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner_ including a certified peer sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFND0","description":"ICD-OFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCC1","description":"ICD-OJCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA0","description":"ICD-HCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAC0","description":"ICD-FGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12A","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE226","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD1","description":"ICD-KEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13B","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7900","description":"Service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder_ initial 15-29 minutes_ provided remotely by hospital staff who are licensed to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELC1","description":"ICD-EELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA0","description":"ICD-IGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33277","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transport portable x-ray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0070","description":"Transport portable x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQD0","description":"ICD-KEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIE0","description":"ICD-MCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0476U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","description":"CPT-0476U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1834","description":"Pressure sensor system_ includes all components (eg_ introducer sensor)_ intramuscular (imp)_ exc mobile (wireless) software app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ famotidine_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0028","description":"Injection_ famotidine_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNC1","description":"ICD-BCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQE1","description":"ICD-HDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCD0","description":"ICD-GDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no offer eol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9381","description":"Doc med reas no offer eol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.tuberculo dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87556","description":"M.tuberculo dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAE0","description":"ICD-BCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9809","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Buprenorphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0592","description":"Buprenorphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB1","description":"ICD-LARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 17-24 weeks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2260","description":"Induced abortion 17-24 weeks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE0","description":"ICD-IGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1C","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC1","description":"ICD-OKUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC23B","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE1","description":"ICD-FBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17271","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBD0","description":"ICD-IDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYD0","description":"ICD-DEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXE0","description":"ICD-BGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD0","description":"ICD-EHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGA1","description":"ICD-KHGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC21","description":"ICD-3LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hpv combo assay ca screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0476","description":"Hpv combo assay ca screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16030","description":"Dress/debrid p-thick burn l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKC1","description":"ICD-GBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post >=4srfc resinbase cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2394","description":"Post >=4srfc resinbase cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7658","description":"Isoproterenol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJC1","description":"ICD-NIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB112","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOC0","description":"ICD-CIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVB1","description":"ICD-KCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUF0","description":"ICD-AEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8668","description":"Fun stat score ue < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA35","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD140","description":"Special Care High _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIA1","description":"ICD-CEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB11","description":"ICD-4LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC1","description":"ICD-NBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EA31","description":"ICD-3EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1033","description":"Nonpneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra stage 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53425","description":"Reconstruct urethra stage 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPB0","description":"ICD-FIPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC31","description":"ICD-2DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPC0","description":"ICD-FDPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin pinch graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15050","description":"Skin pinch graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE0","description":"ICD-GCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0469T","description":"Retinal polarization scan_ ocular screening with on-site automated results_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm antibody test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89325","description":"Sperm antibody test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach-esoph voice pros pt in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8507","description":"Trach-esoph voice pros pt in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I&d abscess p-spine l/s/ls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22015","description":"I&d abscess p-spine l/s/ls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasmaprotein fract_5%_250ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9048","description":"Plasmaprotein fract_5%_250ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA1","description":"ICD-JICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oasis burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4103","description":"Oasis burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36810","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACD0","description":"ICD-FACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGC1","description":"ICD-KIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNE0","description":"ICD-NHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIA0","description":"ICD-MDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCA1","description":"ICD-BGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF1","description":"ICD-JCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIE0","description":"ICD-AEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81214","description":"BRCA1 (breast cancer 1) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie_ exon 13 del 3.835kb_ exo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCD1","description":"ICD-JDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0934T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","description":"CPT-0934T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF0","description":"ICD-EFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC1","description":"ICD-JBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA0","description":"ICD-KCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2094","description":"Documentation Of Patient Reason(S) For Not Prescribing Ace Inhibitor Or Arb Or Arni Therapy (E.G._ Patient Declined_ Other Patient Reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANA0","description":"ICD-CANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35305","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETB0","description":"ICD-FETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE0","description":"ICD-JELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCB0","description":"ICD-FBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy w/bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45305","description":"Proctosigmoidoscopy w/bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXE0","description":"ICD-GIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA1","description":"ICD-CFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca scrn not hi rsk ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0121","description":"Colon ca scrn not hi rsk ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft 2 veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35682","description":"Composite byp grft 2 veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIB1","description":"ICD-FBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC0","description":"ICD-JAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27138","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOF1","description":"ICD-DCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYB1","description":"ICD-DEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA1","description":"ICD-JCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraosseous joint stblztion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0335T","description":"Extraosseous joint stblztion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLA0","description":"ICD-AHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0B","description":"Low Rehab_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External transmitter_ cgm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9277","description":"External transmitter_ cgm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81538","description":"Oncology lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c rna 4to12 wk after med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9209","description":"Hep c rna 4to12 wk after med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC155","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trimethobenzamide hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3250","description":"Trimethobenzamide hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1491","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","description":"HCPCS-M1491","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJA1","description":"ICD-KCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAMC0","description":"ICD-KAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPA0","description":"ICD-CEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA0","description":"ICD-AECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFA0","description":"ICD-JAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plastazote sandal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3265","description":"Plastazote sandal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC1","description":"ICD-BBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIE1","description":"ICD-KBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWC0","description":"ICD-KGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQB1","description":"ICD-KFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD1","description":"ICD-NLMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC26","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70390","description":"X-ray exam of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Convert nephrostomy catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50434","description":"Convert nephrostomy catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anchor/screw bn/bn_tis/bn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1713","description":"Anchor/screw bn/bn_tis/bn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26180","description":"Removal of finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJE0","description":"ICD-GFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0675U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675U","description":"CPT-0675U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD0","description":"ICD-AECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGA1","description":"ICD-CBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA0","description":"ICD-MAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Candida dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87482","description":"Candida dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC34","description":"High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose/reagent strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4253","description":"Blood glucose/reagent strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uv lens/es","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2755","description":"Uv lens/es","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23D","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAC1","description":"ICD-MIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs multisource","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77371","description":"Srs multisource","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEA1","description":"ICD-CBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTF1","description":"ICD-OKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIA1","description":"ICD-NCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPB1","description":"ICD-GCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dextran 75 infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7110","description":"Dextran 75 infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAB1","description":"ICD-CFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6611","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","description":"HCPCS-A6611","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKF0","description":"ICD-BAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB30","description":"High Rehab _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01420","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","description":"CPT-01420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRB1","description":"ICD-OHRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC1","description":"ICD-JBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker folding wheeled w/o s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0143","description":"Walker folding wheeled w/o s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nandrolone decanoate 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2320","description":"Nandrolone decanoate 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Musc tst done w/n tst nonext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95887","description":"Musc tst done w/n tst nonext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHC0","description":"ICD-JIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE0","description":"ICD-HIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIED1","description":"ICD-CIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC1","description":"ICD-CEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJA0","description":"ICD-NIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phototherap keratect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0812","description":"Phototherap keratect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0972T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","description":"CPT-0972T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA1","description":"ICD-KGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription of contact lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92314","description":"Prescription of contact lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF0","description":"ICD-JDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUA0","description":"ICD-NLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKF0","description":"ICD-GCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYB0","description":"ICD-KCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert card electrodes dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33211","description":"Insert card electrodes dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC0","description":"ICD-JFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressant not specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80338","description":"Antidepressant not specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amiodarone hcl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0282","description":"Amiodarone hcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDB1","description":"ICD-CHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUE0","description":"ICD-GAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1 thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63046","description":"Remove spine lamina 1 thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromogenic substrate assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85130","description":"Chromogenic substrate assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA204","description":"Clinically Complex _ ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF1","description":"ICD-KHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 2 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64491","description":"Inj paravert f jnt c/t 2 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ custom_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6573","description":"Gradient compression garment_ toe caps_ custom_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal neck/armpit lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38555","description":"Removal neck/armpit lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0237U","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia)_ genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice/home hlth in asst lv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5002","description":"Hospice/home hlth in asst lv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE13C","description":"Clinically Complex _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disease activity not assessed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1006","description":"Disease activity not assessed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA21","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrafiltration monitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9007","description":"Ultrafiltration monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF0","description":"ICD-OGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPD0","description":"ICD-NLPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9089","description":"Bupivacaine_ Collagen-Matrix Implant_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENF1","description":"ICD-BENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruct lesion 15 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17111","description":"Destruct lesion 15 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXD0","description":"ICD-CEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHE0","description":"ICD-IIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96567","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28C","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA1","description":"ICD-GFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4400","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","description":"HCPCS-Q4400","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMA0","description":"ICD-JFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0302","description":"Pre-op service lvrs complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myringotomy laser-assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2225","description":"Myringotomy laser-assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIF1","description":"ICD-FDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSA0","description":"ICD-OCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ustekinumab_ for intravenous injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9487","description":"Ustekinumab_ for intravenous injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAC1","description":"ICD-BCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA1","description":"ICD-CDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNE0","description":"ICD-FHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp ea duct/ampulla dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43277","description":"Ercp ea duct/ampulla dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine tranthor w/o vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62559","description":"Anes spine tranthor w/o vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26720","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE1","description":"ICD-MGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSE0","description":"ICD-GCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External radiation dosimetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77399","description":"External radiation dosimetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51530","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0614","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","description":"HCPCS-J0614","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pd mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8762","description":"Pd mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit contac lens for managmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92072","description":"Fit contac lens for managmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8I","description":"Low Rehab_ ADL Index 0-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7525","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91321","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ 25 mcg/0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGB1","description":"ICD-JDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21193","description":"Reconst lwr jaw w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAA0","description":"ICD-IIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cxr doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3006F","description":"Cxr doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHE1","description":"ICD-GGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCB0","description":"ICD-JFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCC0","description":"ICD-OLCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBA0","description":"ICD-MKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone replce graft first site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4263","description":"Bone replce graft first site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD0","description":"ICD-JGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0637U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0637U","description":"CPT-0637U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDA0","description":"ICD-OFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE1","description":"ICD-NGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWC1","description":"ICD-OIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penile contracture device_ manual_ greater than 3 lbs traction force","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4988","description":"Penile contracture device_ manual_ greater than 3 lbs traction force","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCA1","description":"ICD-AHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC1","description":"ICD-BFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1201","description":"HCPCS-B1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMA1","description":"ICD-GIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJE0","description":"ICD-BEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise low back nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64714","description":"Revise low back nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB0","description":"ICD-KEGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA1","description":"ICD-NHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1711","description":"Moderna Covid-19 vaccine administration - booster dose (SARSCOV2 COVID-19 VAC mRNA 50mcg/0.25mL IM DOSE BOOSTER)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMC0","description":"ICD-FAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m pentetate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9539","description":"Tc99m pentetate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped critical care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99471","description":"Ped critical care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTC1","description":"ICD-CDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC1","description":"ICD-PERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec sit not prim tumor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8723","description":"Spec sit not prim tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA1","description":"ICD-JFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of topiramate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80201","description":"Assay of topiramate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHSC1","description":"ICD-OHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55881","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","description":"CPT-55881","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD0","description":"ICD-FHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEB1","description":"ICD-FHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBC1","description":"ICD-CDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Torsion straight knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2380","description":"Torsion straight knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIC1","description":"ICD-EDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE1","description":"ICD-CHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTF1","description":"ICD-OGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp2 vhd sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0839","description":"Pwc gp2 vhd sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF1","description":"ICD-HFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44340","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALA0","description":"ICD-OALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exchange biliary drg cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47536","description":"Exchange biliary drg cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA0","description":"ICD-JCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWE0","description":"ICD-LBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD1","description":"ICD-JDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Counseling_ individual_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9002","description":"Counseling_ individual_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENE1","description":"ICD-JENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18B","description":"Special Care Low _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERB0","description":"ICD-GERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHID1","description":"ICD-CHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41000","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA0","description":"ICD-KBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fast/dir ldl = 190 mg/dl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9663","description":"Fast/dir ldl = 190 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Demo-smoking cessation coun","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9016","description":"Demo-smoking cessation coun","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urethrlys transvag w/ scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53500","description":"Urethrlys transvag w/ scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transvaginal us non-ob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76830","description":"Transvaginal us non-ob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD0","description":"ICD-HCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKB1","description":"ICD-FFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC1","description":"ICD-FHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB217","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Viral culture","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0416","description":"Viral culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF0","description":"ICD-BCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIE0","description":"ICD-NEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGED0","description":"ICD-MGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9068","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","description":"HCPCS-E1813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthr0 w/debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29862","description":"Hip arthr0 w/debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF0","description":"ICD-DGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE0","description":"ICD-MKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHC0","description":"ICD-MDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDF0","description":"ICD-KDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0889","description":"Daprodustat_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77049","description":"Magnetic resonance imaging_ breast_ without and with contrast material(s)_ including computer-aided detection (CAD real-time lesion detection_ characterization and pharmacokin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery expos/graft artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33987","description":"Artery expos/graft artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18F","description":"Clinically Complex _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTA1","description":"ICD-JFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF1","description":"ICD-IDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18I","description":"Special Care Low _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8923","description":"2d tte w or w/o fol w/con_co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65750","description":"Corneal transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99245","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC1","description":"ICD-JDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20B","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFE1","description":"ICD-CEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF1","description":"ICD-MBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC0","description":"ICD-LFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction anal lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46910","description":"Destruction anal lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLD1","description":"ICD-GDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27331","description":"Explore/treat knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","description":"HCPCS-M1415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec site no lung","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9420","description":"Spec site no lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22850","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocyte transformation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86353","description":"Lymphocyte transformation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talquetamab-tgvs_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3055","description":"Injection_ talquetamab-tgvs_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smear special stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87207","description":"Smear special stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB1","description":"ICD-BCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITB0","description":"ICD-MITB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB1","description":"ICD-AIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF1","description":"ICD-OIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1345","description":"Patients who had a baseline pam score and a second score within 6 to 12 month of baseline pam score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2154","description":"Patient Received At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23030","description":"Drain shoulder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0144U","description":"Drug assay_ definitive_ 160 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE1","description":"ICD-BECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCA1","description":"ICD-FHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA31","description":"ICD-4BA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FA21","description":"ICD-3FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tot contact ak/knee disart s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5650","description":"Tot contact ak/knee disart s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anes spine transthor w/vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62659","description":"Anes spine transthor w/vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red cell mass single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78120","description":"Red cell mass single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8F","description":"High Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9713","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB1","description":"ICD-JHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15941","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9722","description":"Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure_ unless_ since","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc osmotic fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85555","description":"Rbc osmotic fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXA1","description":"ICD-KAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESF0","description":"ICD-PESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42804","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIB0","description":"ICD-BGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54380","description":"Repair penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMD1","description":"ICD-KIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC1","description":"ICD-KERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB0","description":"ICD-FGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD210","description":"Special Care High _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA111","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compounded drug_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7999","description":"Compounded drug_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB136","description":"Reduced Physical Function _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped fbrglas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4012","description":"Cast sup sht arm ped fbrglas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelv band/spread bar thigh c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1640","description":"Pelv band/spread bar thigh c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal monitor/interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59051","description":"Fetal monitor/interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride infected skin add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11001","description":"Debride infected skin add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILE0","description":"ICD-EILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81192","description":"Ntrk2 (Neurotrophic Receptor Tyrosine Kinase 2) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF0","description":"ICD-OBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDF1","description":"ICD-IIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC0","description":"ICD-NIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC1","description":"ICD-EBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg > 48 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6253","description":"Absorpt drg > 48 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEC1","description":"ICD-MFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBE0","description":"ICD-BFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC1","description":"ICD-FACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lab labial veneer porcelain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2962","description":"Lab labial veneer porcelain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31382","description":"Partial removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF1","description":"ICD-KDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport meals recip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0190","description":"Noner transport meals recip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB1","description":"ICD-FBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prostatic rf thermotx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53852","description":"Prostatic rf thermotx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69540","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ ciprofloxacin otic suspension_ 6 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7342","description":"Instillation_ ciprofloxacin otic suspension_ 6 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFUD0","description":"ICD-NFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD1","description":"ICD-BAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flex/ext/rotation wrist unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6624","description":"Flex/ext/rotation wrist unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9999","description":"HCPCS-A9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0440U","description":"Cardiology (coronary heart disease [CHD])_ DNA_ analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019]_ rs1333048 [CDKN2B-AS1]_ rs12129789 [KCND3]_ rs942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disk/foam pad +or- adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5126","description":"Disk/foam pad +or- adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26740","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36215","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIOE1","description":"ICD-DIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUA1","description":"ICD-GIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCE0","description":"ICD-JHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHF0","description":"ICD-AFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWD1","description":"ICD-LEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test urine for porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84119","description":"Test urine for porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy shower protect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7523","description":"Tracheostomy shower protect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDE1","description":"ICD-CIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD135","description":"Special Care Low _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQA1","description":"ICD-GIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFC1","description":"ICD-OIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE1","description":"ICD-GHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86294","description":"Immunoassay tumor qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC0","description":"ICD-BBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC13","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB25A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48150","description":"Partial removal of pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGC1","description":"ICD-CEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28E","description":"Extensive Services _ ADL Index 2-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYD0","description":"ICD-CIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE1","description":"ICD-KDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33367","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCF1","description":"ICD-ABCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx cesium-131 chloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2644","description":"Brachytx cesium-131 chloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE217","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar or lumbar rib pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1040","description":"Lumbar or lumbar rib pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve w/byp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33369","description":"Replace aortic valve w/byp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30400","description":"Reconstruction of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas on statin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9507","description":"Doc reas on statin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNF1","description":"ICD-KDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27147","description":"Revision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22859","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh_ methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93321","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUA1","description":"ICD-OBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD1","description":"ICD-LDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX2C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Emergency Pack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1762","description":"Home Delivered Meals-Emergency Pack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA0","description":"ICD-NAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF0","description":"ICD-BEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52007","description":"Cystoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn for cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9264","description":"Docrsn for cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQC1","description":"ICD-CAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA124","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTF0","description":"ICD-MBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXA0","description":"ICD-KFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular photodynamic ther","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67221","description":"Ocular photodynamic ther","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRE0","description":"ICD-LGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYC1","description":"ICD-GDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE0","description":"ICD-GGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOE0","description":"ICD-LDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ic lbw inf 1500-2500 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99479","description":"Ic lbw inf 1500-2500 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27828","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37275","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","description":"CPT-37275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOB1","description":"ICD-GHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD0","description":"ICD-BGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBE0","description":"ICD-EFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27826","description":"Treat lower leg fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016U","description":"Oncology (hematolymphoid neoplasia)_ RNA_ BCR/ABL1 major and minor breakpoint fusion transcripts_ quantitative PCR amplification_ blood or bone marrow_ report of fusion not de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect leg/ankle tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27616","description":"Resect leg/ankle tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED1","description":"ICD-IIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m aerosol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9567","description":"Technetium tc-99m aerosol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB0","description":"ICD-KCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYF0","description":"ICD-DHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC21","description":"ICD-2CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE0","description":"ICD-AGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBA0","description":"ICD-OJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA0","description":"ICD-GHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDB1","description":"ICD-BIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impr vis acuit w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9516","description":"Impr vis acuit w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD1","description":"ICD-BEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB124","description":"Special Care Low _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11102","description":"Tangential biopsy of skin (eg_ shave_ scoop_ saucerize_ curette); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC0","description":"ICD-PAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0323","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical psychologist or clinical social worker time_ per calendar month. (these services inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWB1","description":"ICD-DCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDD1","description":"ICD-JDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2542","description":"Dental onlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEB0","description":"ICD-GCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of horseshoe kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50540","description":"Revision of horseshoe kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vasc embolize/occlude venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37241","description":"Vasc embolize/occlude venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQD1","description":"ICD-GAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB1","description":"ICD-BAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF0","description":"ICD-PHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLA1","description":"ICD-EGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40654","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC0","description":"ICD-CBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQC1","description":"ICD-OGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6460","description":"Synthetic resorbable wound dressing_ sterile_ pad size 16 sq in or less_ without adhesive border_ each dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCA0","description":"ICD-OCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACF0","description":"ICD-NACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHA0","description":"ICD-AGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMA1","description":"ICD-NLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXF1","description":"ICD-GEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relieve cranial pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61345","description":"Relieve cranial pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0738T","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue_ using data from previously performed magnetic resonance imaging (MRI) examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC246","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavior management","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9920","description":"Behavior management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral aprepitant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8501","description":"Oral aprepitant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFC1","description":"ICD-FGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat scapula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23585","description":"Treat scapula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0823","description":"Pwc gp 2 std cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC21","description":"ICD-2FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD0","description":"ICD-KCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDF0","description":"ICD-BFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BioNextPATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4228","description":"BioNextPATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endo not barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3141F","description":"Upper gi endo not barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi-position stnd fram sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0641","description":"Multi-position stnd fram sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radical resect abd tumor<5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22904","description":"Radical resect abd tumor<5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVE1","description":"ICD-KEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rep partial denture clasp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5630","description":"Rep partial denture clasp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1037","description":"Docking station for use with oral device/appliance used to reduce upper airway collapsibility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD1","description":"ICD-JCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0703","description":"HCPCS-A0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47612","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0739T","description":"Ablation of malignant prostate tissue by magnetic field induction_ including all intraprocedural_ transperineal needle/catheter placement for nanoparticle installation and int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB0","description":"ICD-MFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD1","description":"ICD-CIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7535","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with transluminal stent placement(s)_ includes angioplasty within the same v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coccidioides antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86635","description":"Coccidioides antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD1","description":"ICD-JEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF0","description":"ICD-FGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1829","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","description":"HCPCS-E1829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1053","description":"Leg pain was measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months) post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAD1","description":"ICD-JFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA0","description":"ICD-CCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fludeoxyglucose f18 up to 15 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9609","description":"Fludeoxyglucose f18 up to 15 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC104","description":"Clinically Complex _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assessment of aphasia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96105","description":"Assessment of aphasia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLF1","description":"ICD-OKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0627T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Fluoroscopic Guidance_ Lumbar; First Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap es sph augment dev place","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0392T","description":"Lap es sph augment dev place","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1601","description":"HCPCS-C1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61584","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD244","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMF0","description":"ICD-CDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tkr composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9233","description":"Tkr composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTB0","description":"ICD-CDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDD1","description":"ICD-GGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC140","description":"Special Care High _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67218","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAF1","description":"ICD-ACAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telehealth transmit_ per min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1014","description":"Telehealth transmit_ per min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWF0","description":"ICD-GIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22855","description":"Remove spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLB0","description":"ICD-NJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAE1","description":"ICD-MLAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98000","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","description":"CPT-98000","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile ducts/pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74300","description":"X-ray bile ducts/pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB150","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMD0","description":"ICD-MJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLCE1","description":"ICD-NLCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABC1","description":"ICD-AABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iadna-dna/rna probe tq 12-25","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87507","description":"Iadna-dna/rna probe tq 12-25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74775","description":"X-ray exam of perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0519U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","description":"CPT-0519U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNE1","description":"ICD-JBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow-up/reassessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0316","description":"Follow-up/reassessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF1","description":"ICD-GDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGC1","description":"ICD-BAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of testis(es)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54680","description":"Relocation of testis(es)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8656","description":"Fun stat score le < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX2C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chiropractic manj 5 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98942","description":"Chiropractic manj 5 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA1","description":"ICD-EBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7523","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQD1","description":"ICD-OFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD0","description":"ICD-MHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC1","description":"ICD-OIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENE1","description":"ICD-CENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYC1","description":"ICD-LBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing systemic antimicrobials","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9960","description":"Documentation of medical reason(s) for prescribing systemic antimicrobials","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7524","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7524","description":"HCPCS-J7524","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA206","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHF1","description":"ICD-FCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2056","description":"Ciltacabtagene autoleucel_ up to 100 million autologous B-cell maturation antigen (BCMA) dir CAR-positive T cells_ inc leukapheresis and dose prep procs_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0322U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites_ liquid chromatography with tandem mass spectrom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC06","description":"Very High Rehab _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm tum deep 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25073","description":"Exc forearm tum deep 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC52","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29902","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBED1","description":"ICD-BBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27882","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE1","description":"ICD-OESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE1","description":"ICD-NLGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of abdominal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27100","description":"Transfer of abdominal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methylprednisolone acetate_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1010","description":"Injection_ methylprednisolone acetate_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatogram assay sugars","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84375","description":"Chromatogram assay sugars","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59325","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYF1","description":"ICD-HCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AC31","description":"ICD-4AC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient enrolled in hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9858","description":"Patient enrolled in hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA105","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81441","description":"Inherited bone marrow failure syndromes (IBMFS) (eg_ Fanconi anemia_ dyskeratosis congenita_ Diamond-Blackfan anemia_ Shwachman-Diamond syndrome_ GATA2 deficiency syndrome_ co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE0","description":"ICD-NHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNE0","description":"ICD-OFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transtracheal oxygen cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4608","description":"Transtracheal oxygen cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA236","description":"Clinically Complex _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPA0","description":"ICD-GBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7550","description":"Cystourethroscopy_ with biopsy(ies) with adjuctive blue light cystoscopy with fluorescent imaging agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0865T","description":"Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies)_ including lesion identification_ characterizatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTE0","description":"ICD-KBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDB0","description":"ICD-OIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADE1","description":"ICD-MADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD1","description":"ICD-ECHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC130","description":"Special Care Low _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair facial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69745","description":"Repair facial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE0","description":"ICD-BAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of arm artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34111","description":"Removal of arm artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOF0","description":"ICD-OCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAID0","description":"ICD-EAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRE1","description":"ICD-KGRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay activated protein c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85307","description":"Assay activated protein c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44391","description":"Colonoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGWD1","description":"ICD-CGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUF1","description":"ICD-OAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC1","description":"ICD-ABHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0825T","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1852","description":"Knee orthosis (KO)_ double upright_ thigh and calf_ with adjustable flexion and extension joint (unicentric or polycentric)_ medial-lateral and rotation control_ with or witho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70547","description":"Mr angiography neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQA0","description":"ICD-GHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2120","description":"Within The Past 2 Years_ Calcium And/Or Vitamin D Optimization Has Not Been Ordered Or Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFND1","description":"ICD-FFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0895T","description":"Connection of liver allograft to normothermic machine perfusion device_ hemostasis control; initial 4 hours of monitoring time_ including hourly physiological and laboratory a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1052","description":"Leg pain was not measured by the Visual Analog Scale (VAS) within three months preoperatively and at one year (9 to 15 months)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5362","description":"Speech screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED0","description":"ICD-JEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSD1","description":"ICD-OFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIME0","description":"ICD-IIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAF0","description":"ICD-OJAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJD0","description":"ICD-OJJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of implanted vestibular device_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0727T","description":"Removal and replacement of implanted vestibular device_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2 shl symphys-stern cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0460","description":"Tlso 2 shl symphys-stern cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDA0","description":"ICD-EGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHA0","description":"ICD-MJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Galsulfase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1458","description":"Galsulfase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC0","description":"ICD-JDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBA1","description":"ICD-JDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0600","description":"Non-ionizing diagnostic procedure capable of quantifying_ monitoring_ and recording changes in structure of enamel_ dentin_ and cementum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES10C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56630","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDD0","description":"ICD-OIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE0","description":"ICD-GITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC0","description":"ICD-BEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNF0","description":"ICD-CCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92543","description":"Caloric vestibular test_ each irrigation (binaural_ bithermalstimulation constitutes four tests)_ with recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paliperidone palmitate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2426","description":"Paliperidone palmitate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1194","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDA1","description":"ICD-MLDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xi pta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85270","description":"Clot factor xi pta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9717","description":"Documentation stating the patient has an active diagnosis of depression or has diagnosed bipolar disorder_ therefore screening or follow-up not required","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD0","description":"ICD-CIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair umbilical lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49611","description":"Repair umbilical lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYE0","description":"ICD-CAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEF1","description":"ICD-FEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of leg infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73592","description":"X-ray exam of leg infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal add over 3.25d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2320","description":"Lens trifocal add over 3.25d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTD1","description":"ICD-JGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse liver duct & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47802","description":"Fuse liver duct & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSC1","description":"ICD-PKSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXE0","description":"ICD-JGXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GILC0","description":"ICD-GILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dicyclomine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0500","description":"Dicyclomine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF1","description":"ICD-NEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c therapy started","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9206","description":"Hep c therapy started","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWE0","description":"ICD-ODWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1054T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1054T","description":"CPT-1054T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQE0","description":"ICD-GGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair webbed toe(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28345","description":"Repair webbed toe(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA0","description":"ICD-GGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2140","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Leg Pain Measured By The Visual Analog Scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coma stimulation per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9056","description":"Coma stimulation per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pentamidine iseth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0080","description":"Injection_ pentamidine iseth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJA1","description":"ICD-FHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF1","description":"ICD-OELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVC0","description":"ICD-NFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27146","description":"Incision of hip bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9035","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9690","description":"Patient receiving hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCF1","description":"ICD-NCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIA0","description":"ICD-IGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAA1","description":"ICD-JIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKE0","description":"ICD-OHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE1","description":"ICD-JIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovas non-cardiac abl cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1888","description":"Endovas non-cardiac abl cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTB0","description":"ICD-NBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology tissue of origin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81504","description":"Oncology tissue of origin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXC0","description":"ICD-NEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQF1","description":"ICD-DHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD1","description":"ICD-NKKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGD1","description":"ICD-OFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBB1","description":"ICD-IFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDC1","description":"ICD-IBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC44","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bcg vaccine intravesical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90586","description":"Bcg vaccine intravesical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE1","description":"ICD-DEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply surf ldr radionuclide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77789","description":"Apply surf ldr radionuclide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQD0","description":"ICD-HFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0175","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","description":"HCPCS-J0175","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collect/review data from pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99091","description":"Collect/review data from pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCB1","description":"ICD-MFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRF1","description":"ICD-CIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76870","description":"Us exam scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who had a transplant prior to initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1262","description":"Patients who had a transplant prior to initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLD1","description":"ICD-KFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHC0","description":"ICD-OLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1982","description":"Catheter_ Pressure-Generating_ One-Way Valve_ Intermittently Occlusive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA0","description":"ICD-BFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDC0","description":"ICD-AEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEID0","description":"ICD-BEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77436","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","description":"CPT-77436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILD0","description":"ICD-EILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPD1","description":"ICD-NHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Male vacuum erection system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7900","description":"Male vacuum erection system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALB1","description":"ICD-CALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVB0","description":"ICD-GAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPA0","description":"ICD-OCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0134","description":"Injection_ acetaminophen (fresenius kabi) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTE1","description":"ICD-NFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKB0","description":"ICD-OAKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC1","description":"ICD-BACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPF0","description":"ICD-CAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35081","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHF0","description":"ICD-GCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKA0","description":"ICD-OGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTE0","description":"ICD-CCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE1","description":"ICD-KBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Malaria antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86750","description":"Malaria antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18F","description":"Clinically Complex _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9768","description":"Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME0","description":"ICD-OEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28E","description":"Special Care High _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cases in which an inhalational anesthetic is used only for induction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9955","description":"Cases in which an inhalational anesthetic is used only for induction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43300","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXC1","description":"ICD-FEXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supported employ_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2023","description":"Supported employ_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37262","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","description":"CPT-37262","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31287","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFE0","description":"ICD-BEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQF0","description":"ICD-HGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43621","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB0","description":"ICD-BGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGED0","description":"ICD-CGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic 2nd+ inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64462","description":"Pvb thoracic 2nd+ inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB1","description":"ICD-EFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice refer visit nonmd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0255","description":"Hospice refer visit nonmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CoreCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4240","description":"CoreCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUA0","description":"ICD-KHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYF1","description":"ICD-DBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Card MRI veloc flow mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75565","description":"Card MRI veloc flow mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQA1","description":"ICD-HIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA0","description":"ICD-BFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37222","description":"Iliac revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo community","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9152","description":"Mapcp demo community","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLF1","description":"ICD-BHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQE0","description":"ICD-KCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic sigmoidoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45330","description":"Diagnostic sigmoidoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUE1","description":"ICD-OAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18E","description":"Clinically Complex _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADC1","description":"ICD-FADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1469","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","description":"HCPCS-M1469","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ carfilzomib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9047","description":"Injection_ carfilzomib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE1","description":"ICD-CIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF0","description":"ICD-DARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBD1","description":"ICD-OIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 1 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2610","description":"Inlay porcelain/ceramic 1 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB1","description":"ICD-HFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67921","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALA1","description":"ICD-GALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF0","description":"ICD-OCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD0","description":"ICD-EIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXB1","description":"ICD-JDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0344U","description":"Hepatology (nonalcoholic fatty liver disease [NAFLD])_ semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD1","description":"ICD-NHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKB0","description":"ICD-CGKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2003","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA31","description":"ICD-4GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFME1","description":"ICD-MFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCF1","description":"ICD-IGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0901","description":"HCPCS-C0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTA0","description":"ICD-CCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAF0","description":"ICD-JFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPA0","description":"ICD-JCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy eyelid & lid margin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67810","description":"Biopsy eyelid & lid margin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21079","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Position wc cush wdth>=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2606","description":"Position wc cush wdth>=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEE1","description":"ICD-NDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove & graft wrist lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25135","description":"Remove & graft wrist lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL3B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculate eggs/animal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87250","description":"Virus inoculate eggs/animal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDC0","description":"ICD-GFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3356","description":"Pulpal regeneration interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIE0","description":"ICD-JDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","description":"CPT-01810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7649","description":"Isoetharine non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILD1","description":"ICD-IILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBD0","description":"ICD-IFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF1","description":"ICD-BHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEA1","description":"ICD-OHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0119U","description":"Oncology (urothelial)_ mRNA_ gene expression profiling by real-time quantit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPA1","description":"ICD-NCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDC0","description":"ICD-GGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCD0","description":"ICD-ABCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 2.6-7.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12032","description":"Intmd rpr s/a/t/ext 2.6-7.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIF0","description":"ICD-MEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDF1","description":"ICD-EBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microsurgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69990","description":"Microsurgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pro flex/ext cont","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5859","description":"Knee-shin pro flex/ext cont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCD1","description":"ICD-OBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture typing glc/hplc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87143","description":"Culture typing glc/hplc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCC1","description":"ICD-CFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDB1","description":"ICD-BFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCE0","description":"ICD-KCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45380","description":"Colonoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC1B","description":"Very High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPA0","description":"ICD-NAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEB1","description":"ICD-FEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB0","description":"ICD-KHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES350","description":"Extensive Services _ ADL Index 2-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral infusion pump sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0791","description":"Parenteral infusion pump sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIA0","description":"ICD-AGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISD1","description":"ICD-PISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF1","description":"ICD-KDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE160","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEE0","description":"ICD-JGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITC0","description":"ICD-GITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA231","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCB1","description":"ICD-IGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24400","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA31","description":"ICD-3DA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMA0","description":"ICD-AAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBA0","description":"ICD-MJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDF0","description":"ICD-BGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE0","description":"ICD-GDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXB0","description":"ICD-KHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1101T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1101T","description":"CPT-1101T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0911T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","description":"CPT-0911T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAE1","description":"ICD-EDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBA0","description":"ICD-BFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1401","description":"HCPCS-A1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD1","description":"ICD-AFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCF1","description":"ICD-JDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE1","description":"ICD-NFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38573","description":"Laparoscopy_ surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling_ peritoneal washings_ peritoneal biopsy(ies)_ omentectomy_ and diaphragm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGC1","description":"ICD-KEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKE1","description":"ICD-BGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD0","description":"ICD-GHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62140","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUB0","description":"ICD-OAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA0","description":"ICD-FHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dc power adapter_ port conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1358","description":"Dc power adapter_ port conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00942","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","description":"CPT-00942","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGE1","description":"ICD-BCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of shoulder cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29055","description":"Application of shoulder cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD0","description":"ICD-EBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUA1","description":"ICD-MLUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEC1","description":"ICD-CCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9836","description":"Reason for not administering trastuzumab documented (e.g._ patient declined_ patient died_ patient transferred_ contraindication or other clinical exclusion_ neoadjuvant chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caster wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2395","description":"Caster wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGF1","description":"ICD-BGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJLF0","description":"ICD-NJLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sialodochoplasty","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7982","description":"Sialodochoplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8F","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA1","description":"ICD-JAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67346","description":"Biopsy eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIE0","description":"ICD-ABIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18C","description":"Clinically Complex _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGA1","description":"ICD-FBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic implnt urinary 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8606","description":"Synthetic implnt urinary 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of foot joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28020","description":"Exploration of foot joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPE0","description":"ICD-GFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0222T","description":"Plmt post facet implt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0493","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle_ used in conjunction with the power source and control electronics unit_ controlled by phon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIF0","description":"ICD-AIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA1A","description":"Medium Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMD0","description":"ICD-OLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCDB1","description":"ICD-BCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCC0","description":"ICD-AFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED1","description":"ICD-AGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0577","description":"Injection_ buprenorphine extended-release (brixadi)_ less than or equal to 7 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intra-arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79445","description":"Nuclear rx intra-arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF1","description":"ICD-DFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKA0","description":"ICD-FFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA1","description":"ICD-NGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us nuchal meas add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76814","description":"Ob us nuchal meas add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRB0","description":"ICD-DHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFB1","description":"ICD-BDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUA0","description":"ICD-JBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVC1","description":"ICD-ODVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGB1","description":"ICD-ODGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC0","description":"ICD-KFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inversion/eversion correction device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9285","description":"Inversion/eversion correction device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reas no perf foot exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9502","description":"Med reas no perf foot exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHA1","description":"ICD-BHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYE0","description":"ICD-DAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23146","description":"Removal of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAC1","description":"ICD-BDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63251","description":"Anesth removal of nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB1","description":"ICD-CFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVE1","description":"ICD-NEVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCLC1","description":"ICD-BCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ rimabotulinumtoxinb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0587","description":"Inj_ rimabotulinumtoxinb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open biopsy of lung pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32098","description":"Open biopsy of lung pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUE1","description":"ICD-NHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8A","description":"High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2540","description":"Thigh/wght bear lacer molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular stim for shock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0745","description":"Neuromuscular stim for shock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD1","description":"ICD-FCBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA11","description":"ICD-2KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE11B","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLE0","description":"ICD-NDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUF1","description":"ICD-BFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF0","description":"ICD-ODDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6082","description":"Implant Supported Crown - Porcelain Fused To Predominatly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYC1","description":"ICD-LEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hbv assess&results intrp 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3517F","description":"Hbv assess&results intrp 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33300","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78708","description":"K flow/funct image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elect stim wound care not pd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0282","description":"Elect stim wound care not pd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE0","description":"ICD-OLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIID0","description":"ICD-IIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC14","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart image (pet) single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78491","description":"Heart image (pet) single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Normal saline solution infus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7030","description":"Normal saline solution infus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWE1","description":"ICD-KBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC156","description":"Clinically Complex _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Offset knee joint each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2390","description":"Offset knee joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bezlotoxumab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0565","description":"Injection_ bezlotoxumab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33250","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBE0","description":"ICD-FFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0520U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","description":"CPT-0520U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF1","description":"ICD-PERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD1","description":"ICD-JDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARD1","description":"ICD-DARD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYA1","description":"ICD-LIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex for speech device rx addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92608","description":"Ex for speech device rx addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD0","description":"ICD-CAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD0","description":"ICD-OHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA0","description":"ICD-MBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKF0","description":"ICD-OAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0532T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; implantable monitor only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAID1","description":"ICD-GAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cur funct asses; no care pln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8543","description":"Cur funct asses; no care pln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRE1","description":"ICD-GFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE1","description":"ICD-OFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrig cone/cath w brs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4399","description":"Ostomy irrig cone/cath w brs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3761","description":"Elbow orthosis (EO)_ with adjustable position locking joint(s)_ prefabricated_ off-the-shelf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repos car modulj tranvns elt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0415T","description":"Repos car modulj tranvns elt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBE0","description":"ICD-AIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44151","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of troponin quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84484","description":"Assay of troponin quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28E","description":"Special Care High _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE1","description":"ICD-GGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0263U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 16 central carbon metabolites (ie_a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ succinat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of wrist capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25085","description":"Incision of wrist capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFF0","description":"ICD-NFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB1","description":"ICD-NFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVD1","description":"ICD-FDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB214","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYD0","description":"ICD-CBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATF1","description":"ICD-KATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42507","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVC0","description":"ICD-OJVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66150","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","description":"CPT-01936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUB0","description":"ICD-AEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFC1","description":"ICD-JIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTA1","description":"ICD-MDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOF0","description":"ICD-PJOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXD0","description":"ICD-KIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2215","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL1C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flulaval vacc_ 3 yrs & >_ im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2036","description":"Flulaval vacc_ 3 yrs & >_ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38A","description":"Extensive Services _ ADL Index 2-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCME1","description":"ICD-JCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF0","description":"ICD-HIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQE0","description":"ICD-CBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psych hlth fac svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2013","description":"Psych hlth fac svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC0","description":"ICD-CCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA0","description":"ICD-KCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOC0","description":"ICD-KEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accession of brush biopsy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0486","description":"Accession of brush biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9071","description":"Injection_ cyclophosphamide_ (AuroMedics)_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYB0","description":"ICD-HFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAB1","description":"ICD-KHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEA1","description":"ICD-CDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB0","description":"ICD-CABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty rest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4212","description":"Gingivectomy/plasty rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op asst doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9615","description":"Pre-op asst doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEB0","description":"ICD-GGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQF1","description":"ICD-CHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Azathioprine oral 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7500","description":"Azathioprine oral 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ stranded_ c-131","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2642","description":"Brachytx_ stranded_ c-131","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5A","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2298","description":"Complex rehabilitative power wheelchair accessory_ power seat elevation system_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE0","description":"ICD-JGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC3B","description":"Ultra High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dyphylline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1180","description":"Dyphylline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pafolacianine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9603","description":"Injection_ pafolacianine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe outflare wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3390","description":"Shoe outflare wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clsd ostomy pouch w/o barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5052","description":"Clsd ostomy pouch w/o barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2072","description":"Medication Assisted Treatment_ Buprenorphine (Implant Insertion And Removal); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual An","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sebelipase alfa_ 1mg (Kanuma)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9478","description":"Injection_ sebelipase alfa_ 1mg (Kanuma)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deoxyribonuclease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86215","description":"Deoxyribonuclease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEE1","description":"ICD-CBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDF1","description":"ICD-KGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC0","description":"ICD-HEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFC0","description":"ICD-BHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD120","description":"Special Care Low _ ADL Index 11-14/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening performed and negative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9920","description":"Screening performed and negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Online e/m by phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99444","description":"Online e/m by phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA25B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corplex P_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4231","description":"Corplex P_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENB1","description":"ICD-NENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor two proteins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81508","description":"Ftl cgen abnor two proteins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere trifocal 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2300","description":"Lens sphere trifocal 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0605","description":"General Inpatient Care - A flat per diem rates before area wage adjustment for inpatient acute care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1218","description":"Patient has copd symptoms (e.g._ dyspnea_ cough/sputum_ wheezing)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQC0","description":"ICD-CIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conformity evaluation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5020","description":"Conformity evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEE1","description":"ICD-BAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCEF0","description":"ICD-BCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38531","description":"Biopsy or excision of lymph node(s); open_ inguinofemoral node(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF0","description":"ICD-NHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort iii w/ lefort i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21155","description":"Lefort iii w/ lefort i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF0","description":"ICD-EBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4D","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA1","description":"ICD-FDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGC0","description":"ICD-JHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect radius tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24152","description":"Resect radius tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair_ ped size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1037","description":"Transport chair_ ped size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt/redo neurostim 1 array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61885","description":"Insrt/redo neurostim 1 array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB1","description":"ICD-BCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75807","description":"Lymph vessel x-ray trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated hemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83036","description":"Glycosylated hemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16071","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16071","description":"CPT-16071","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXD0","description":"ICD-BBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect foot/toe tumor < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28046","description":"Resect foot/toe tumor < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHRD1","description":"ICD-GHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of leg artery clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34203","description":"Removal of leg artery clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd demo bundle-level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9014","description":"Esrd demo bundle-level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal stenosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30465","description":"Repair nasal stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photochemotherapy with uv-b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96910","description":"Photochemotherapy with uv-b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIED1","description":"ICD-GIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0068","description":"Professional services for the administration of antiinfective_ pain management_ chelation_ pulmonary hypertension_ and/or inotr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87449","description":"IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDF1","description":"ICD-FEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cros hearing aid dispens fee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5200","description":"Cros hearing aid dispens fee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo ia infuse each addl hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96423","description":"Chemo ia infuse each addl hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSE1","description":"ICD-LDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove bladder/create pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51596","description":"Remove bladder/create pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7558","description":"Catheter placement in coronary artery(s) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE212","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60545","description":"Explore adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory setting substance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9475","description":"Ambulatory setting substance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC0","description":"ICD-KINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB1","description":"ICD-NFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92273","description":"Electroretinography (ERG)_ with interpretation and report; full field (ie_ ffERG_ flash ERG_ Ganzfeld ERG)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE1","description":"ICD-GCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECC1","description":"ICD-NECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTC0","description":"ICD-NHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGE0","description":"ICD-NLGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phlebotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99195","description":"Phlebotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric wheelchair nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1229","description":"Pediatric wheelchair nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0201","description":"Covid-19 vaccine admin inside a patient_s home; reported only once per individual home per date of service when only covid-19 vaccine admin is performed at the patients home","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEF1","description":"ICD-OBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSE0","description":"ICD-DBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve_ inter limb comp dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4600","description":"Sleeve_ inter limb comp dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28E","description":"Special Care High _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF0","description":"ICD-BDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES205","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABE1","description":"ICD-BABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wilate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7183","description":"Wilate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6071","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97710","description":"","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9797","description":"Patient is not on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE0","description":"ICD-KDSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUC1","description":"ICD-GEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5947","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5947","description":"CDT-D5947","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove renal tube w/fluoro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50389","description":"Remove renal tube w/fluoro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72149","description":"MRI lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0882T","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration_ including lead placement and removal_ upper extremity_ minimum of 10 minut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0A","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHF1","description":"ICD-FHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGA1","description":"ICD-JAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNF1","description":"ICD-CBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELC0","description":"ICD-JELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB0","description":"ICD-IDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46705","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKD0","description":"ICD-FGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD0","description":"ICD-BFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSC1","description":"ICD-CFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED0","description":"ICD-FGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD1","description":"ICD-BDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2a/180","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0145","description":"Peg interferon alfa-2a/180","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRF0","description":"ICD-PKRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer administration set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7003","description":"Nebulizer administration set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB1","description":"ICD-AGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1 mic or T1a documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9704","description":"AJCC breast cancer stage I: T1 mic or T1a documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj pls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0409T","description":"Insj/rplc cardiac modulj pls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dimethyl sulfoxide 50% 50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1212","description":"Dimethyl sulfoxide 50% 50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8C","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTF0","description":"ICD-MCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDF1","description":"ICD-CHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/review interpret only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93272","description":"Ecg/review interpret only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD0","description":"ICD-KEPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26040","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMB1","description":"ICD-KDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0463","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","description":"HCPCS-J0463","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGB0","description":"ICD-BGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLA0","description":"ICD-CHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC224","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD1","description":"ICD-NGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC1","description":"ICD-CGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64597","description":"Insertion or replacement of percutaneous electrode array_ peripheral nerve_ with integrated neurostimulator_ including imaging guidance_ when performed; each additional electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-123 iobenguane","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9582","description":"Iodine i-123 iobenguane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTD1","description":"ICD-EFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFC0","description":"ICD-BFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE0","description":"ICD-ECBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBA1","description":"ICD-MDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF0","description":"ICD-KCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFB1","description":"ICD-NBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC1","description":"ICD-BEGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF1","description":"ICD-GGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/subs interv >30 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0397","description":"Alcohol/subs interv >30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJD0","description":"ICD-BIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVB1","description":"ICD-NEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA1","description":"ICD-MLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27403","description":"Repair of knee cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES33B","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKND1","description":"ICD-OKND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24102","description":"Remove elbow joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","description":"HCPCS-A2039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual ep acuity screen auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0333T","description":"Visual ep acuity screen auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAD0","description":"ICD-GGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAB0","description":"ICD-JHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEF0","description":"ICD-OGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motor speech goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9186","description":"Motor speech goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAA0","description":"ICD-OIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEE0","description":"ICD-GDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYC1","description":"ICD-PFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAE0","description":"ICD-NFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of stomach and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43825","description":"Fusion of stomach and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYC0","description":"ICD-OHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93622","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 1.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0601","description":"Repl batt silver oxide 1.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKE0","description":"ICD-BCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of collarbone joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23106","description":"Incision of collarbone joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE135","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not eligible ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8936","description":"Pt not eligible ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC0","description":"ICD-FHNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMF1","description":"ICD-MDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01634","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","description":"CPT-01634","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3A","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High activity knee frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5930","description":"High activity knee frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAA0","description":"ICD-OBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28192","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACC1","description":"ICD-MACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound filler dry form / gram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6262","description":"Wound filler dry form / gram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWC0","description":"ICD-LGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Approp diuretic tstng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4190F","description":"Approp diuretic tstng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2403","description":"Chloroprocaine hcl ophthalmic_ 3% gel_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF1","description":"ICD-OLSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose/normal saline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7042","description":"5% dextrose/normal saline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCB1","description":"ICD-NJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0681","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","description":"HCPCS-J0681","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA215","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma discharge plan presnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5250F","description":"Asthma discharge plan presnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5126","description":"Injection_ bevacizumab-maly_ biosimilar_ (alymsys)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOD0","description":"ICD-GHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain tumor w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62164","description":"Remove brain tumor w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD1","description":"ICD-DHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0528T","description":"Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values_ with analysis_ review_ and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray skull epidural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75872","description":"Vein x-ray skull epidural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES155","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us < 14 wks addl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76802","description":"Ob us < 14 wks addl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumizyme injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0221","description":"Lumizyme injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC0","description":"ICD-KGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glofitamab-gxbm_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9286","description":"Injection_ glofitamab-gxbm_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (qual)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83630","description":"Lactoferrin fecal (qual)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27048","description":"Exc hip/pelv tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of heart lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93505","description":"Biopsy of heart lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve stimulator for tx n&v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0765","description":"Nerve stimulator for tx n&v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFE0","description":"ICD-OHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSD0","description":"ICD-KCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFB1","description":"ICD-ODFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC220","description":"Clinically Complex _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCCF0","description":"ICD-BCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEB0","description":"ICD-JEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7509","description":"Methylprednisolone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8005","description":"HCPCS-C8005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-osseointegrated snd proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8692","description":"Non-osseointegrated snd proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMC0","description":"ICD-CFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1016","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve (Monarch external Trigeminal Nerve Stimulation (eTNS) System.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUE0","description":"ICD-MHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC1","description":"ICD-OCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLD1","description":"ICD-FBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDF1","description":"ICD-EEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD1","description":"ICD-FEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDB1","description":"ICD-FIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB1","description":"ICD-KEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBD0","description":"ICD-OJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCED1","description":"ICD-NCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee ext/flex w act res ctrl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1812","description":"Knee ext/flex w act res ctrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE1","description":"ICD-GEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACC0","description":"ICD-BACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74020","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palatal lift prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5955","description":"Palatal lift prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2160","description":"Patient Received At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After The Pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6075","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHC0","description":"ICD-AAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCD1","description":"ICD-NCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQC0","description":"ICD-KBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAF1","description":"ICD-CHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSF1","description":"ICD-OJSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC0","description":"ICD-MGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of zinc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84630","description":"Assay of zinc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEE1","description":"ICD-IFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA1","description":"ICD-PIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE0","description":"ICD-OFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0189T","description":"Remote real-time interactive video-conferenced critical care_ evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA0","description":"ICD-LCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph fundoplasty lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43327","description":"Esoph fundoplasty lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWD0","description":"ICD-DEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1003","description":"HCPCS-B1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBB0","description":"ICD-EEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLE1","description":"ICD-KHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0244","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strattice tm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4130","description":"Strattice tm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDC1","description":"ICD-MCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0669U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0669U","description":"CPT-0669U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCA1","description":"ICD-JCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYA1","description":"ICD-PGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1503","description":"HCPCS-A1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-27458","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","description":"CPT-27458","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8E","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IB21","description":"ICD-2IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMF1","description":"ICD-ACMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYC1","description":"ICD-KCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUA0","description":"ICD-OLUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYC0","description":"ICD-OKYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADC1","description":"ICD-JADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBD1","description":"ICD-EEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA00","description":"Default_ /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days_ or SNF notified untimely of MSP denial_ or SNF notified untimely of revocation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJC0","description":"ICD-GEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acid perfusion of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91030","description":"Acid perfusion of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYC1","description":"ICD-GGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Becaplermin gel 1%_ 0.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0157","description":"Becaplermin gel 1%_ 0.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj naloxone hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2310","description":"Inj naloxone hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diag bronchoscope/catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31643","description":"Diag bronchoscope/catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMA1","description":"ICD-IDMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test rbc protoporphyrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84203","description":"Test rbc protoporphyrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWC1","description":"ICD-KAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMB0","description":"ICD-MIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA53","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDE1","description":"ICD-AFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appl desensitizing resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9911","description":"Appl desensitizing resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB205","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEME1","description":"ICD-AEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE1","description":"ICD-DDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD1","description":"ICD-KFVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFF0","description":"ICD-GFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD1","description":"ICD-FDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGC1","description":"ICD-CBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27217","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 antibody testing of or","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3645","description":"Hiv-1 antibody testing of or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYE0","description":"ICD-LAYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diethylstilbestrol injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9165","description":"Diethylstilbestrol injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL23","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF0","description":"ICD-BBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES136","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPB1","description":"ICD-OCPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB0","description":"ICD-GDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57120","description":"Closure of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKE1","description":"ICD-GCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"12-24hr sealed lead acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0733","description":"12-24hr sealed lead acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD0","description":"ICD-NEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teprotumumab-trbw_10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9061","description":"Injection_ teprotumumab-trbw_10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"T-cell depletion of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38210","description":"T-cell depletion of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete cbc automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85027","description":"Complete cbc automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJUE1","description":"ICD-OJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLB0","description":"ICD-NFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rsa spine exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348T","description":"Rsa spine exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety counseling dem order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6102F","description":"Safety counseling dem order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fo pip dip jnt/sprng pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3925","description":"Fo pip dip jnt/sprng pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYB0","description":"ICD-KBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRD1","description":"ICD-DCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACB0","description":"ICD-FACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEB1","description":"ICD-CEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLB0","description":"ICD-MGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravasc us heart add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92979","description":"Intravasc us heart add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMD1","description":"ICD-MDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8A","description":"Very High Rehab _ ADL Index 0-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRE0","description":"ICD-DHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLA1","description":"ICD-JBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYF0","description":"ICD-DAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQF0","description":"ICD-CDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWA1","description":"ICD-CIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alglucosidase alfa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0220","description":"Alglucosidase alfa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYB1","description":"ICD-DCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj melphalan hydrochl 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9245","description":"Inj melphalan hydrochl 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHD1","description":"ICD-AEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB1","description":"ICD-CAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34490","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHE0","description":"ICD-IGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF1","description":"ICD-OFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB23B","description":"Clinically Complex _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pedicle soft tissue graft pr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4270","description":"Pedicle soft tissue graft pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGE0","description":"ICD-OJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENA0","description":"ICD-OENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF1","description":"ICD-CBOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1dose menig vac btwn 11 & 13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9414","description":"1dose menig vac btwn 11 & 13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLA0","description":"ICD-GDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13131","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDE0","description":"ICD-KFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUF1","description":"ICD-KAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE1","description":"ICD-IALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA0","description":"ICD-MHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25680","description":"Treat wrist fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC1","description":"ICD-JEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug admin & hemodynmic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93463","description":"Drug admin & hemodynmic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0101","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0101","description":"CDT-D0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB1","description":"ICD-GELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA1","description":"ICD-LBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF1","description":"ICD-FCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELB0","description":"ICD-NELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lactoferrin fecal (quant)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83631","description":"Lactoferrin fecal (quant)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients With Moderate Or Severe Mitral Stenosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0044","description":"Patients With Moderate Or Severe Mitral Stenosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDD0","description":"ICD-JFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA31","description":"ICD-2LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQB1","description":"ICD-HDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAB1","description":"ICD-GHAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist/forearm lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25116","description":"Remove wrist/forearm lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETE0","description":"ICD-NETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285T","description":"Periph field stimul analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxychloroquine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80220","description":"Hydroxychloroquine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXD1","description":"ICD-JGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRB1","description":"ICD-LBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy roof of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42100","description":"Biopsy roof of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavyduty walker no wheels","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0148","description":"Heavyduty walker no wheels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA1","description":"ICD-BILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJD0","description":"ICD-FGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Utility services waiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2035","description":"Utility services waiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB213","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD0","description":"ICD-NIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shigella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86771","description":"Shigella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0603","description":"HCPCS-B0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKB1","description":"ICD-CDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA105","description":"Reduced Physical Function _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total knee arthroplasty","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27447","description":"Total knee arthroplasty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKA1","description":"ICD-KCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bilat dil retinal exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3000","description":"Bilat dil retinal exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/submuc inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45335","description":"Sigmoidoscopy w/submuc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF1","description":"ICD-MJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 9 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP09","description":"Auto.test pane pricing code_ 9 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periton dialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0507F","description":"Periton dialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVF1","description":"ICD-FGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC1","description":"ICD-CFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTD1","description":"ICD-MDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBC0","description":"ICD-FHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC0","description":"ICD-OGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap w/omentopexy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49326","description":"Lap w/omentopexy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9139","description":"Injection_ Factor IX_ albumin fusion protein (recombinant)_ Idelvion_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB0","description":"ICD-KAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC0","description":"ICD-HDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCB1","description":"ICD-IFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig geno no antvir tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8458","description":"Pt inelig geno no antvir tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA254","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electro hearng aid test one","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92594","description":"Electro hearng aid test one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9170","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9170","description":"HCPCS-C9170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9244","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9244","description":"CDT-D9244","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lactic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83605","description":"Assay of lactic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26373","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNF1","description":"ICD-FHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9569","description":"Technetium tc-99m auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA0","description":"ICD-AAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eswl for gallstones","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9034","description":"Eswl for gallstones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUF1","description":"ICD-KDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9738","description":"Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA0","description":"ICD-EILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTE1","description":"ICD-JCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22854","description":"Insertion of intervertebral biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29550","description":"Strapping of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0167U","description":"Gonadotropin chorionic (hCG) immunoassay with direct optical observation blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUD0","description":"ICD-KEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87533","description":"Hhv-6 dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB260","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26605","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaporizer room type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0605","description":"Vaporizer room type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMA1","description":"ICD-MBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACB1","description":"ICD-KACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEB1","description":"ICD-CIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of breast open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19101","description":"Biopsy of breast open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB1","description":"ICD-JCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUD1","description":"ICD-KAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29895","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60270","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF0","description":"ICD-MGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYA1","description":"ICD-HIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHE0","description":"ICD-IEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd lesion ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43270","description":"Egd lesion ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXC1","description":"ICD-GDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFME1","description":"ICD-OFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blm gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81209","description":"Blm gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF0","description":"ICD-OJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPB0","description":"ICD-CGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibular rehab per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9476","description":"Vestibular rehab per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DESE0","description":"ICD-DESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Additive for enteral formula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4104","description":"Additive for enteral formula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC110","description":"Special Care High _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SanoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4319","description":"SanoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYB0","description":"ICD-OFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB1","description":"ICD-DGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRA0","description":"ICD-ODRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSE1","description":"ICD-KDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin fetal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85460","description":"Hemoglobin fetal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDA0","description":"ICD-ECDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDC0","description":"ICD-FEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD1","description":"ICD-OGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42500","description":"Repair salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQF0","description":"ICD-PBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42836","description":"Removal of adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE1","description":"ICD-BCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPE0","description":"ICD-FFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Campylobacter antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86625","description":"Campylobacter antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85420","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33031","description":"Partial removal of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJA1","description":"ICD-NJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFC0","description":"ICD-BEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB131","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low back disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63030","description":"Low back disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 8 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP08","description":"Auto.test pane pricing code_ 8 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD1","description":"ICD-AEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE1","description":"ICD-NGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX01","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF0","description":"ICD-JFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOE0","description":"ICD-OAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9307","description":"HCPCS-C9307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26685","description":"Treat hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINF1","description":"ICD-JINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADF0","description":"ICD-EADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLED1","description":"ICD-MLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/ureteral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50329","description":"Prep renal graft/ureteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA1","description":"ICD-OFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE1","description":"ICD-MBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC1","description":"ICD-LIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA246","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVE0","description":"ICD-GBVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD104","description":"Clinically Complex _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQA0","description":"ICD-PIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE1","description":"ICD-HARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB1","description":"ICD-AFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUA1","description":"ICD-FEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUC0","description":"ICD-OKUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68100","description":"Biopsy of eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2+ anti-hyprtnsv agents tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4145F","description":"2+ anti-hyprtnsv agents tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0654U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0654U","description":"CPT-0654U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC0","description":"ICD-OILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26130","description":"Remove wrist joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Outpatient_ ed_ or observation visits that result in an inpatient admission","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2176","description":"Outpatient_ ed_ or observation visits that result in an inpatient admission","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate oviduct(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58611","description":"Ligate oviduct(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUF1","description":"ICD-CBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF0","description":"ICD-FHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fix partial denture section","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9120","description":"Fix partial denture section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cryofibrinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82585","description":"Assay of cryofibrinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In111 capromab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9507","description":"In111 capromab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVC0","description":"ICD-GDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAE0","description":"ICD-JEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2315","description":"Lens lenticular trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDF0","description":"ICD-MFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-96041","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","description":"CPT-96041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pericard exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32661","description":"Thoracoscopy w/pericard exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC1","description":"ICD-OJSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27266","description":"Treat hip dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF1","description":"ICD-IFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKB1","description":"ICD-GIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB1","description":"ICD-BCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0302","description":"HCPCS-B0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37257","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","description":"CPT-37257","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Slp stdy unatnd w/anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95801","description":"Slp stdy unatnd w/anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVA1","description":"ICD-OEVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47135","description":"Transplantation of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAD1","description":"ICD-CHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC1","description":"ICD-GHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVC1","description":"ICD-NKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"B cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86355","description":"B cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWF1","description":"ICD-LDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 std seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0868","description":"Pwc gp 4 std seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol compressor adjust pr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0572","description":"Aerosol compressor adjust pr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health risk assessment test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99420","description":"Health risk assessment test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBB0","description":"ICD-EBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDC0","description":"ICD-NDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31577","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1077T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1077T","description":"CPT-1077T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUB1","description":"ICD-KIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYB1","description":"ICD-LFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEE1","description":"ICD-JEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonemergency transport taxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0100","description":"Nonemergency transport taxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2B","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKA0","description":"ICD-KGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA1","description":"ICD-NBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD1","description":"ICD-JGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE1","description":"ICD-NACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbital prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5915","description":"Orbital prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB1","description":"ICD-GHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDF0","description":"ICD-JFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of head of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23195","description":"Removal of head of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHD0","description":"ICD-ODHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCB1","description":"ICD-CHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD0","description":"ICD-FDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00926","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","description":"CPT-00926","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin pro/pos wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2608","description":"Skin pro/pos wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit nb care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99502","description":"Home visit nb care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33430","description":"Replacement of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intra-atrial pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93610","description":"Intra-atrial pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24077","description":"Resect arm/elbow tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILA1","description":"ICD-MILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERD1","description":"ICD-PERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood/lymph system procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38999","description":"Blood/lymph system procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPC0","description":"ICD-NHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28X","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB1","description":"ICD-JFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHA0","description":"ICD-MBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID0","description":"ICD-BDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEE0","description":"ICD-IDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA10","description":"Default_ /5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB1","description":"ICD-LAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA1","description":"ICD-JANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC0","description":"ICD-CGQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUE1","description":"ICD-BBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNE1","description":"ICD-NBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDC0","description":"ICD-NGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6722","description":"Crown resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLC0","description":"ICD-NFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE216","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERD1","description":"ICD-HERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC125","description":"Special Care High _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0406","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0406","description":"CDT-D0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA1","description":"ICD-EICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43118","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anabolic steroid 3 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80328","description":"Anabolic steroid 3 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB1","description":"ICD-PBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOA0","description":"ICD-LAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAF1","description":"ICD-MDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlorpromazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3230","description":"Chlorpromazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sympathectomy supfc palmar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64823","description":"Sympathectomy supfc palmar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB0","description":"ICD-OLGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDF1","description":"ICD-EFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL3D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCF1","description":"ICD-NKCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB45","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7202","description":"Injection_ factor IX_ albumin fusion protein_ (recombinant)_ Idelvion_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33965","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJA0","description":"ICD-JFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl/idrl lsn any lvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63290","description":"Bx/exc xdrl/idrl lsn any lvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ingest challenge addl 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95079","description":"Ingest challenge addl 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMC0","description":"ICD-BEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD256","description":"Clinically Complex _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDF0","description":"ICD-OFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA1","description":"ICD-CGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTE1","description":"ICD-EHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (ANI)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0802","description":"Injection_ corticotropin (ANI)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61450","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTD0","description":"ICD-GFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUF1","description":"ICD-KEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIC0","description":"ICD-MHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF0","description":"ICD-ECAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1207","description":"Number of patients screened for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAF0","description":"ICD-AAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYB1","description":"ICD-GCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCB1","description":"ICD-CBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYE1","description":"ICD-HIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4133F","description":"Antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVD1","description":"ICD-KDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE0","description":"ICD-JEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIC1","description":"ICD-BDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE0","description":"ICD-CCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster integrated whl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2222","description":"Solid caster integrated whl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB1","description":"ICD-OFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLME1","description":"ICD-OLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7212","description":"Factor viia (antihemophilic factor_ recombinant)-jncw (sevenfact)_ 1 microgram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF1","description":"ICD-LGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAD1","description":"ICD-CEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNE1","description":"ICD-CGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lngleg cylndr ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4035","description":"Cast sup lngleg cylndr ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQB1","description":"ICD-OCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA0","description":"ICD-CAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0546","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","description":"HCPCS-G0546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123U","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML41","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90712","description":"Poliovirus vaccine_ (any type(s)) (opv)_ live_ for oral use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJF0","description":"ICD-CGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQE1","description":"ICD-HEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit pain mgmt per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9325","description":"Hit pain mgmt per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERC0","description":"ICD-KERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBC0","description":"ICD-JGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory tst complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92588","description":"Evoked auditory tst complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eribulin mesylate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9179","description":"Eribulin mesylate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMD0","description":"ICD-GHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHA0","description":"ICD-GCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA1","description":"ICD-KACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1197","description":"Itch severity assessment score is reduced by 2 or more points from the initial (index) assessment score to the follow-up visit score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHD0","description":"ICD-JHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnio Wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4181","description":"Amnio Wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopic sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92614","description":"Laryngoscopic sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair with fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0163","description":"Commode chair with fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patten bottom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2370","description":"Patten bottom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEB0","description":"ICD-IBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLE0","description":"ICD-CBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25B","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQB0","description":"ICD-LAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISC0","description":"ICD-OISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA220","description":"Clinically Complex _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC0","description":"ICD-OCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCD0","description":"ICD-MFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA1","description":"ICD-MFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF0","description":"ICD-JHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKF1","description":"ICD-JIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE1","description":"ICD-OLNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE0","description":"ICD-CIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA145","description":"Clinically Complex _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc chronic addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92944","description":"Prq card revasc chronic addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIA0","description":"ICD-FGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ biva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0640U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0640U","description":"CPT-0640U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1462","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","description":"HCPCS-M1462","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB1","description":"ICD-OLCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDB1","description":"ICD-KCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF0","description":"ICD-FFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27685","description":"Revision of lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJB1","description":"ICD-GCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC101","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICAD1","description":"ICD-ICAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tcat mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33419","description":"Repair tcat mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMB0","description":"ICD-BCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE116","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE0","description":"ICD-GGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA34","description":"High Rehab _ ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC07","description":"Medium Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGC1","description":"ICD-CIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECA0","description":"ICD-OECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0295U","description":"Oncology (Breast Ductal Carcinoma In Situ)_ Protein Expression Profiling By Immunohistochemistry Of 7 Proteins (Cox2_ Foxa1_ Her2_ Ki-67_ P16_ Pr_ Siah2)_ With 4 Clinicopathol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQE0","description":"ICD-LDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81432","description":"Hereditary breast cancer-related disorders (eg_ hereditary breast cancer_ hereditary ovarian cancer_ hereditary endometrial cancer); genomic sequence analysis panel_ must incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20B","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE1","description":"ICD-NIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc cur funct assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8541","description":"No doc cur funct assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of transcortin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84449","description":"Assay of transcortin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTE0","description":"ICD-JDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPB0","description":"ICD-JAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD1","description":"ICD-FHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of orbit (transcranial approach); with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61332","description":"Exploration of orbit (transcranial approach); with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBB0","description":"ICD-KHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCF0","description":"ICD-ICCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYD1","description":"ICD-HCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTA1","description":"ICD-GGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hallus-valgus nt dyn pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3100","description":"Hallus-valgus nt dyn pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGF0","description":"ICD-JDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4339","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","description":"HCPCS-Q4339","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13A","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acellular derm matrix implt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15777","description":"Acellular derm matrix implt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD1","description":"ICD-CFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis via catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4054F","description":"Hemodialysis via catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0251U","description":"Hepcidin-25_ Enzyme-Linked Immunosorbent Assay (Elisa)_ Serum Or Plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJF1","description":"ICD-OHJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace part denture teeth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5640","description":"Replace part denture teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDE0","description":"ICD-OFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pho doc >1 cecal ldmk com ex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9612","description":"Pho doc >1 cecal ldmk com ex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINB1","description":"ICD-NINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2126","description":"Patients 66 Years Of Age Or Older And Had At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA0","description":"ICD-OKMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKA1","description":"ICD-OHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF0","description":"ICD-GGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTC0","description":"ICD-OLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGB0","description":"ICD-JHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R & l heart cath congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93533","description":"R & l heart cath congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11420","description":"Exc h-f-nk-sp b9+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0438U","description":"Drug metabolism (adverse drug reactions and drug response)_ buccal specimen_ gene-drug interactions_ variant analysis of 33 genes_ including deletion/duplication analysis of C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFD1","description":"ICD-BFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v auto rescreen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88148","description":"Cytopath c/v auto rescreen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENE1","description":"ICD-NENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given vte prophylx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4044F","description":"Doc order given vte prophylx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88299","description":"Cytogenetic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans elec jt stim dev sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0762","description":"Trans elec jt stim dev sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCC0","description":"ICD-MDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0428","description":"Bls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEB1","description":"ICD-ODEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD1","description":"ICD-OKYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair oviduct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58750","description":"Repair oviduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331U","description":"Oncology (hematolymphoid neoplasia)_ optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow_ report of clinically s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMF0","description":"ICD-IFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81105","description":"Human Platelet Antigen 1 genotyping (HPA-1)_ ITGB3 (integrin_ beta 3 [platelet glycoprotein IIIa]_ antigen CD61 [GPIIIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHD0","description":"ICD-OAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"20+ cc syringe only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4213","description":"20+ cc syringe only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBA1","description":"ICD-JEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRA1","description":"ICD-HCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye sockets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21261","description":"Revise eye sockets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYE1","description":"ICD-PCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sever cranial nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64771","description":"Sever cranial nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photopheresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36522","description":"Photopheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD0","description":"ICD-OHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266U","description":"Unexplained constitutional or other heritable disorders or syndromes_ tissue-specific gene expression by whole-transcriptome and next-generation sequencing_ blood_ formalin-fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15574","description":"Pedcle fh/ch/ch/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHE1","description":"ICD-GAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE1","description":"ICD-NDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPE1","description":"ICD-BEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRF0","description":"ICD-CBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0996T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","description":"CPT-0996T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4B","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spine fusion extra segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22634","description":"Spine fusion extra segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAA0","description":"ICD-BDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25545","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB0","description":"ICD-LCQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB0","description":"ICD-MBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC135","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Agalsidase beta injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0180","description":"Agalsidase beta injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFE0","description":"ICD-FAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8C","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate crtd sns w/pgrmg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0273T","description":"Interrogate crtd sns w/pgrmg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lovotibeglogene autotemcel_ per treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3394","description":"Injection_ lovotibeglogene autotemcel_ per treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUB1","description":"ICD-NGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBB0","description":"ICD-MIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64553","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD0","description":"ICD-FAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (Cuvitru)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1555","description":"Injection_ immune globulin (Cuvitru)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymph system imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78195","description":"Lymph system imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20962","description":"Other bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4206","description":"1 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spirom fev/fvc>/=70%/w/ocopd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3027F","description":"Spirom fev/fvc>/=70%/w/ocopd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSB1","description":"ICD-DDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1017","description":"Clinical decision support mechanism Health Help_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14C","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ reslizumab_ 1 mg (Cinqair)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9481","description":"Injection_ reslizumab_ 1 mg (Cinqair)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD1","description":"ICD-JDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLE1","description":"ICD-OCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL55","description":"High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUB1","description":"ICD-IHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Torsion mechanism knee/ankle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2861","description":"Torsion mechanism knee/ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIE0","description":"ICD-OHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINF1","description":"ICD-KINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43288","description":"Esophagectomy_ total or near total_ with thoracoscopic mobilization of the upper_ middle_ and lower mediastinal esophagus_ with separate laparoscopic proximal gastrectomy_ wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB1","description":"ICD-KEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3085F","description":"Suicide risk assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add mr guide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19288","description":"Perq dev breast add mr guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA0","description":"ICD-JIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat dislocation/fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23665","description":"Treat dislocation/fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC33","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUB1","description":"ICD-EEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19294","description":"Preparation of tumor cavity_ with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1215","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g._ patients with dementia or tracheostomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDC0","description":"ICD-KDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF1","description":"ICD-BHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQC1","description":"ICD-KAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sr89 strontium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9600","description":"Sr89 strontium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cancer stage docd metast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3301F","description":"Cancer stage docd metast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tl201 thallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9505","description":"Tl201 thallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89250","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCB1","description":"ICD-ECCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHD0","description":"ICD-MHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWD1","description":"ICD-KIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYB0","description":"ICD-PIYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX13","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0784T","description":"Insertion or replacement of percutaneous electrode array_ spinal_ with integrated neurostimulator_ including imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIMD0","description":"ICD-NIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMF0","description":"ICD-AAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64640","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray kidneys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75833","description":"Vein x-ray kidneys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex hd hosp bed > 600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0302","description":"Ex hd hosp bed > 600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens spher bifoc plano 4.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2200","description":"Lens spher bifoc plano 4.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB246","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of pancreas open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48100","description":"Biopsy of pancreas open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB1","description":"ICD-HERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDE0","description":"ICD-FIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRE0","description":"ICD-CGRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB0","description":"ICD-HEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation for wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9156","description":"Evaluation for wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6446","description":"Conform band s w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Swallow goal status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8997","description":"Swallow goal status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUC0","description":"ICD-JGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of toe fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28515","description":"Treatment of toe fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB126","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD0","description":"ICD-EBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heat lamp with stand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0205","description":"Heat lamp with stand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESA1","description":"ICD-PESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0644U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0644U","description":"CPT-0644U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-82234","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","description":"CPT-82234","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB245","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC1","description":"ICD-GHJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Athletic train eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97005","description":"Athletic train eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCB0","description":"ICD-OCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal pillows","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7033","description":"Replacement nasal pillows","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHC0","description":"ICD-NIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty control cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6660","description":"Heavy duty control cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE112","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA21","description":"ICD-2JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61314","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB0","description":"ICD-KHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDD1","description":"ICD-NJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB1","description":"ICD-JHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQA1","description":"ICD-GEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nepuitant 300 mg and palonosetron 0.5 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9978","description":"Nepuitant 300 mg and palonosetron 0.5 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHD1","description":"ICD-MDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0661","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","description":"HCPCS-G0661","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retinal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67208","description":"Treatment of retinal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDF1","description":"ICD-GEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years And Older With A Diagnosis Of Frailty","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2131","description":"Patients 81 Years And Older With A Diagnosis Of Frailty","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt immunity to hep b docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3216F","description":"Pt immunity to hep b docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCE1","description":"ICD-IGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2920","description":"Methylprednisolone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9685","description":"E & M Of Beneficiary_S Ac Change Cond Nsg Fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOD1","description":"ICD-OBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOD1","description":"ICD-OAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTE1","description":"ICD-OLTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505F","description":"Hemodialysis plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE140","description":"Special Care Low _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht arm ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4011","description":"Cast sup sht arm ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDF1","description":"ICD-OCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gluc monitor purchase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1030","description":"Gluc monitor purchase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA1","description":"ICD-FCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB0","description":"ICD-NGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29000","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; biopsy(ies)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38221","description":"Diagnostic bone marrow; biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pres antibiotic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8711","description":"Pres antibiotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00176","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","description":"CPT-00176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body crvcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63300","description":"Remove vert xdrl body crvcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBID1","description":"ICD-GBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JA31","description":"ICD-1JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJE0","description":"ICD-OIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9777","description":"Esophageal mucosal integrity testing by electrical impedance_ transoral (list separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIC1","description":"ICD-AAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVD0","description":"ICD-OAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFB1","description":"ICD-OHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA32","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1090","description":"Lumbar sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ dual_ rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1785","description":"Pmkr_ dual_ rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQA1","description":"ICD-GBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEA1","description":"ICD-FDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJD1","description":"ICD-NIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB0","description":"ICD-IATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE1","description":"ICD-JDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYE0","description":"ICD-CHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8X","description":"High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0146","description":"Principal illness navigation - peer support_ additional 30 minutes per calendar month (list separately in addition to g0140)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF0","description":"ICD-NDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso full corset","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0976","description":"Lso full corset","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 12-25 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87633","description":"Resp virus 12-25 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCC0","description":"ICD-OFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endoscopy performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3130F","description":"Upper gi endoscopy performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap gastric bypass/roux-en-y","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43644","description":"Lap gastric bypass/roux-en-y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy and biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45331","description":"Sigmoidoscopy and biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB110","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/ coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4561F","description":"Pt w/ coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr pck base combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0489","description":"Pwr pck base combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXB0","description":"ICD-ODXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSF0","description":"ICD-HHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ewhfo rigid w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3765","description":"Ewhfo rigid w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAE0","description":"ICD-EHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLB1","description":"ICD-CBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBA1","description":"ICD-KGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LA11","description":"ICD-2LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 in w/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6246","description":"Hydrogel drg >16<=48 in w/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVD1","description":"ICD-JAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"New lenses in pts old frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0595","description":"New lenses in pts old frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12A","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWE1","description":"ICD-PLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKE0","description":"ICD-NGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOA0","description":"ICD-CHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0664U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0664U","description":"CPT-0664U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67312","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26478","description":"Lengthening of hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0932T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","description":"CPT-0932T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo variable frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5714","description":"Knee-shin exo variable frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF0","description":"ICD-MDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE0","description":"ICD-OJOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBD0","description":"ICD-EIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABB0","description":"ICD-MABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIF1","description":"ICD-KGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCC1","description":"ICD-CBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert aqueous drain device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0253T","description":"Insert aqueous drain device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Holotranscobalamin_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0103T","description":"Holotranscobalamin_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAD1","description":"ICD-EAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC106","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4468","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak 4 bar link w/fric swing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5611","description":"Ak 4 bar link w/fric swing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUF0","description":"ICD-OKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated rbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85041","description":"Automated rbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABE0","description":"ICD-IABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9053","description":"Injection_ crizanlizumab-tmca_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct inverted nipple(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19355","description":"Correct inverted nipple(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD1","description":"ICD-KIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15999","description":"Removal of pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC1","description":"ICD-OJKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUE1","description":"ICD-FHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOC0","description":"ICD-OEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLD0","description":"ICD-ECLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Internal nerve revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64727","description":"Internal nerve revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculoplasty laser surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65855","description":"Trabeculoplasty laser surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATA0","description":"ICD-FATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGB0","description":"ICD-KGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB0","description":"ICD-JHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF0","description":"ICD-FDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42409","description":"Drainage of salivary cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGA1","description":"ICD-JDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1017T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","description":"CPT-1017T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVE1","description":"ICD-JIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00851","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","description":"CPT-00851","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33813","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTA0","description":"ICD-MHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33362","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC1","description":"ICD-BIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGE0","description":"ICD-NGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral talus autogrft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28446","description":"Osteochondral talus autogrft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ penile_ non-inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2622","description":"Prosthesis_ penile_ non-inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJB0","description":"ICD-NDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0405","description":"HCPCS-C0405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWD1","description":"ICD-DCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBA1","description":"ICD-CCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20D","description":"Clinically Complex _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTF0","description":"ICD-MHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADE0","description":"ICD-CADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE1","description":"ICD-CERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD1","description":"ICD-OIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYE0","description":"ICD-GGYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35005","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABF0","description":"ICD-OABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC0","description":"ICD-GCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tens two lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0720","description":"Tens two lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA1","description":"ICD-CELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth lumbar puncture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63551","description":"Anesth lumbar puncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAD1","description":"ICD-IAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE21C","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE0","description":"ICD-FBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMC0","description":"ICD-KDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Im admin 1st/only component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90460","description":"Im admin 1st/only component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap radical hyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58548","description":"Lap radical hyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18H","description":"Special Care High _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCC0","description":"ICD-EFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHC0","description":"ICD-KDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of burn scab initi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16035","description":"Incision of burn scab initi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50327","description":"Prep renal graft/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHB0","description":"ICD-KFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No hepc rna after med no rsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9211","description":"No hepc rna after med no rsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPB0","description":"ICD-NGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMA1","description":"ICD-CCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20C","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0659","description":"Drug test(s)_ definitive_ utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25400","description":"Repair radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNE0","description":"ICD-FFNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID1","description":"ICD-OJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temp fml iu valve-pmp rplcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0597T","description":"Temp fml iu valve-pmp rplcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEC0","description":"ICD-KGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFE0","description":"ICD-JGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA0","description":"ICD-PIYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIA0","description":"ICD-IIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86702","description":"Hiv-2 antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC0","description":"ICD-OJDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1821","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","description":"HCPCS-L1821","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEC0","description":"ICD-KDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2 contents liquid lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8121","description":"O2 contents liquid lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAME0","description":"ICD-CAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted molecular pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81479","description":"Unlisted molecular pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1933","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","description":"HCPCS-L1933","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJF0","description":"ICD-BGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65222","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE0","description":"ICD-NKAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay everolimus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80169","description":"Drug assay everolimus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIA0","description":"ICD-JGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB0","description":"ICD-BDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTD1","description":"ICD-KGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8F","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern block > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49587","description":"Rpr umbil hern block > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF0","description":"ICD-KDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJC0","description":"ICD-JFJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC46","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37283","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","description":"CPT-37283","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEA1","description":"ICD-CCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24115","description":"Remove/graft bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGTB1","description":"ICD-EGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC20A","description":"Special Care High _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES351","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMB1","description":"ICD-GDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC1","description":"ICD-FBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFIC1","description":"ICD-GFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinsert spinal fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22849","description":"Reinsert spinal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allergy/immunology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0060","description":"Allergy/immunology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEND1","description":"ICD-BEND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debridement & contouring","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6102","description":"Debridement & contouring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCB0","description":"ICD-FHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD1","description":"ICD-OCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYA1","description":"ICD-GCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC1","description":"ICD-HBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg ped fbrgls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4040","description":"Cast sup shrt leg ped fbrgls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB117","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0559","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","description":"HCPCS-G0559","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA0","description":"ICD-KEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYB1","description":"ICD-PHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulpal regeneration initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3355","description":"Pulpal regeneration initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46750","description":"Repair of anal sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9450","description":"Injection Fluocinolone Acetonide Intravitreal Implant_ 0.01mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain cavity fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61020","description":"Remove brain cavity fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","description":"HCPCS-M1435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70332","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDC1","description":"ICD-MDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/w resect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32667","description":"Thoracoscopy w/w resect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE260","description":"Special Care High _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Near ifr spectrsc of wounds","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0286T","description":"Near ifr spectrsc of wounds","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion up to 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96369","description":"Sc ther infusion up to 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"non - surgical sialolithotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7979","description":"non - surgical sialolithotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJC1","description":"ICD-CAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj mepivacaine hcl/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0670","description":"Inj mepivacaine hcl/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift for pt furn-electr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0628","description":"Seat lift for pt furn-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNA0","description":"ICD-JDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25907","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAC1","description":"ICD-KAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF1","description":"ICD-AELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC1","description":"ICD-PAQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67908","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB112","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Budesonide comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7634","description":"Budesonide comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUA1","description":"ICD-EGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTC0","description":"ICD-AHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-53865","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","description":"CPT-53865","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nebulizer w/ compressor & he","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0585","description":"Nebulizer w/ compressor & he","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrig drug delivery device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96523","description":"Irrig drug delivery device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOA0","description":"ICD-DDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBE1","description":"ICD-EGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kit gene targeted seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81272","description":"Kit gene targeted seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCB0","description":"ICD-EDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX40","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHC1","description":"ICD-BIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB43","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB1","description":"ICD-NBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPE1","description":"ICD-OBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56651","description":"Anesth cabg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXF1","description":"ICD-OIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCE0","description":"ICD-GFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1184","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g._ allergy_ intolerance_ infectious etiology_ pancrea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD0","description":"ICD-OAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF0","description":"ICD-DGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rib gusset (elastic) each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1280","description":"Rib gusset (elastic) each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gentamicin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80170","description":"Assay of gentamicin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB0","description":"ICD-JDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIE1","description":"ICD-FHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF1","description":"ICD-IEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creatine mb fraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82553","description":"Creatine mb fraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHE1","description":"ICD-GFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFA0","description":"ICD-FHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of forearm cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29075","description":"Application of forearm cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc rsn do qual life assm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9635","description":"No doc rsn do qual life assm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90593","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","description":"CPT-90593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21243","description":"Reconstruction of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue soft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7286","description":"Biopsy of oral tissue soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKF0","description":"ICD-BEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0407U","description":"Nephrology (diabetic chronic kidney disease [CKD])_ multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1)_ soluble tumor n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBC1","description":"ICD-JEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No trnsfr from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0582F","description":"No trnsfr from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acute hepatitis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80074","description":"Acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0456T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic seal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE0","description":"ICD-MBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICD0","description":"ICD-KICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE0","description":"ICD-EAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACB1","description":"ICD-BACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86328","description":"Immunoassay for infectious agent antibody(ies)_ qualitative or semi-quantitative_ single step method (eg. reagent strip); severe acute respiratory system coronavirus 2 (SARS C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARD0","description":"ICD-LARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0783T","description":"Transcutaneous auricular neurostimulation_ set-up_ calibration_ and patient education on use of equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE0","description":"ICD-DFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBC1","description":"ICD-KBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD1","description":"ICD-GGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTD1","description":"ICD-MFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus samplng 1/2 node","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31652","description":"Bronch ebus samplng 1/2 node","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"System reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9192","description":"System reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC0","description":"ICD-FFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family homecare training 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5110","description":"Family homecare training 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBC0","description":"ICD-JIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKB1","description":"ICD-OCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILC1","description":"ICD-OILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDC1","description":"ICD-EDDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64580","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC0","description":"ICD-OEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEB0","description":"ICD-GFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61559","description":"Excision of skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB0","description":"ICD-FBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWB1","description":"ICD-DAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUF1","description":"ICD-NLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA1","description":"ICD-OJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSD0","description":"ICD-PDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC0","description":"ICD-GDJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFA0","description":"ICD-NKFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB0","description":"ICD-JIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47741","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF0","description":"ICD-DCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA0","description":"ICD-DGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC1","description":"ICD-KAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lower extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93925","description":"Lower extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit20.1-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12046","description":"Intmd rpr n-hf/genit20.1-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rerepair fem hernia reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49555","description":"Rerepair fem hernia reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMF0","description":"ICD-AIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRD1","description":"ICD-LHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCB0","description":"ICD-CDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove colloid cyst w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62162","description":"Remove colloid cyst w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/insert drug implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11983","description":"Remove/insert drug implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24B","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32850","description":"Donor pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD0","description":"ICD-AHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRF1","description":"ICD-PIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9975","description":"Injection Factor V111 FC Fusion Protein (Recombinant) Per IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA23","description":"Low Rehab_ ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28545","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Financial management_ self-directed_ waiver; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2050","description":"Financial management_ self-directed_ waiver; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1901","description":"HCPCS-C1901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE0","description":"ICD-OINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE1","description":"ICD-PLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supported housing_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0043","description":"Supported housing_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 1 cc/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11950","description":"Tx contour defects 1 cc/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meprobamate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6052","description":"Meprobamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF0","description":"ICD-AFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA1","description":"ICD-BIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFF1","description":"ICD-OCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pasrr level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2010","description":"Pasrr level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78272","description":"Vitamin B-12 absorption studies combined_ with and without intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLF0","description":"ICD-FCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB1","description":"ICD-KCCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score neck/ts >=0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8671","description":"Fun stat score neck/ts >=0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYA0","description":"ICD-CFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINC1","description":"ICD-KINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFD0","description":"ICD-NAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA1","description":"ICD-MFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OATB0","description":"ICD-OATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dispens fee immunosupressive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0510","description":"Dispens fee immunosupressive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5878","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5878","description":"CDT-D5878","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCC0","description":"ICD-JFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE1","description":"ICD-KINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPD0","description":"ICD-NCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infrared therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97026","description":"Infrared therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND1","description":"ICD-BIND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTA0","description":"ICD-NHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQD1","description":"ICD-GEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD1","description":"ICD-GCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gr34 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2359","description":"Gr34 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML13","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"carePATCH_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4236","description":"carePATCH_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0801","description":"Injection_ corticotropin (Acthar Gel)_ up to 40 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us guide vascular access","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76937","description":"Us guide vascular access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVA1","description":"ICD-CDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Safety equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0700","description":"Safety equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC1","description":"ICD-FAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLB0","description":"ICD-CDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69631","description":"Repair eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMD0","description":"ICD-AIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWE0","description":"ICD-PEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC121","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJF1","description":"ICD-BFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERE0","description":"ICD-PERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ria nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83519","description":"Ria nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin pneum swg frc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5822","description":"Endo knee-shin pneum swg frc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF1","description":"ICD-CAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPE0","description":"ICD-ODPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood type antigen donor ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86902","description":"Blood type antigen donor ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE0","description":"ICD-ICBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0480T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2_ or each additional 1% of body surface area of infants a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket hip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5702","description":"Replace socket hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMF1","description":"ICD-NBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA1","description":"ICD-DERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resp suction oral interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7047","description":"Resp suction oral interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0D","description":"Low Rehab_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF1","description":"ICD-MLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVF1","description":"ICD-GFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRB1","description":"ICD-ODRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD1","description":"ICD-OKDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0289U","description":"Neurology (Alzheimer Disease)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 24 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colectomy w/ileoanal anast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44157","description":"Colectomy w/ileoanal anast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE0","description":"ICD-NCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJF0","description":"ICD-NAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADB1","description":"ICD-BADB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC1","description":"ICD-BBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supplemental electrical test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92547","description":"Supplemental electrical test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB0","description":"ICD-GDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETF1","description":"ICD-FETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mogamulizumab-kpkc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9204","description":"Injection_ mogamulizumab-kpkc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLB0","description":"ICD-IGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00640","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","description":"CPT-00640","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDC1","description":"ICD-BGDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25D","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1073T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1073T","description":"CPT-1073T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTA0","description":"ICD-KHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC210","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDA0","description":"ICD-NGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paclitaxel injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9267","description":"Paclitaxel injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAGC0","description":"ICD-FAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE0","description":"ICD-DHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB1","description":"ICD-FFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB120","description":"Special Care Low _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX5A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHB1","description":"ICD-FDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAF1","description":"ICD-NAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLE0","description":"ICD-JHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biovance tri-layer or biovance 3l_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4283","description":"Biovance tri-layer or biovance 3l_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0007U","description":"Drug test(s)_ presumptive_ with definitive confirmation of positive results_ any number of drug classes_ urine_ includes specimen verification including DNA authentication in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLA1","description":"ICD-MBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA0","description":"ICD-OLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALE0","description":"ICD-MALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52332","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIF0","description":"ICD-ODIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); binding antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86041","description":"Acetylcholine receptor (AChR); binding antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD1","description":"ICD-FHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFA1","description":"ICD-OLFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65135","description":"Insert ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42844","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit complex cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5501","description":"Hit complex cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC0","description":"ICD-MDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFID1","description":"ICD-KFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF0","description":"ICD-GEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81535","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb thxpy rxd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8473","description":"Ace/arb thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj lumbar plexus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64449","description":"N block inj lumbar plexus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB1","description":"ICD-NGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise kneecap with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27438","description":"Revise kneecap with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE224","description":"Special Care High _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cyp2c19 gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81225","description":"Cyp2c19 gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_ ha_ i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2634","description":"Brachytx_ non-str_ ha_ i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg <1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56151","description":"Anesth heart surg <1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18F","description":"Special Care High _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental panoramic film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0330","description":"Dental panoramic film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital outpt clinic visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0463","description":"Hospital outpt clinic visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction maxilla total","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7946","description":"Reconstruction maxilla total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLE1","description":"ICD-JGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLD0","description":"ICD-CGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy/needle bx each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31629","description":"Bronchoscopy/needle bx each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTD1","description":"ICD-CGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28I","description":"Special Care High _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37270","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","description":"CPT-37270","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0998T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","description":"CPT-0998T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGF0","description":"ICD-NAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lenticular lens_ single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2121","description":"Lenticular lens_ single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair wide w/ leg rests","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1092","description":"Wheelchair wide w/ leg rests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flutamide 125 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0175","description":"Flutamide 125 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF0","description":"ICD-KFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC32","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interleukin-6 (Il-6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83529","description":"Interleukin-6 (Il-6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc funct and care plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8539","description":"Doc funct and care plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA2B","description":"Ultra High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5172","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5172","description":"HCPCS-Q5172","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked/cnsld aed effects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6070F","description":"Pt asked/cnsld aed effects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB241","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm device progr eval dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93280","description":"Pm device progr eval dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61705","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapy exercise joint rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4018F","description":"Therapy exercise joint rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF1","description":"ICD-IDUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contour back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2293","description":"Contour back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEB0","description":"ICD-OCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt pulse gen w/singl lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33240","description":"Insrt pulse gen w/singl lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4243","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4243","description":"HCPCS-Q4243","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA1","description":"ICD-JEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abd paracentesis w/imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49083","description":"Abd paracentesis w/imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYA0","description":"ICD-KDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD1","description":"ICD-EDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTB1","description":"ICD-NKTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0548U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","description":"CPT-0548U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52647","description":"Laser surgery of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE235","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWF0","description":"ICD-HEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPB1","description":"ICD-OHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE131","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain cavity shunt w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62201","description":"Brain cavity shunt w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1628","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGE1","description":"ICD-GAGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA0","description":"ICD-FCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45110","description":"Removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHF0","description":"ICD-CGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0183","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","description":"HCPCS-G0183","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14C","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUC1","description":"ICD-JEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEC0","description":"ICD-KBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0876T","description":"Duplex scan of hemodialysis fistula_ computer-aided_ limited (volume flow_ diameter_ and depth_ including only body of fistula)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB1","description":"ICD-CGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD216","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBNB1","description":"ICD-CBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture of specimen by kit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87084","description":"Culture of specimen by kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33315","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBF1","description":"ICD-AFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEE1","description":"ICD-GEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52224","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1818","description":"HCPCS-J1818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC111","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA0","description":"ICD-JAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD0","description":"ICD-KHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin w/noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6252","description":"Bridge resin w/noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophth us b w/non-quant a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76512","description":"Ophth us b w/non-quant a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83528","description":"Assay of intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKE1","description":"ICD-KIKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93985","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB3C","description":"Very High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22846","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE0","description":"ICD-IIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Warming card for nwt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0232","description":"Warming card for nwt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27513","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab post/core + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2954","description":"Prefab post/core + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE210","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD1","description":"ICD-BATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEAB0","description":"ICD-OEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD1","description":"ICD-IEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHF0","description":"ICD-OEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Darbepoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0881","description":"Darbepoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE1","description":"ICD-JHXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sc r pos/lat pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0649","description":"Lso sc r pos/lat pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB22","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity high","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3472F","description":"Ra disease activity high","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIE0","description":"ICD-NIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHB1","description":"ICD-JBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB0B","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC1","description":"ICD-PFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF1","description":"ICD-AFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methotrexate (Xatmep)_ oral_ 2.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8612","description":"Methotrexate (Xatmep)_ oral_ 2.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ischm stroke symp lt3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1065F","description":"Ischm stroke symp lt3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA11","description":"ICD-2IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB0","description":"ICD-FHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8599","description":"No asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMF1","description":"ICD-GAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88237","description":"Tissue culture bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC1","description":"ICD-DFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder joint surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23101","description":"Shoulder joint surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD124","description":"Clinically Complex _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc initial","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3351","description":"Apexification/recalc initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place breast cath for rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19297","description":"Place breast cath for rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7667","description":"Metaproterenol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99205","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTF0","description":"ICD-OCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXE1","description":"ICD-GAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumoc vac/admin/rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4040F","description":"Pneumoc vac/admin/rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi-vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9153","description":"Multi-vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathologists/dermatopathologists providing a second opinion on a biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9784","description":"Pathologists/dermatopathologists providing a second opinion on a biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLC0","description":"ICD-FCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIF0","description":"ICD-NAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPD0","description":"ICD-KGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0250U","description":"Oncology (Solid Organ Neoplasm)_ Targeted Genomic Sequence Dna Analysis Of 505 Genes_ Interrogation For Somatic Alterations (Snvs [Single Nucleotide Variant]_ Small Insertions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUB0","description":"ICD-ODUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKA1","description":"ICD-NAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA0","description":"ICD-NDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65810","description":"Drainage of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDTB&VINCULIN IGG ANTB IA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0176U","description":"CDTB&VINCULIN IGG ANTB IA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHED1","description":"ICD-IHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAA1","description":"ICD-KAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEF1","description":"ICD-JAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15016","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","description":"CPT-15016","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD256","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31259","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)_ including sphenoidotomy_ with removal of tissue from the sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF0","description":"ICD-IGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUC1","description":"ICD-JFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lat thorax spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22532","description":"Lat thorax spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA05","description":"Default_ /SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTE1","description":"ICD-GFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hair removal by electrolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17380","description":"Hair removal by electrolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score ue not done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8670","description":"Fun stat score ue not done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35180","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent placemt retro carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37217","description":"Stent placemt retro carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSF0","description":"ICD-CFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebond/cement/repair retain","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8693","description":"Rebond/cement/repair retain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF1","description":"ICD-GFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0962T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","description":"CPT-0962T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0753T","description":"Digitization of glass microscope slides for level IV_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0659U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0659U","description":"CPT-0659U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITE0","description":"ICD-OITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVE0","description":"ICD-NCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49618","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE1","description":"ICD-FHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of fibula fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27781","description":"Treatment of fibula fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHD1","description":"ICD-AAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQE1","description":"ICD-PBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIE0","description":"ICD-MBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIC0","description":"ICD-EBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME1","description":"ICD-GHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDB0","description":"ICD-JGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41017","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA1","description":"ICD-JCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther behav svc_ per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2019","description":"Ther behav svc_ per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLD1","description":"ICD-OHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35475","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1013T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","description":"CPT-1013T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBE0","description":"ICD-FHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALC0","description":"ICD-KALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2211","description":"Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum 5 cm or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49203","description":"Exc abd tum 5 cm or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat scor nek/ts not don","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8674","description":"Fun stat scor nek/ts not don","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFD1","description":"ICD-KCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC1","description":"ICD-KGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQA1","description":"ICD-CBQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tens suppl 2 lead per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4595","description":"Tens suppl 2 lead per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGA0","description":"ICD-CDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF0","description":"ICD-OITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc surveillance for disease","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9052","description":"Onc surveillance for disease","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDA0","description":"ICD-JFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth intrcrn nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22051","description":"Anesth intrcrn nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXD0","description":"ICD-JBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB43","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fosphenytoin inj pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2009","description":"Fosphenytoin inj pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD1","description":"ICD-MAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert eye socket implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67550","description":"Insert eye socket implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377U","description":"Cardiovascular disease_ quantification of advanced serum or plasma lipoprotein profile_ by nuclear magnetic resonance (NMR) spectrometry with report of a lipoprotein profile (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTB1","description":"ICD-KBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ margetuximab-cmkb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9353","description":"Injection_ margetuximab-cmkb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIE1","description":"ICD-FBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infiltration of sustained release therapeutic drug - single or multiple sites","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9613","description":"Infiltration of sustained release therapeutic drug - single or multiple sites","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB4B","description":"High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8C","description":"Very High Rehab _ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9172","description":"Injection_ docetaxel (ingenus) not therapeutically equivalent to j9171_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLD0","description":"ICD-EDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD155","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1112","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amines vaginal fluid qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82120","description":"Amines vaginal fluid qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72158","description":"MRI lumbar spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immediate breast prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19340","description":"Immediate breast prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plate pheres leukoredu irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9037","description":"Plate pheres leukoredu irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRB1","description":"ICD-LFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch for bar w lk fl/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4423","description":"Ost pch for bar w lk fl/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE1","description":"ICD-IACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ferumoxytol_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0138","description":"Ferumoxytol_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABD0","description":"ICD-NABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64809","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01965","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","description":"CPT-01965","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF1","description":"ICD-BHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE1","description":"ICD-BFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Restrata_ Per Square Centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2007","description":"Restrata_ Per Square Centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABD1","description":"ICD-KABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC0","description":"ICD-NJHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERD1","description":"ICD-LERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWF0","description":"ICD-CDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fmr1 gene detection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81243","description":"Fmr1 gene detection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB0","description":"ICD-CEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA0B","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWF0","description":"ICD-PLWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27520","description":"Treat kneecap fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPC1","description":"ICD-FBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOB1","description":"ICD-OIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp fem-ant-post tib/prl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35666","description":"Art byp fem-ant-post tib/prl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA0","description":"ICD-HHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE0","description":"ICD-BEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0207","description":"Traumatic brain injury with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33770","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF1","description":"ICD-KCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBB0","description":"ICD-NHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plastic Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4027","description":"Plastic Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDC0","description":"ICD-JIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37145","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUA1","description":"ICD-OIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe sole wedge outside sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3360","description":"Shoe sole wedge outside sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTA0","description":"ICD-OFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF1","description":"ICD-JFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41010","description":"Incision of tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF1","description":"ICD-JBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17272","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft achilles tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27652","description":"Repair/graft achilles tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma stent/stud/bttn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7524","description":"Tracheostoma stent/stud/bttn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnio tri-core amniotic_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4295","description":"Amnio tri-core amniotic_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ fresh or frozen tissue or cells_ report of specific gene rearra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXF0","description":"ICD-NCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGE0","description":"ICD-JFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJA1","description":"ICD-OJJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75982","description":"Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB1","description":"ICD-LBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWD1","description":"ICD-GCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24360","description":"Reconstruct elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithymocyte globuln rabbit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7511","description":"Antithymocyte globuln rabbit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0543U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","description":"CPT-0543U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWB0","description":"ICD-LAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fludarabine phosphate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9185","description":"Fludarabine phosphate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKA0","description":"ICD-GIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF1","description":"ICD-GIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB0","description":"ICD-JGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFD1","description":"ICD-KFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Salmonella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86768","description":"Salmonella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2204","description":"Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1303","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1303","description":"CDT-D1303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA0","description":"ICD-AIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERC0","description":"ICD-GERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCB1","description":"ICD-GHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIB1","description":"ICD-IFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISF0","description":"ICD-OISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALD1","description":"ICD-BALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Separate eyelid adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68340","description":"Separate eyelid adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWE1","description":"ICD-PGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBB0","description":"ICD-MEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPE1","description":"ICD-NFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELD1","description":"ICD-JELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA0","description":"ICD-OAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXE0","description":"ICD-OEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC0","description":"ICD-GACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE0","description":"ICD-NCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX44","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tetracyclin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0120","description":"Tetracyclin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non cutaneous loc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9295","description":"Non cutaneous loc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWC1","description":"ICD-LBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB121","description":"Special Care Low _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy excisional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20245","description":"Bone biopsy excisional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIME0","description":"ICD-GIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF0","description":"ICD-EBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMB0","description":"ICD-BDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWD0","description":"ICD-LBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42210","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMA0","description":"ICD-FIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNC0","description":"ICD-NJNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNF0","description":"ICD-GCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87492","description":"Chylmd trach dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dist revas ligation hemo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36838","description":"Dist revas ligation hemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0155U","description":"Oncology (breast cancer)_ DNA_ PIK3CA (phosphatidylinositol-4_5-bisphosphate 3-kinase_ catalytic subunit alpha) (eg_ breast cancer) gene analysis (ie_ p.C420R_ p.E542K_ p.E545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTC0","description":"ICD-FFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE25B","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0429T","description":"Rmvl nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCD1","description":"ICD-GGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICF0","description":"ICD-CICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Puncture/clear windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31612","description":"Puncture/clear windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5115","description":"Injection_ rituximab-abbs_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dementia mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8761","description":"Dementia mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKA0","description":"ICD-KIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1495","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","description":"HCPCS-M1495","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","description":"HCPCS-L6028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWE1","description":"ICD-DIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81514","description":"Infectious Disease_ Bacterial Vaginosis And Vaginitis_ Quantitative Real-Time Amplification Of Dna Markers For Gardnerella Vaginalis_ Atopobium Vaginae_ Megasphaera Type 1_ Ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF0","description":"ICD-MCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0478T","description":"Recording of fetal magnetic cardiac signal using at least 3 channels; review_ interpretation_ report by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50727","description":"Revise ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQC1","description":"ICD-OHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1282","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTA1","description":"ICD-JGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOA1","description":"ICD-OFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB0","description":"ICD-HAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE1","description":"ICD-MFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANB1","description":"ICD-JANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC53","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC216","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0018","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies_ other t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9834","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCB1","description":"ICD-AFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73503","description":"X-ray exam hip uni 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So hard plas stabili pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3677","description":"So hard plas stabili pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE0","description":"ICD-JBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos clin depres scrn f/u doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8431","description":"Pos clin depres scrn f/u doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syme typ expandabl wall sckt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5630","description":"Syme typ expandabl wall sckt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42300","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spirom doc rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3023F","description":"Spirom doc rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJD0","description":"ICD-NHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYE0","description":"ICD-DEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUA1","description":"ICD-GGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGA0","description":"ICD-CGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDE0","description":"ICD-MBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCA1","description":"ICD-CCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUC0","description":"ICD-MGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB0","description":"ICD-GBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF0","description":"ICD-AADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD106","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE0","description":"ICD-HFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE146","description":"Special Care High _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA112","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCME0","description":"ICD-BCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen system liquid portabl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0435","description":"Oxygen system liquid portabl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB1","description":"ICD-FGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead wires_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4557","description":"Lead wires_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analyze sp inf pump w/reprog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62368","description":"Analyze sp inf pump w/reprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13A","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro gastrointestinal tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44500","description":"Intro gastrointestinal tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bia whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358T","description":"Bia whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise vag graft via vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57295","description":"Revise vag graft via vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNE1","description":"ICD-CFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33476","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQF0","description":"ICD-PGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE1","description":"ICD-KIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"3 cc sterile syringe&needle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4208","description":"3 cc sterile syringe&needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit alpha-1-proteinas diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9346","description":"Hit alpha-1-proteinas diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSC1","description":"ICD-LBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRA1","description":"ICD-GBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVF0","description":"ICD-BAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUE0","description":"ICD-KCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87494","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","description":"CPT-87494","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF1","description":"ICD-FCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDD1","description":"ICD-JCDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBB0","description":"ICD-BDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2596","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","description":"HCPCS-J2596","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE251","description":"Special Care Low _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL20","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYA1","description":"ICD-PIYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj iris prosth sec io lens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0618T","description":"Insj iris prosth sec io lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD1","description":"ICD-GEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA0","description":"ICD-BBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCC1","description":"ICD-CGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43652","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE0","description":"ICD-EFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLD0","description":"ICD-FHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0486U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","description":"CPT-0486U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTF0","description":"ICD-KBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/diag concurrent inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96368","description":"Ther/diag concurrent inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC1","description":"ICD-KHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF0","description":"ICD-BILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0483T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach_ including transseptal puncture_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx done w/colposcopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58110","description":"Bx done w/colposcopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE1","description":"ICD-BEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB1","description":"ICD-NFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB251","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93355","description":"Echocardiography_ transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg_TAVR_ transcatheter pulmonary valve repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIC0","description":"ICD-OBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANA0","description":"ICD-OANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMD1","description":"ICD-CHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC1","description":"ICD-CHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGED1","description":"ICD-KGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXB0","description":"ICD-GHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF0","description":"ICD-EHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFD1","description":"ICD-NLFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 2","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1782","description":"vaccine administration-human papillomavirus - Dose 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB201","description":"Reduced Physical Function _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWA1","description":"ICD-OGWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99243","description":"Office consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYC1","description":"ICD-CEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDC1","description":"ICD-GEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ dual mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2367","description":"Battery charger_ dual mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81443","description":"Genetic testing for severe inherited conditions (eg_ cystic fibrosis_ Ashkenazi Jewish-associated disorders [eg_ Bloom syndrome_ Canavan disease_ Fanconi anemia type C_ mucoli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEE1","description":"ICD-BIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch forearm each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0111","description":"Crutch forearm each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDB1","description":"ICD-BDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB1","description":"ICD-JBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5242","description":"Hearing aid_ monaural_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF0","description":"ICD-FACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC0","description":"ICD-BEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29355","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMC1","description":"ICD-OLMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2782","description":"Crown 3/4 cast noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total electr w/ mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0265","description":"Hosp bed total electr w/ mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB1","description":"ICD-OEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE231","description":"Special Care High _ ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD1","description":"ICD-OBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACA1","description":"ICD-OACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HISTOPLASM CAPSULATUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87385","description":"IAAD IA HISTOPLASM CAPSULATUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE1","description":"ICD-FGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWF0","description":"ICD-DIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIC0","description":"ICD-KDIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA1","description":"ICD-HDWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85732","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stoma plug or seal_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5081","description":"Stoma plug or seal_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound exam aaa screen","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0389","description":"Ultrasound exam aaa screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attempted vbac after care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59622","description":"Attempted vbac after care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370U","description":"Infectious agent detection by nucleic acid (DNA and RNA)_ surgical wound pathogens_ 34 microorganisms and identification of 21 associated antibiotic-resistance genes_ multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJE0","description":"ICD-KFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUA1","description":"ICD-BIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BA11","description":"ICD-4BA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF1","description":"ICD-JCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC1","description":"ICD-GBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27137","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apnea monitor w recorder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0619","description":"Apnea monitor w recorder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC1","description":"ICD-CINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC0","description":"ICD-ABDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBC0","description":"ICD-AHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQF0","description":"ICD-CAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD1","description":"ICD-KEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPB1","description":"ICD-FFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ptnotrcvngsteroid>/=10mg/day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3750F","description":"Ptnotrcvngsteroid>/=10mg/day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0547U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","description":"CPT-0547U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopha dx beta amyloid pet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9599","description":"Radiopha dx beta amyloid pet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAND0","description":"ICD-GAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD1","description":"ICD-CBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE1","description":"ICD-OJSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWC1","description":"ICD-PGWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cesarean delivery only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59514","description":"Cesarean delivery only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA255","description":"Clinically Complex _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUA0","description":"ICD-JCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefoperazone sod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0021","description":"Injection_ cefoperazone sod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLF0","description":"ICD-OCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBB1","description":"ICD-CGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF0","description":"ICD-OKOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB11","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA0","description":"ICD-OITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB20C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66505","description":"Incision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26852","description":"Fusion of knuckle with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHF1","description":"ICD-GEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC141","description":"Special Care Low _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB1","description":"ICD-MLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQF0","description":"ICD-GEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUA1","description":"ICD-BBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair urethrovaginal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57311","description":"Repair urethrovaginal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4415","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","description":"HCPCS-Q4415","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC1","description":"ICD-NEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD1","description":"ICD-GABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admit w/in 180d req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9412","description":"Admit w/in 180d req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NEURO INH ATAXIA DNA 51 GENE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0217U","description":"NEURO INH ATAXIA DNA 51 GENE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53452","description":"PERIURETHRAL TRANSPERINEAL ADJUSTABLE BALLOON CONTINENCE DEVICE; UNILATERAL INSERTION_ INCLUDING CYSTOURETHROSCOPY AND IMAGING GUIDANCE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8701","description":"Powered upper extremity range of motion assist device_ elbow_ wrist_ hand with single or double upright(s)_ includes microproce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0525F","description":"Initial visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB0","description":"ICD-CCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB1","description":"ICD-BHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLD1","description":"ICD-JGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE0","description":"ICD-BIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sock fracture or equal each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3995","description":"Sock fracture or equal each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALB0","description":"ICD-NALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93976","description":"Vascular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB1","description":"ICD-HASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging mult","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78103","description":"Bone marrow imaging mult","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home Delivered Meals-Frozen Entree","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1760","description":"Home Delivered Meals-Frozen Entree","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hib prp-omp vacc 3 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90647","description":"Hib prp-omp vacc 3 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD1","description":"ICD-CDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSD0","description":"ICD-KBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngography_ contrast_ radiological supervision and interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70373","description":"Laryngography_ contrast_ radiological supervision and interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD114","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIE0","description":"ICD-OIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE0","description":"ICD-JBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JA31","description":"ICD-2JA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXB1","description":"ICD-BEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3A","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2147","description":"Leg Pain Measured By The Visual Analog Scale (Vas) At One Year (9 To 15 Months) Postoperatively Was Greater Than 3.0 And Leg Pain Measured By The Visual Analog Scale (Vas) Wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77074","description":"X-rays bone survey limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA11","description":"ICD-2CA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF1","description":"ICD-NLHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long qt synd gene full seq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81280","description":"Long qt synd gene full seq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCC0","description":"ICD-IGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval for deep sed/gen anesth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9219","description":"Eval for deep sed/gen anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGNA1","description":"ICD-GGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain outer ear canal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69020","description":"Drain outer ear canal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF0","description":"ICD-KBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1083T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1083T","description":"CPT-1083T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBID0","description":"ICD-JBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVD0","description":"ICD-BCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE1","description":"ICD-KICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFE1","description":"ICD-FEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aflibercept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0178","description":"Aflibercept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVF0","description":"ICD-KDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deionizer h2o puri system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1615","description":"Deionizer h2o puri system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIE0","description":"ICD-CAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9973","description":"Epoetin beta_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HA21","description":"ICD-4HA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIE0","description":"ICD-CIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE0","description":"ICD-KGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPB0","description":"ICD-NJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVA1","description":"ICD-KHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUF0","description":"ICD-MIUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJA1","description":"ICD-KAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0927T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","description":"CPT-0927T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOA0","description":"ICD-LBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIE0","description":"ICD-IBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Desoxycorticosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82633","description":"Desoxycorticosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22868","description":"Insertion of interlaminar/interspinous process stabilization/distraction device_ without fusion_ including image guidance when performed_ with open decompression_ lumbar; seco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC0","description":"ICD-JGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE1","description":"ICD-NKVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE136","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADC0","description":"ICD-EADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJA1","description":"ICD-KHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACA0","description":"ICD-CACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam knee 4 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73564","description":"X-ray exam knee 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYB0","description":"ICD-CCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stimulation pacing heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93623","description":"Stimulation pacing heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ copanlisib_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9057","description":"Injection_ copanlisib_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exsufflation belt_ includes all supplies and accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1021","description":"Exsufflation belt_ includes all supplies and accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-27713","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","description":"CPT-27713","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental retainr cast metl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6545","description":"Dental retainr cast metl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transthor diaphrag hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43335","description":"Transthor diaphrag hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Circum 28 days or older","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54161","description":"Circum 28 days or older","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programmable infusion pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0783","description":"Programmable infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB1","description":"ICD-FDMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC0","description":"ICD-NBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99416","description":"Prolong clincl staff svc add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7521","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography with right heart catheterization with endo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXB1","description":"ICD-GEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"App topical fluoride varnish","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99188","description":"App topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEF1","description":"ICD-GCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBC0","description":"ICD-EEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand deformity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26580","description":"Repair hand deformity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB0","description":"ICD-OKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBB0","description":"ICD-NIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA1","description":"ICD-CARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11446","description":"Exc face-mm b9+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0018","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD1","description":"ICD-BGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYF1","description":"ICD-OKYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29819","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5B","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt pulse gen sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4638","description":"Repl batt pulse gen sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Panoramic x-ray of jaws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70355","description":"Panoramic x-ray of jaws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cltx thigh fx w/mnpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27268","description":"Cltx thigh fx w/mnpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHE0","description":"ICD-ODHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF1","description":"ICD-GCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of ankle ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27695","description":"Repair of ankle ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGE1","description":"ICD-OCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brow nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64732","description":"Incision of brow nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEE1","description":"ICD-OHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRB1","description":"ICD-KCRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD0","description":"ICD-JFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tonsils","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42826","description":"Removal of tonsils","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy l/s facet jnt addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64636","description":"Destroy l/s facet jnt addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive hormone patch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7304","description":"Contraceptive hormone patch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0881T","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system_ including placement of an oral device_ monitoring of patient tolerance to treatment_ and remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85018","description":"Hemoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD0","description":"ICD-KHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37226","description":"Fem/popl revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for future fall risk_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1070","description":"Patient not screened for future fall risk_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ inotuzumab ozogamicin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9028","description":"Injection_ inotuzumab ozogamicin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33363","description":"Replace aortic valve open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDC1","description":"ICD-ABDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stool cultr aerobic bact ea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87046","description":"Stool cultr aerobic bact ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUB1","description":"ICD-MHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJE1","description":"ICD-NIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ occlusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2628","description":"Catheter_ occlusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWB0","description":"ICD-PIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEC1","description":"ICD-OEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75451","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imaging coil_ mr_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1770","description":"Imaging coil_ mr_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Porcine implant_ permacol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9364","description":"Porcine implant_ permacol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEB0","description":"ICD-GHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmnioBand_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4168","description":"AmnioBand_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEC0","description":"ICD-MJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt has resp insufficiency","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1504F","description":"Pt has resp insufficiency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB0","description":"ICD-GARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phys exam for college","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0622","description":"Phys exam for college","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGE1","description":"ICD-CHGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA1","description":"ICD-MLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0959T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","description":"CPT-0959T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEC1","description":"ICD-NFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC1","description":"ICD-FELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC1","description":"ICD-KDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRC0","description":"ICD-HHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0102","description":"HCPCS-A0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD0","description":"ICD-KGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44314","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB1","description":"ICD-JBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE124","description":"Special Care Low _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9149","description":"Medical home level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61315","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet image full body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78813","description":"Pet image full body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA0","description":"ICD-IHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACE0","description":"ICD-NACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hbot_ full body chamber_ 30m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0277","description":"Hbot_ full body chamber_ 30m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE1","description":"ICD-GGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQA1","description":"ICD-LFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"General Surgery Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4007","description":"General Surgery Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81344","description":"TBP (TATA box binding protein) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES154","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face-mm b9+marg 2.1-3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11443","description":"Exc face-mm b9+marg 2.1-3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIA0","description":"ICD-ADIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syst antimicrobial thx rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4131F","description":"Syst antimicrobial thx rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Storage/year oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89346","description":"Storage/year oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA1","description":"ICD-AHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57265","description":"Combined anteroposterior colporrhaphy_ including cystourethroscopy_ when performed; with enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE0","description":"ICD-BHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9141","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD0","description":"ICD-PLQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxillofacial fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21100","description":"Maxillofacial fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tone decay hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92563","description":"Tone decay hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOD0","description":"ICD-OKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of histamine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83088","description":"Assay of histamine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVE0","description":"ICD-NLVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF0","description":"ICD-KHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal topography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92025","description":"Corneal topography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMB1","description":"ICD-GGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD1","description":"ICD-GEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGWA0","description":"ICD-PGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYD0","description":"ICD-PAYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9348","description":"CT scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUA0","description":"ICD-IIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of eyelid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21282","description":"Revision of eyelid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISE1","description":"ICD-GISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWD1","description":"ICD-GFWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA0","description":"ICD-MLBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMF0","description":"ICD-GIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXB1","description":"ICD-OBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1202","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period_ (e.g._ patient declined_ other patient reasons)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQB1","description":"ICD-HAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE0","description":"ICD-GIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVA1","description":"ICD-FCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD1","description":"ICD-HBWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLC1","description":"ICD-MCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce clavicle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23490","description":"Reinforce clavicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0527T","description":"Insertion or replacement of intracardiac ischemia monitoring system_ including testing of the lead and monitor_ initial system programming_ and imaging supervision and interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF0","description":"ICD-HBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6197","description":"replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis_ per implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPE1","description":"ICD-GHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMD1","description":"ICD-KHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVD0","description":"ICD-JCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc with wrong event","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8912","description":"Pt doc with wrong event","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF1","description":"ICD-JGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD230","description":"Special Care High _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXB1","description":"ICD-GDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99403","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemostats for dialysis_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1637","description":"Hemostats for dialysis_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11B","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC0","description":"ICD-GGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDF1","description":"ICD-IBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQF1","description":"ICD-KHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBJA1","description":"ICD-GBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTA0","description":"ICD-FFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTF0","description":"ICD-AFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA11","description":"ICD-1LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPB1","description":"ICD-OGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDF1","description":"ICD-FIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBF1","description":"ICD-EIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEC1","description":"ICD-FEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7546","description":"Removal and replacement of externally accessible nephroureteral catheter (eg_ external/internal stent) requiring fluoroscopic guidance_ with ureteral stricture balloon dilatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00560","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","description":"CPT-00560","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert ant segment drain int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0191T","description":"Insert ant segment drain int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLB1","description":"ICD-AFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA1","description":"ICD-NBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/prop/diag inj/inf proc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96379","description":"Ther/prop/diag inj/inf proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular imp_ aqueous drain de","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1783","description":"Ocular imp_ aqueous drain de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPB0","description":"ICD-KHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB0","description":"ICD-OLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOD0","description":"ICD-OIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAB0","description":"ICD-JCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB120","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE0","description":"ICD-AGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXE0","description":"ICD-CHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEE0","description":"ICD-NIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove elbow joint implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24160","description":"Remove elbow joint implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJD1","description":"ICD-OGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA8I","description":"Medium Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKB0","description":"ICD-OJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conz of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57461","description":"Conz of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01392","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","description":"CPT-01392","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch support remov prem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3030","description":"Foot arch support remov prem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00104","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","description":"CPT-00104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81305","description":"MYD88 (myeloid differentiation primary response 88) (eg_ Waldenstrom_s macroglobulinemia_ lymphoplasmacytic leukemia) gene analysis_ p.Leu265Pro (L265P) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSA1","description":"ICD-KCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8X","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUB0","description":"ICD-IEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA1","description":"ICD-OELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD117","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8H","description":"High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQC1","description":"ICD-OFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJA0","description":"ICD-OHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 3 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34843","description":"Endovasc visc aorta 3 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Structured Day Habilitation Group 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0105","description":"Structured Day Habilitation Group 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA1","description":"ICD-AEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVD1","description":"ICD-BEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0631T","description":"Transcutaneous Visible Light Hyperspectral Imaging Measurement Of Oxyhemoglobin_ Deoxyhemoglobin_ And Tissue Oxygenation_ With Interpretation And Report_ Per Extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF1","description":"ICD-NFXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sternal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1050","description":"Sternal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVE1","description":"ICD-JDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No record of HBV results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9915","description":"No record of HBV results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB1","description":"ICD-FIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radium/radioisotope therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77799","description":"Radium/radioisotope therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0022U","description":"Targeted genomic sequence analysis panel_ cholangiocarcinoma and non-small cell lung neoplasia_ DNA and RNA analysis_ 1-23 genes_ interrogation for sequence variants and rearr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXB1","description":"ICD-OJXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Omeza Collagen Matrix_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2014","description":"Omeza Collagen Matrix_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tract frame attach footboard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0870","description":"Tract frame attach footboard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTA1","description":"ICD-MBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNC0","description":"ICD-KDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rozanolixizumab-noli_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9333","description":"Injection_ rozanolixizumab-noli_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTC0","description":"ICD-KGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLA1","description":"ICD-ADLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61889","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver_ including craniectomy or craniotomy_ when performed_ with direct or inductive coupling_ with co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Ramucirumab_ 5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9025","description":"Injection_ Ramucirumab_ 5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays at surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74301","description":"X-rays at surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA8I","description":"Very High Rehab _ ADL Index 0-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acoustic immitance testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92570","description":"Acoustic immitance testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHC1","description":"ICD-EDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Annual gynecological examina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0612","description":"Annual gynecological examina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3D","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing facility care init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99305","description":"Nursing facility care init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGA0","description":"ICD-JCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUE0","description":"ICD-JDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB0","description":"ICD-GDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF1","description":"ICD-OEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOA1","description":"ICD-CGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vutrisiran_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0225","description":"Injection_ vutrisiran_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIB0","description":"ICD-KGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAF0","description":"ICD-BHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJB1","description":"ICD-KBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA0","description":"ICD-NBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA0","description":"ICD-KDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWC1","description":"ICD-CAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bitolterol mesylate comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7628","description":"Bitolterol mesylate comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDD0","description":"ICD-OKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/a/gen/trk20.1-30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12006","description":"Rpr s/n/a/gen/trk20.1-30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87483","description":"Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg_ Neisseria meningitidis_ Streptococcus pneumoniae_ Listeria_ Haemophilus influenza","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elective surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9643","description":"Elective surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJE1","description":"ICD-GCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21627","description":"Sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD0","description":"ICD-HDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Saquinavir_ 200 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0140","description":"Saquinavir_ 200 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gamma globulin > 10 cc inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1560","description":"Gamma globulin > 10 cc inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat pelvic ring fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27218","description":"Treat pelvic ring fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQB0","description":"ICD-LGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVA0","description":"ICD-GCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKC1","description":"ICD-BCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45116","description":"Partial removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43762","description":"Replacement of gastrostomy tube_ percutaneous_ includes removal_ when performed_ without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0166U","description":"Liver disease_ 10 biochemical assays (a2-macroglobulin_ haptoglobin_ apolipoprotein A1_ bilirubin_ GGT_ ALT_ AST_ triglycerides_ cholesterol_ fasting glucose) and biometric an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB31","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Completed epsdt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0302","description":"Completed epsdt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPD0","description":"ICD-GHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA1","description":"ICD-PIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXC1","description":"ICD-FHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYB1","description":"ICD-LEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES106","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITC0","description":"ICD-BITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDA0","description":"ICD-KDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4345","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","description":"HCPCS-Q4345","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML03","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDVE0","description":"ICD-KDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5263","description":"Hearing aid_ disp_ binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALB0","description":"ICD-KALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHC0","description":"ICD-EBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33276","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s])_ including vessel catheterization_ all imaging guidance_ and pulse generator initial ana","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brst cncr stage > t1n0m0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8881","description":"Brst cncr stage > t1n0m0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC41","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHB1","description":"ICD-OAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB1","description":"ICD-CDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB0","description":"ICD-BFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28X","description":"Special Care High _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDD0","description":"ICD-OGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6036","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","description":"HCPCS-L6036","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual pump enema_ reusable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4459","description":"Manual pump enema_ reusable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44144","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain canal shunt procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61070","description":"Brain canal shunt procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chylmd trach dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87491","description":"Chylmd trach dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64600","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHC0","description":"ICD-GHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMF0","description":"ICD-OFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEC0","description":"ICD-FGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive management and care coordination for advanced illness_ per calendar month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0311","description":"Comprehensive management and care coordination for advanced illness_ per calendar month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBC0","description":"ICD-ABBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99282","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hip socket fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27222","description":"Treat hip socket fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine ost pch bar w lock fln","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4433","description":"Urine ost pch bar w lock fln","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYC0","description":"ICD-KIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJME0","description":"ICD-OJME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEC1","description":"ICD-BEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronary artery correction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33502","description":"Coronary artery correction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD0","description":"ICD-FHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA0","description":"ICD-NAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endocrinology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4004","description":"Endocrinology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEF1","description":"ICD-OKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF0","description":"ICD-GDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","description":"CPT-93145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abduction bar-straight","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2310","description":"Abduction bar-straight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sperm duct surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92251","description":"Anesth sperm duct surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virus inoculate tissue addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87253","description":"Virus inoculate tissue addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tens four lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0730","description":"Tens four lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHID0","description":"ICD-OHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAC0","description":"ICD-NIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psa screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0103","description":"Psa screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYE1","description":"ICD-PBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthening of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27393","description":"Lengthening of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81362","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKD1","description":"ICD-KBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEB0","description":"ICD-MGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNF0","description":"ICD-GFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBB0","description":"ICD-OFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC0","description":"ICD-GGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rigid wheeled walker adj/fix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0141","description":"Rigid wheeled walker adj/fix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWD0","description":"ICD-GAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2058","description":"Chronic Care Management Services_ Each Additional 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional_ Per Calendar Month (Li","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGB0","description":"ICD-CDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome karyotype study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88280","description":"Chromosome karyotype study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGF1","description":"ICD-BHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgigraft-dual_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4219","description":"Surgigraft-dual_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC0","description":"ICD-CFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCD0","description":"ICD-IGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNF1","description":"ICD-JGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB11C","description":"Special Care Low _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIE0","description":"ICD-FGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBA1","description":"ICD-CHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38530","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12041","description":"Intmd rpr n-hf/genit 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA0","description":"ICD-IAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME1","description":"ICD-FIME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37251","description":"Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vessel (list separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF0","description":"ICD-IGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX32","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical testimony","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99075","description":"Medical testimony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6024","description":"Collagen dsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAF1","description":"ICD-KGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE1","description":"ICD-EHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dorsi & plantar flex ass/res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2220","description":"Dorsi & plantar flex ass/res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast supplies (plaster)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4580","description":"Cast supplies (plaster)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9488","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC0","description":"ICD-KEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen handling office-lab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99000","description":"Specimen handling office-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40510","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD1","description":"ICD-OCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo doub solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1990","description":"Afo doub solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgmdsc w/band ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45350","description":"Sgmdsc w/band ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB1","description":"ICD-IACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB20C","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE1","description":"ICD-OJQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCE0","description":"ICD-AHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirate/inj ganglion cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20612","description":"Aspirate/inj ganglion cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGE1","description":"ICD-KGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHED1","description":"ICD-FHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUD1","description":"ICD-JFUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Podiatry Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4028","description":"Podiatry Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ciliary endoscopic ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66711","description":"Ciliary endoscopic ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21451","description":"Anesth skull drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAD1","description":"ICD-JEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6100","description":"Removal of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD22B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB21","description":"ICD-2GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQE0","description":"ICD-KGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aed garment w elec analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0606","description":"Aed garment w elec analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKF0","description":"ICD-BIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24930","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAF1","description":"ICD-CFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE1","description":"ICD-ADHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA0","description":"ICD-AAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXF0","description":"ICD-NJXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC1","description":"ICD-OFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlh uterus 250 g or less","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58570","description":"Tlh uterus 250 g or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc dx unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9067","description":"Onc dx nsclc dx unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBA1","description":"ICD-NKBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXE1","description":"ICD-FGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB0","description":"ICD-JBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental prophylaxis child","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1120","description":"Dental prophylaxis child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression wrap with adjustable straps_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6584","description":"Gradient compression wrap with adjustable straps_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No 1dose meni vac btwn 11&13","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9415","description":"No 1dose meni vac btwn 11&13","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA1","description":"ICD-FAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagosc flex trnsn biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43198","description":"Esophagosc flex trnsn biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMD0","description":"ICD-AFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atropine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7635","description":"Atropine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC13D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB1","description":"ICD-ABTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAC1","description":"ICD-CEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0470T","description":"Optical coherence tomography (OCT) for microstructural and morphological imaging of skin_ image acquisition_ interpretation_ and report; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE215","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUF1","description":"ICD-GIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97165","description":"Occupational therapy evaluation_ low complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes a brief history including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA55","description":"Low Rehab_ ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE1","description":"ICD-KDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not performing a dilated macular examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9976","description":"Documentation of patient reason(s) for not performing a dilated macular examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g ch add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15278","description":"Skn sub grft f/n/hf/g ch add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXE1","description":"ICD-GEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plastic mold recipro hip & c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2627","description":"Plastic mold recipro hip & c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOD1","description":"ICD-PAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGE0","description":"ICD-ODGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5112","description":"Injection_ trastuzumab-dttb_ biosimilar_ (Ontruzant)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0082U","description":"Rx tst def 09+ rx/sbsts ur reprt pres/abs ea rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML5A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX26","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2168","description":"Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBB1","description":"ICD-EDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg thorac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22212","description":"Incis 1 vertebral seg thorac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Refill/maint pump/resvr syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96522","description":"Refill/maint pump/resvr syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB1","description":"ICD-OBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOB1","description":"ICD-LBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC1","description":"ICD-BFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVE1","description":"ICD-BBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31075","description":"Exploration of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9716","description":"BMI is documented as being outside of normal limits_ follow-up plan is not completed for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthoptic training; under supervision of a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92066","description":"Orthoptic training; under supervision of a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHID1","description":"ICD-IHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIC0","description":"ICD-MFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA1","description":"ICD-GGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD1","description":"ICD-FECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct scan for localization","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77011","description":"Ct scan for localization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE0","description":"ICD-AHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical reason for no beta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9190","description":"Medical reason for no beta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFC0","description":"ICD-NFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABC1","description":"ICD-FABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9812","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9812","description":"HCPCS-C9812","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAA1","description":"ICD-KGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE1","description":"ICD-CIFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA31","description":"ICD-3IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BCG live intravesical instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9030","description":"BCG live intravesical instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELB1","description":"ICD-EELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMD1","description":"ICD-FFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34704","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEC0","description":"ICD-IHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp&up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51729","description":"Cystometrogram w/vp&up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78830","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I&d abscess extraoral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7520","description":"I&d abscess extraoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9276","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","description":"HCPCS-J9276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt w cath maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9240","description":"Doc pt w cath maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF0","description":"ICD-CCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC0","description":"ICD-AGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mohs addl stage t/a/l","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17314","description":"Mohs addl stage t/a/l","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDD1","description":"ICD-BDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMB1","description":"ICD-KEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD226","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Butorphanol tartrate 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0595","description":"Butorphanol tartrate 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTD1","description":"ICD-MKTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33935","description":"Transplantation heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHD0","description":"ICD-JIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHBD0","description":"ICD-MHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSD1","description":"ICD-CGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth tympanotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12651","description":"Anesth tympanotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB0","description":"ICD-KIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cftr gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81221","description":"Cftr gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA0","description":"ICD-NFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB31","description":"ICD-4IB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body pos current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8981","description":"Body pos current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC0","description":"ICD-BABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cvr hip disart","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5707","description":"Custom shape cvr hip disart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF0","description":"ICD-BFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment within 120 days of the index assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1363","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esano aca_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4275","description":"Esano aca_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC0","description":"ICD-MICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF1","description":"ICD-HHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2398","description":"Wheelchair Accessory_ Dynamic Positioning Hardware For Back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD0","description":"ICD-ADTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of corticosteroids 17","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83491","description":"Assay of corticosteroids 17","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2080","description":"Each Additional 30 Minutes Of Counseling In A Week Of Medication Assisted Treatment_ (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20910","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11100","description":"Biopsy of skin_ subcutaneous tissue and/or mucous membrane (including simple closure)_ unless otherwise listed; single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKE0","description":"ICD-JGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE1","description":"ICD-HGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOD0","description":"ICD-GFOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prostate prob score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0010M","description":"Onc prostate prob score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPE0","description":"ICD-OKPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC1","description":"ICD-FDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLF0","description":"ICD-GGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28H","description":"Clinically Complex _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICA1","description":"ICD-MICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4596","description":"Cranial electrotherapy stimulation (CES) system supplies and accessories_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo plastic molded w/ankle j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1970","description":"Afo plastic molded w/ankle j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHA0","description":"ICD-KBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCB1","description":"ICD-GBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJE1","description":"ICD-BAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Somatropin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2941","description":"Somatropin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33737","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGA1","description":"ICD-CIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27704","description":"Removal of ankle implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNC1","description":"ICD-JGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anal pressure record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91122","description":"Anal pressure record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neonate crit care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99469","description":"Neonate crit care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63277","description":"Bx/exc xdrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27618","description":"Exc leg/ankle tum < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAED1","description":"ICD-EAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE0","description":"ICD-OFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25443","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF0","description":"ICD-KDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTE0","description":"ICD-NLTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc >1 sinus ct w 90d dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9351","description":"Doc >1 sinus ct w 90d dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FB21","description":"ICD-4FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHC1","description":"ICD-JAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWC1","description":"ICD-OBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15951","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of bile ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47700","description":"Exploration of bile ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA226","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62321","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYB1","description":"ICD-HEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA1","description":"ICD-BCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36223","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVD0","description":"ICD-KFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/ed teleconsult70","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0427","description":"Inpt/ed teleconsult70","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of pelvis brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20662","description":"Application of pelvis brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA04","description":"Default_ /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chorionic gonadotropin/1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0725","description":"Chorionic gonadotropin/1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC1","description":"ICD-OFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65114","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA216","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No sent lymph node biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8882","description":"No sent lymph node biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB240","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00921","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","description":"CPT-00921","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWA1","description":"ICD-KIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp comm supp svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2016","description":"Comp comm supp svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61518","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVE0","description":"ICD-OJVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGC0","description":"ICD-NLGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEE0","description":"ICD-FDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze>16 <= 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6403","description":"Sterile gauze>16 <= 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of semen fructose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82757","description":"Assay of semen fructose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73110","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath indw foley 3 way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4346","description":"Cath indw foley 3 way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNA0","description":"ICD-NLNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFC0","description":"ICD-NKFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBA1","description":"ICD-GCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl girdle milwaukee orth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4000","description":"Repl girdle milwaukee orth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD1","description":"ICD-MDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJB0","description":"ICD-BBJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC1","description":"ICD-JHPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC1","description":"ICD-CHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDB1","description":"ICD-NGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCD0","description":"ICD-OFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBF0","description":"ICD-JHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28430","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37276","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","description":"CPT-37276","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJND0","description":"ICD-OJND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIME0","description":"ICD-KIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD0","description":"ICD-ODDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDD0","description":"ICD-BGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD0","description":"ICD-HGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Free assay (ft-3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84481","description":"Free assay (ft-3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOC1","description":"ICD-GCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCD0","description":"ICD-EHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artacent wound_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4169","description":"Artacent wound_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supply kit homemi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4222","description":"Parenteral supply kit homemi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVC1","description":"ICD-OHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETB0","description":"ICD-GETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMC0","description":"ICD-AHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2526","description":"Contact lens_ hydrophilic_ with blue-violet filter_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEB0","description":"ICD-MIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydration status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2018F","description":"Hydration status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14C","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nafcillin sodium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0032","description":"Injection_ nafcillin sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Standard control cable extra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6655","description":"Standard control cable extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEA1","description":"ICD-FIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB0","description":"ICD-HBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMB0","description":"ICD-CDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX21","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2047","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2047","description":"HCPCS-A2047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01130","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","description":"CPT-01130","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWE0","description":"ICD-HGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHC0","description":"ICD-FCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optx thigh fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27269","description":"Optx thigh fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXE0","description":"ICD-BDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYE0","description":"ICD-OIYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE1","description":"ICD-CASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx cast molded to pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2108","description":"Afo tib fx cast molded to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANB1","description":"ICD-GANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy nerve of eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67345","description":"Destroy nerve of eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr face/mm 12.6-20 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12055","description":"Intmd rpr face/mm 12.6-20 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23A","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay c-d transfer measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82373","description":"Assay c-d transfer measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFME1","description":"ICD-JFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALB0","description":"ICD-GALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDF1","description":"ICD-GGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA1","description":"ICD-EDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No reason for no hep c geno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9208","description":"No reason for no hep c geno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNA0","description":"ICD-OJNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBE0","description":"ICD-OEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20102","description":"Explore wound abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF1","description":"ICD-AFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open bone biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20251","description":"Open bone biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4042","description":"Cast sup lng leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQD1","description":"ICD-PGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHK1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9791","description":"Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent_ chest_ including preparation andadministration of agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB54","description":"Very High Rehab _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36217","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"H2o stat docd normal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2030F","description":"H2o stat docd normal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDB1","description":"ICD-KGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBHA1","description":"ICD-NBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICDB1","description":"ICD-ICDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF1","description":"ICD-AIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA21","description":"Medium Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation digit complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20822","description":"Replantation digit complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJC1","description":"ICD-BFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESB0","description":"ICD-LESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R hrt coronary artery angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93456","description":"R hrt coronary artery angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27380","description":"Repair of kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGC0","description":"ICD-KGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eld mal scrn pos no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8735","description":"Eld mal scrn pos no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSF0","description":"ICD-GHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPC1","description":"ICD-JDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDD0","description":"ICD-MEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 5_ gene duplication/multiplication) (List s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0075U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ 5_ gene duplication/multiplication) (List s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBE0","description":"ICD-CBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28645","description":"Repair toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4D","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB2C","description":"Very High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81233","description":"BTK (Bruton_s tyrosine kinase) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ C481S_ C481R_ C481F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETB0","description":"ICD-EETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25520","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYA1","description":"ICD-CCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKA1","description":"ICD-JHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation hemorrhoid w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0249T","description":"Ligation hemorrhoid w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0328U","description":"Drug assay_ definitive_ 120 or more drugs and metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ includes specimen validity and a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval on foot documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8410","description":"Eval on foot documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20983","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBB0","description":"ICD-NGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0985T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","description":"CPT-0985T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62121","description":"Incise skull repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWE0","description":"ICD-GDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD1","description":"ICD-GDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKC0","description":"ICD-JEKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNF0","description":"ICD-KHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFF1","description":"ICD-KFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA0","description":"ICD-JGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","description":"CPT-98014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2173","description":"Uri episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPC1","description":"ICD-KDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB1","description":"ICD-FIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPA0","description":"ICD-GEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE0","description":"ICD-OEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITE0","description":"ICD-MITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1603","description":"HCPCS-A1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain shoulder bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23035","description":"Drain shoulder bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11981","description":"Insert drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2042","description":"Tisagenlecleucel_ up to 600 million car-positive viable t-cells_ including leukopheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINF1","description":"ICD-GINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD1","description":"ICD-BFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUE1","description":"ICD-JHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air injection into abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49400","description":"Air injection into abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76001","description":"Fluoroscopy_ physician or other qualified health care professional time more than 1 hour_ assisting a nonradiologic physician or other qualified health care professional (eg_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE1","description":"ICD-JBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJD0","description":"ICD-NAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD1","description":"ICD-LHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denosumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0897","description":"Denosumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical cap contraceptive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4261","description":"Cervical cap contraceptive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","description":"CPT-98013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinus endo w/balloon dil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31295","description":"Sinus endo w/balloon dil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFE0","description":"ICD-CIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAD1","description":"ICD-JIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA0","description":"ICD-CDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet img wholbod melano nonco","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0219","description":"Pet img wholbod melano nonco","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet image ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78811","description":"Pet image ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87351","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not die within 30 days of the procedure or during the index hospitalization","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9813","description":"Patient did not die within 30 days of the procedure or during the index hospitalization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec gene test hyp cardiomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3866","description":"Spec gene test hyp cardiomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive review of data","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88325","description":"Comprehensive review of data","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat vaginal bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57180","description":"Treat vaginal bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0687","description":"Injection_ cefazolin sodium (WG Critical Care)_ not therapeutically equivalent to J0690_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287U","description":"Oncology (Thyroid)_ Dna And Mrna_ Next-Generation Sequencing Analysis Of 112 Genes_ Fine Needle Aspirate Or Formalin-Fixed Paraffin-Embedded (Ffpe) Tissue_ Algorithmic Predict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE0","description":"ICD-BEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJA0","description":"ICD-NHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria x10sv add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33258","description":"Ablate atria x10sv add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB1","description":"ICD-HHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy faceplt/silicone ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4384","description":"Ostomy faceplt/silicone ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA1","description":"ICD-CHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBPD0","description":"ICD-FBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI brain done 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3112F","description":"CT/MRI brain done 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abduct rotation bar w/o shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3150","description":"Abduct rotation bar w/o shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Outrigger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1080","description":"Outrigger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add mech leg elevation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1009","description":"Add mech leg elevation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB254","description":"Clinically Complex _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec stains not for microorg","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0477","description":"Spec stains not for microorg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPE1","description":"ICD-OHPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOF1","description":"ICD-OKOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCE0","description":"ICD-FBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33860","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDE0","description":"ICD-OKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCD1","description":"ICD-JHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens hydrophilic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2520","description":"Contact lens hydrophilic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPF0","description":"ICD-OKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIC1","description":"ICD-MLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No unheal etoh user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9622","description":"No unheal etoh user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44378","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91301","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 100 mcg/0.5mL dosage_ for in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4383","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","description":"HCPCS-Q4383","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wearable artificial kidney","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1632","description":"Wearable artificial kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hair trnspl 1-15 punch grfts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15775","description":"Hair trnspl 1-15 punch grfts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC0","description":"ICD-CDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct elbow lat ligmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24344","description":"Reconstruct elbow lat ligmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD0","description":"ICD-GHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Affinity1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4159","description":"Affinity1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOD1","description":"ICD-HEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice routine home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2042","description":"Hospice routine home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6081","description":"Scaling and debridement in the presence of inflammation or mucositis of a single implant_ including cleaning of the implant surfaces_ without flap entry and closure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4C","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB14","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATC0","description":"ICD-IATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt asked re sleep disturb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4328F","description":"Pt asked re sleep disturb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE1","description":"ICD-MHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICA1","description":"ICD-KICA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHB1","description":"ICD-EDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA0","description":"ICD-JAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression glove_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6581","description":"Gradient compression glove_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJA1","description":"ICD-OKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occult bld feces 1-3 tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82272","description":"Occult bld feces 1-3 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD1","description":"ICD-CIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAA1","description":"ICD-IBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp periodontal evaluation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0180","description":"Comp periodontal evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJA1","description":"ICD-OFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0894T","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0368U","description":"Oncology (colorectal cancer)_ evaluation for mutations of APC_ BRAF_ CTNNB1_ KRAS_ NRAS_ PIK3CA_ SMAD4_ and TP53_ and methylation markers (MYO1G_ KCNQ5_ C9ORF50_ FLI1_ CLIP4_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIB1","description":"ICD-BFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKB1","description":"ICD-NIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth electroshock","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10451","description":"Anesth electroshock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8869","description":"Patient has documented immunity to hepatitis B and initiating anti-TNF therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9721","description":"Patient not ambulatory_ bed ridden_ immobile_ confined to chair_ wheelchair bound_ dependent on helper pushing wheelchair_ independent in wheelchair or minimal help in wheelch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ taliglucerase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3060","description":"Injection_ taliglucerase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIE1","description":"ICD-FDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory test limited","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92587","description":"Evoked auditory test limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No antihist/decong rx/recom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4134F","description":"No antihist/decong rx/recom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJD1","description":"ICD-CEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYD1","description":"ICD-PGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0930T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","description":"CPT-0930T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF0","description":"ICD-GHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29720","description":"Repair of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAE1","description":"ICD-OJAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2799","description":"Interim crown-further treatment or completion of diagnosis necessary prior to final impression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJF0","description":"ICD-GIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/lithotripsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52353","description":"Cystouretero w/lithotripsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide for amniocentesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76946","description":"Echo guide for amniocentesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB0","description":"ICD-OIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97130","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKA1","description":"ICD-JGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0116U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ usin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair no. 2 footplates","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0970","description":"Wheelchair no. 2 footplates","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low density lipoprotein(ldl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2120","description":"Low density lipoprotein(ldl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUC0","description":"ICD-OIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKB0","description":"ICD-JIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEB1","description":"ICD-KFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD216","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF1","description":"ICD-IIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAB0","description":"ICD-NIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepb vacc 2 dose adolesc im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90743","description":"Hepb vacc 2 dose adolesc im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath tbs c/v manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88164","description":"Cytopath tbs c/v manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy pouch solid deodorant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4395","description":"Ostomy pouch solid deodorant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9292","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","description":"HCPCS-J9292","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHA0","description":"ICD-CBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stool collection pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4330","description":"Stool collection pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF0","description":"ICD-CBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stomach surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43999","description":"Stomach surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2247","description":"Injection_ micafungin sodium (par pharm) not thereapeutically equivalent to j2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWF0","description":"ICD-LIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place device/marker_ non pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9728","description":"Place device/marker_ non pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYA0","description":"ICD-HBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat combo w/o shear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1006","description":"Pwr seat combo w/o shear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPD0","description":"ICD-JCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4B","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 3 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0399","description":"Home sleep test/type 3 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA2C","description":"High Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0240U","description":"NFCT DS RNA 3 TARGETS UPPER RESPIRATORY SPECIMEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAF0","description":"ICD-CCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF0","description":"ICD-NGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHXC0","description":"ICD-GHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB31","description":"ICD-1EB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBME1","description":"ICD-OBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFA0","description":"ICD-KHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22103","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAD1","description":"ICD-KHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe calip plate exist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3600","description":"Trans shoe calip plate exist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWB0","description":"ICD-DBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg ped plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4031","description":"Cast sup lng leg ped plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31292","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAC0","description":"ICD-CGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA0","description":"ICD-AEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB20","description":"Low Rehab_ ADL Index 11-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1703","description":"HCPCS-B1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open treatment of rib fracture without fixation_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21805","description":"Open treatment of rib fracture without fixation_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33018","description":"Pericardial Drainage With Insertion Of Indwelling Catheter_ Percutaneous_ Including Fluoroscopy And/Or Ultrasound Guidance_ When Performed; Birth Through 5 Years Of Age Or Any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA0","description":"ICD-IBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27514","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL41","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYA0","description":"ICD-CBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic image bone marrow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77084","description":"Magnetic image bone marrow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2124","description":"Patients 66-80 Years Of Age And Had At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Dementia Medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMC0","description":"ICD-EGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18H","description":"Special Care High _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD0","description":"ICD-IBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corf related serv 15 mins ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0409","description":"Corf related serv 15 mins ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1216","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTF1","description":"ICD-NKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrogastrography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91132","description":"Electrogastrography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA1","description":"ICD-CAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFD0","description":"ICD-ODFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis composite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0005F","description":"Osteoarthritis composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTB1","description":"ICD-EHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1094T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1094T","description":"CPT-1094T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE251","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstr w/lat flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19361","description":"Breast reconstr w/lat flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXB0","description":"ICD-FGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUE1","description":"ICD-ADUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze <= 16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6402","description":"Sterile gauze <= 16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSE1","description":"ICD-DHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDD1","description":"ICD-ECDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8H","description":"Very High Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFF0","description":"ICD-OIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk/ak locking mechanism","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5671","description":"Bk/ak locking mechanism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mesh (implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1781","description":"Mesh (implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHF1","description":"ICD-GFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUB1","description":"ICD-NAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB21","description":"ICD-3LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kanamycin sulfate 500 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1840","description":"Kanamycin sulfate 500 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC1","description":"ICD-JEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF1","description":"ICD-CECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6530","description":"Compression stocking bk18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC0","description":"ICD-BFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE1","description":"ICD-FALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC1","description":"ICD-NIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Determines Patient Does Not Require Referral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0038","description":"Clinician Determines Patient Does Not Require Referral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","description":"HCPCS-E0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUE0","description":"ICD-GBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESE1","description":"ICD-KESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHF0","description":"ICD-AEHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1024","description":"Clinical Decision Support Mechanism Radrite_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bursa of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28001","description":"Drainage of bursa of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging multiple areas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78305","description":"Bone imaging multiple areas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLD0","description":"ICD-NFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML15","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF0","description":"ICD-JBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKD1","description":"ICD-OBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVC1","description":"ICD-KIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast milk proc/store/dist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2101","description":"Breast milk proc/store/dist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oscillating tracking test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92545","description":"Oscillating tracking test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOE1","description":"ICD-KHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF0","description":"ICD-CEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC0","description":"ICD-KCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cord blood harvesting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2140","description":"Cord blood harvesting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA1","description":"ICD-JDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA31","description":"ICD-1LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinusoidal rotational test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92546","description":"Sinusoidal rotational test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYC0","description":"ICD-DDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHE1","description":"ICD-JAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct chest spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72128","description":"Ct chest spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABE1","description":"ICD-MABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSB1","description":"ICD-GGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66605","description":"Removal of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperi needle place pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55875","description":"Transperi needle place pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80505","description":"Pathology Clinical Consultation; For A Highly Complex Clinical Problem_ With Comprehensive Review Of Patient_S History And Medical Records And High Level Of Medical Decision M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seg pneumatic appl full arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0668","description":"Seg pneumatic appl full arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIB0","description":"ICD-IAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ed svc ckd ind per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0420","description":"Ed svc ckd ind per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB0","description":"ICD-OFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD0","description":"ICD-HGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18X","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0069U","description":"Oncology (colorectal)_ microRNA_ RT-PCR expression profiling of miR-31-3p_ formalin-fixed paraffin-embedded tissue_ algorithm reported as an expression score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMC0","description":"ICD-MAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBC0","description":"ICD-CEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54220","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic bone marrow; aspiration(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38220","description":"Diagnostic bone marrow; aspiration(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAA1","description":"ICD-KDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent observation care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99225","description":"Subsequent observation care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gated heart multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78473","description":"Gated heart multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1259","description":"Patients listed on the kidney-pancreas transplant waitlist or who received a living donor transplant within the first year following initiation of dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKD1","description":"ICD-FCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFB0","description":"ICD-BGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD0","description":"ICD-LBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD124","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB0","description":"ICD-NLXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nutri counsel-control caries","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1310","description":"Nutri counsel-control caries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotic rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4065F","description":"Antipsychotic rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq art m-thrombect &/nfs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61645","description":"Perq art m-thrombect &/nfs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETB1","description":"ICD-IETB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9989","description":"Documentation Of Medical Reason(S) For Not Administering Pneumococcal Vaccine (E.G._ Adverse Reaction To Vaccine)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUF0","description":"ICD-BHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0358U","description":"Neurology (mild cognitive impairment)_ analysis of B-amyloid 1-42 and 1-40_ chemiluminescence enzyme immunoassay_ cerebral spinal fluid_ reported as positive_ likely positive_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0D","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRD1","description":"ICD-LGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQE0","description":"ICD-HGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29897","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACF1","description":"ICD-CACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA1","description":"ICD-IILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNE0","description":"ICD-ODNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE1","description":"ICD-FHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0649T","description":"Quantitative magnetic resonance for analysis of tissue composition (eg_ fat_ iron_ water content)_ including multiparametric data acquisition_ data preparation and transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61541","description":"Incision of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72010","description":"Radiologic examination_ spine_ entire_ survey study_ anteroposterior an lateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBFD1","description":"ICD-NBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth bladder stone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87051","description":"Anesth bladder stone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB31","description":"Low Rehab_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70328","description":"X-ray exam of jaw joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA11","description":"ICD-4FA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE1","description":"ICD-DFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD1","description":"ICD-DISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69641","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97157","description":"Multiple-family group adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)_ face-to-face w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92081","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA21","description":"ICD-3DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSB0","description":"ICD-KGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDB1","description":"ICD-FFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJB1","description":"ICD-KFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Craniofacial approach skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61580","description":"Craniofacial approach skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHME1","description":"ICD-AHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family homecare train/sessio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5111","description":"Family homecare train/sessio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB156","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDF1","description":"ICD-NLDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECB0","description":"ICD-IECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair modified fontan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33615","description":"Repair modified fontan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBA0","description":"ICD-JHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF1","description":"ICD-FAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid lined pre one pie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0488","description":"Tlso rigid lined pre one pie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sitz bath/equipment w/faucet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0161","description":"Sitz bath/equipment w/faucet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC0","description":"ICD-GFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1075","description":"Radiation Therapy For Bladder Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess cyst contrast inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49424","description":"Assess cyst contrast inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFA0","description":"ICD-FBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBQE0","description":"ICD-GBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC0","description":"ICD-GBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELB1","description":"ICD-OELB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23B","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE1","description":"ICD-CGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB0","description":"ICD-NJNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral grav diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9341","description":"Hit enteral grav diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDB1","description":"ICD-NDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCA1","description":"ICD-MCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD0","description":"ICD-GCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA0","description":"ICD-ADCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKC1","description":"ICD-JBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDC0","description":"ICD-EGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRF0","description":"ICD-KFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUD1","description":"ICD-NIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71023","description":"Chest x-ray and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIF1","description":"ICD-MAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy for lvrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32672","description":"Thoracoscopy for lvrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minor blunt trauma w/head ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9529","description":"Minor blunt trauma w/head ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366T","description":"Group adaptive behavior treatment by protocol_ administered by technician_ face-to-face with two or more patients; first 30 minutes of technician time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC0","description":"ICD-DGOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caffeine citrate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0706","description":"Caffeine citrate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCE1","description":"ICD-BDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED1","description":"ICD-BDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay nonantibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83516","description":"Immunoassay nonantibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28D","description":"Special Care Low _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC1","description":"ICD-IFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFF1","description":"ICD-JEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81289","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; known familial variant(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIE1","description":"ICD-JIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKF0","description":"ICD-FAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI upper extremity w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73218","description":"MRI upper extremity w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhcp-serv of ot_ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0152","description":"Hhcp-serv of ot_ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEC1","description":"ICD-NJEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHF1","description":"ICD-KDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cleft palate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42200","description":"Reconstruct cleft palate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test for porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84106","description":"Test for porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUA1","description":"ICD-GBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv syst funj test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95923","description":"Autonomic nrv syst funj test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEE1","description":"ICD-GFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB60","description":"Ultra High Rehab _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16020","description":"Dress/debrid p-thick burn s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIA0","description":"ICD-OLIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC0","description":"ICD-OADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spontaneous nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92541","description":"Spontaneous nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBD1","description":"ICD-OFBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOA0","description":"ICD-PAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC246","description":"Clinically Complex _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500T","description":"Infectious agent detection by nucleic acid (DNA or RNA)_ human papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg_ 16_ 18_ 31_ 33_ 35_ 39_ 45_ 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of jaw nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64738","description":"Incision of jaw nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthe <60 min as docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4256F","description":"Anesthe <60 min as docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELB0","description":"ICD-GELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a normal neurological examination","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9535","description":"Patients with a normal neurological examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implnt_bon void filler-strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9362","description":"Implnt_bon void filler-strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB31","description":"ICD-3JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA0","description":"ICD-CGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA0","description":"ICD-OEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHE1","description":"ICD-AHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36516","description":"Therapeutic apheresis; with extracorporeal immunoadsorption_ selective adsorption or selective filtration and plasma reinfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA1","description":"ICD-HDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQB1","description":"ICD-LHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLA1","description":"ICD-KBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYC1","description":"ICD-CDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95833","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEBA1","description":"ICD-EEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBE1","description":"ICD-KCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug_brand name","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5001","description":"Prescription drug_brand name","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTF0","description":"ICD-ADTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXF0","description":"ICD-NHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGF1","description":"ICD-GCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icut allergy test-delayed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95028","description":"Icut allergy test-delayed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5821","description":"Denture interm part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWD1","description":"ICD-KGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD0","description":"ICD-JFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBA0","description":"ICD-MCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGSD1","description":"ICD-KGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1802","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1802","description":"CDT-D1802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADA0","description":"ICD-CADA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBE0","description":"ICD-KGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 3 piece rigid shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0492","description":"Tlso 3 piece rigid shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVF0","description":"ICD-BGVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10005","description":"Fine needle aspiration biopsy_ including ultrasound guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVA0","description":"ICD-CEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD0","description":"ICD-IHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGD0","description":"ICD-OJGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC1","description":"ICD-IDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METF1","description":"ICD-METF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Identify sperm tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89264","description":"Identify sperm tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma plan of care documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1223","description":"Glaucoma plan of care documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB0","description":"ICD-ECHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOA0","description":"ICD-DAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92242","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report_ unilateral or b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthodontic retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8680","description":"Orthodontic retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTA0","description":"ICD-OBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVE1","description":"ICD-GGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD1","description":"ICD-LFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58559","description":"Hysteroscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWA0","description":"ICD-CFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho abduction static plastic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1660","description":"Ho abduction static plastic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB46","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD0","description":"ICD-JIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF1","description":"ICD-MHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD1","description":"ICD-BGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDF1","description":"ICD-NGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOB1","description":"ICD-DGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61520","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD0","description":"ICD-OEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASD0","description":"ICD-CASD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAF1","description":"ICD-IAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA210","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC0","description":"ICD-OIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE1","description":"ICD-GGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOB1","description":"ICD-CCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABB1","description":"ICD-NABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJF0","description":"ICD-NBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTF0","description":"ICD-BFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74170","description":"Ct abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit new","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99203","description":"Office/outpatient visit new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj open reduct-dislocation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7810","description":"Tmj open reduct-dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILF1","description":"ICD-OILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ immune globulin (xembify)_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1558","description":"Injection_ immune globulin (xembify)_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLF1","description":"ICD-OBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBE0","description":"ICD-ODBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61566","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gum graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41870","description":"Gum graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF1","description":"ICD-BBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCE0","description":"ICD-MLCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF1","description":"ICD-JAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen prsmptv 1 class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80302","description":"Drug screen prsmptv 1 class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHD1","description":"ICD-IBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA1","description":"ICD-KCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSE0","description":"ICD-HCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67515","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCND0","description":"ICD-OCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC0","description":"ICD-MHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBF1","description":"ICD-OHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIE0","description":"ICD-JBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate >200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072T","description":"Us leiomyomata ablate >200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1605","description":"Pacemaker_ leadless_ dual chamber (right atrial and right ventricular implantable components)_ rate-responsive_ including all necessary components for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pin knuckle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26706","description":"Pin knuckle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analysis nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88356","description":"Analysis nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko w adj flex/ext rotat mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1846","description":"Ko w adj flex/ext rotat mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF1","description":"ICD-AGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0803","description":"HCPCS-B0803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAF1","description":"ICD-EBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rep dev_ urinary_ w/o sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2631","description":"Rep dev_ urinary_ w/o sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA1","description":"ICD-MIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81364","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHQD1","description":"ICD-OHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB204","description":"Special Care Low _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQB1","description":"ICD-DFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD135","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIC1","description":"ICD-NKIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit cont anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9336","description":"Hit cont anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXC1","description":"ICD-NKXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIC0","description":"ICD-OGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protein western blot tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88371","description":"Protein western blot tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurological procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95999","description":"Neurological procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASA0","description":"ICD-GASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILD1","description":"ICD-NILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40720","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA213","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9463","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAF0","description":"ICD-IDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronch ebus ivntj perph les","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31654","description":"Bronch ebus ivntj perph les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec osteogen stim implanted","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0749","description":"Elec osteogen stim implanted","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBD0","description":"ICD-CDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKD0","description":"ICD-KIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF1","description":"ICD-GATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol open","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6713","description":"Ped term dev_ hand_ vol open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAD1","description":"ICD-IIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD0","description":"ICD-CGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHF0","description":"ICD-MLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21127","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAA0","description":"ICD-GIAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9065","description":"Injection_ romidepsin_ non-lypohilized (e.g. liquid)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE15B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUB1","description":"ICD-KFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92002","description":"Eye exam new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIF0","description":"ICD-FCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDE0","description":"ICD-NBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRB1","description":"ICD-HBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLE1","description":"ICD-FFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9042","description":"Injection_ bendamustine HCL (Belrapzo)_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi out nrm param nof/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8419","description":"Calc bmi out nrm param nof/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX17","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47561","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of support implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20680","description":"Removal of support implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWF1","description":"ICD-CAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC0","description":"ICD-NLHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHB0","description":"ICD-BFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23B","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation stating the patient has received or is currently receiving palliative or hospice care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1307","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOE1","description":"ICD-ODOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD1","description":"ICD-PKOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trunk/thor pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0450","description":"Tlso flex trunk/thor pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med txmnt options rvwd w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4325F","description":"Med txmnt options rvwd w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral - complete series of radiographic images - image capture only","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0709","description":"Intraoral - complete series of radiographic images - image capture only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEC0","description":"ICD-FIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC1","description":"ICD-BGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apheresis rbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36512","description":"Apheresis rbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIC0","description":"ICD-JGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYC0","description":"ICD-KGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDME0","description":"ICD-MDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rocker bottom_ contact afo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2232","description":"Rocker bottom_ contact afo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAB1","description":"ICD-GIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0556T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; assessment of bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF1","description":"ICD-ODTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJC0","description":"ICD-NGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMD0","description":"ICD-OJMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE0","description":"ICD-NDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML12","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"General health panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80050","description":"General health panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE1","description":"ICD-PGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE1","description":"ICD-NCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEC1","description":"ICD-BDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closd rductn splint alveolus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7670","description":"Closd rductn splint alveolus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic single","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2118","description":"Lens aniseikonic single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76529","description":"Echo exam of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC56","description":"Ultra High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace vad intra w/bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33983","description":"Replace vad intra w/bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish inner ear window","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69820","description":"Establish inner ear window","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGA0","description":"ICD-NHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC124","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF0","description":"ICD-CAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntiol category 4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q1004","description":"Ntiol category 4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUD1","description":"ICD-CDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIB1","description":"ICD-IHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOE1","description":"ICD-DHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tongue laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41251","description":"Repair tongue laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDB1","description":"ICD-FDDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF0","description":"ICD-CIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEF0","description":"ICD-MDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANB1","description":"ICD-BANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ PTEN hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0101U","description":"Hereditary colon cancer disorders (eg_ Lynch syndrome_ PTEN hamartoma syndrome_ Cowden syndrome_ familial adenomatosis polyposis)_ genomic sequence analysis panel utili","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTA1","description":"ICD-NCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITA0","description":"ICD-EITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Innovamatrix FS_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2013","description":"Innovamatrix FS_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC0","description":"ICD-GIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral supp not othrws c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9999","description":"Parenteral supp not othrws c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGC0","description":"ICD-NEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4338","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","description":"HCPCS-Q4338","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUC0","description":"ICD-KDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41850","description":"Treatment of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLB1","description":"ICD-KCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy soft tissue of back","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21925","description":"Biopsy soft tissue of back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services provided as part of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9991","description":"Services provided as part of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFB1","description":"ICD-KHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE0","description":"ICD-KCXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC1","description":"ICD-JBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA0","description":"ICD-AFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0585U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","description":"CPT-0585U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF0","description":"ICD-MABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy implant stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52282","description":"Cystoscopy implant stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCE0","description":"ICD-OFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX06","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYC0","description":"ICD-HGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0508T","description":"Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density_ tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGF1","description":"ICD-OHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1805","description":"Injection_ esmolol hydrochloride_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBE0","description":"ICD-NFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6005","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCLF1","description":"ICD-KCLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETA0","description":"ICD-IETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCD1","description":"ICD-MDCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSD1","description":"ICD-GDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA0","description":"ICD-JHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF1","description":"ICD-OIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0301","description":"HCPCS-B0301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGA0","description":"ICD-GHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBPB0","description":"ICD-NBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical home_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0281","description":"Medical home_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of adp & amp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82030","description":"Assay of adp & amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF0","description":"ICD-BIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC SOLID TUMOR 30 PRTN TRGT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0174U","description":"ONC SOLID TUMOR 30 PRTN TRGT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETA1","description":"ICD-GETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services of skilled nurse in home health setting_ each 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0154","description":"Services of skilled nurse in home health setting_ each 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Totazoline hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2670","description":"Totazoline hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXF1","description":"ICD-OCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5149","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","description":"HCPCS-Q5149","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent placemt ante carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37218","description":"Stent placemt ante carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC1","description":"ICD-ICIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC0","description":"ICD-NDFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC225","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63057","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESE0","description":"ICD-OESE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51960","description":"Revision of bladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHE0","description":"ICD-CDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILB1","description":"ICD-BILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYB1","description":"ICD-KHYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37286","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","description":"CPT-37286","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28H","description":"Special Care Low _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFHD1","description":"ICD-BFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo tib fx cast plaster mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2106","description":"Afo tib fx cast plaster mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17266","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE1","description":"ICD-MGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQF1","description":"ICD-GGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF0","description":"ICD-OBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genetic counsel 15 mins","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0265","description":"Genetic counsel 15 mins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALE0","description":"ICD-KALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hypnotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90880","description":"Hypnotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of arm nerve(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64713","description":"Revision of arm nerve(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11C","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5138","description":"Injection_ ustekinumab-auub (Wezlana)_ biosimilar_ IV_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise intrspinl lesion crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63270","description":"Excise intrspinl lesion crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEE1","description":"ICD-CAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75891","description":"Vein x-ray liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB225","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0620","description":"Hospital Special Treatment Room Support Component (Hstrsc) Injection/Nerve Block Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opioids & opiate analogs 3/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80363","description":"Opioids & opiate analogs 3/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX53","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatobil syst image w/drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78227","description":"Hepatobil syst image w/drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Japanese encephalitis virus vaccine_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90735","description":"Japanese encephalitis virus vaccine_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEC0","description":"ICD-AGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEE0","description":"ICD-IGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam infant hips dynamic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76885","description":"Us exam infant hips dynamic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery electrocorticogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95829","description":"Surgery electrocorticogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69602","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDA0","description":"ICD-NBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEC1","description":"ICD-OGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAF1","description":"ICD-CAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE1","description":"ICD-MHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC1","description":"ICD-IETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bowel surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44899","description":"Bowel surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVA0","description":"ICD-JGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62000","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGID1","description":"ICD-IGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQE0","description":"ICD-HBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXD1","description":"ICD-FFXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB21","description":"ICD-2HB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKA1","description":"ICD-OAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJB1","description":"ICD-OAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0602U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","description":"CPT-0602U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGE0","description":"ICD-FCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mold socket bent knee shin s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5160","description":"Mold socket bent knee shin s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory shoulder surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23040","description":"Exploratory shoulder surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidrm autogrft t/a/l add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15111","description":"Epidrm autogrft t/a/l add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 9-10 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98929","description":"Osteopath manj 9-10 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33845","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNC0","description":"ICD-NKNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJD1","description":"ICD-BDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVF1","description":"ICD-OBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMB0","description":"ICD-IDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transducer protect/fld bar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1575","description":"Transducer protect/fld bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1141","description":"Functional Status Was Not Measured By The Oxford Knee Score (Oks) At One Year (9 To 15 Months) Postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protect body sock ea pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0984","description":"Protect body sock ea pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc perm/cont/parox atr fib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1060F","description":"Doc perm/cont/parox atr fib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xray endovasc thor ao repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75957","description":"Xray endovasc thor ao repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22110","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle transfers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23397","description":"Muscle transfers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCE1","description":"ICD-MDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC0","description":"ICD-AEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rev artific disc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0098T","description":"Rev artific disc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXA1","description":"ICD-JAXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFA1","description":"ICD-OBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVD0","description":"ICD-GEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKF1","description":"ICD-NFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGD0","description":"ICD-CFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFID1","description":"ICD-EFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATA1","description":"ICD-NATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAA0","description":"ICD-NDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA211","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDE1","description":"ICD-JHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVB1","description":"ICD-ODVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGC1","description":"ICD-OIGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limb exercise test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95875","description":"Limb exercise test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD1","description":"ICD-KDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23525","description":"Treat clavicle dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAA0","description":"ICD-FCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets leukoreduced irrad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9033","description":"Platelets leukoreduced irrad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGC0","description":"ICD-JIGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNF1","description":"ICD-NCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD1","description":"ICD-FAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing loss sequence analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81430","description":"Hearing loss sequence analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cdifficile testing performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3520F","description":"Cdifficile testing performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF0","description":"ICD-BBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9032","description":"Platelets_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image spect sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78451","description":"Ht muscle image spect sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVB1","description":"ICD-JCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKA1","description":"ICD-GDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDD1","description":"ICD-EBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77332","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTE0","description":"ICD-FCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJD0","description":"ICD-BGJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj aripiprazole ext rel 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0401","description":"Inj aripiprazole ext rel 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJA1","description":"ICD-NCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray stress view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77071","description":"X-ray stress view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAEC1","description":"ICD-CAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2C","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHE0","description":"ICD-NCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditory function 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92620","description":"Auditory function 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1023","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1023","description":"HCPCS-E1023","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28F","description":"Special Care High _ ADL Index 2-5/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High strength ltwt whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0004","description":"High strength ltwt whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunofluor antb 1st stain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88346","description":"Immunofluor antb 1st stain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0824T","description":"Transcatheter removal of permanent single-chamber leadless pacemaker_ right atrial_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography an","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSA1","description":"ICD-LHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8I","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC24C","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQB1","description":"ICD-KDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIND0","description":"ICD-BIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58660","description":"Laparoscopy lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD1","description":"ICD-OCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTE0","description":"ICD-BGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF1","description":"ICD-IFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTF0","description":"ICD-JCTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-66683","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","description":"CPT-66683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOF1","description":"ICD-CHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL31","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQC0","description":"ICD-DIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraoral posterior image","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0251","description":"Extraoral posterior image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD1","description":"ICD-GDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACTC1","description":"ICD-ACTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hizentra injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1559","description":"Hizentra injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemoperfusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90997","description":"Hemoperfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture type immunofluoresc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87140","description":"Culture type immunofluoresc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4435","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","description":"HCPCS-Q4435","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63275","description":"Bx/exc xdrl spine lesn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0936T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","description":"CPT-0936T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cutting ramus open w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7943","description":"Cutting ramus open w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lodging costs (e.g. hotel ch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9994","description":"Lodging costs (e.g. hotel ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIF0","description":"ICD-JDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35021","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stainless steel any wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6630","description":"Stainless steel any wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE215","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE0","description":"ICD-GBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGC0","description":"ICD-KAGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLF1","description":"ICD-FDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy lower leg soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27613","description":"Biopsy lower leg soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQF1","description":"ICD-LAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC1","description":"ICD-NCLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBEC1","description":"ICD-CBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB1","description":"ICD-BDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX3C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFB0","description":"ICD-KEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDB0","description":"ICD-JBDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6038","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2184","description":"Injection_ meropenem (b. braun) not therapeutically equivalent to j2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML44","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8969","description":"Documentation of patient reason(s) for not prescribing warfarin or another FDA-approved oral anticoagulant that is FDA approved for the prevention of thromboembolism (e.g._ pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngarment glove-wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6504","description":"Cmprsburngarment glove-wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mitochondrial Antibody (Eg_ M2)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86381","description":"Mitochondrial Antibody (Eg_ M2)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAB1","description":"ICD-JBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME1","description":"ICD-MHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1081T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1081T","description":"CPT-1081T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC1","description":"ICD-NJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serum clotting time tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4771","description":"Serum clotting time tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj nalbuphine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2300","description":"Inj nalbuphine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical traction equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0855","description":"Cervical traction equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of protein any source","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84160","description":"Assay of protein any source","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHA0","description":"ICD-IEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extension per extension per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2760","description":"Extension per extension per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0835T","description":"Digitization of glass microscope slides for cytopathology_ evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis_ first evalua","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCB0","description":"ICD-JHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND1","description":"ICD-CFND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21083","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal leg bone(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27360","description":"Partial removal leg bone(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49623","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair_ any appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient died prior to the end of the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1060","description":"Patient died prior to the end of the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelvis w/o contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74176","description":"Ct abd & pelvis w/o contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","description":"HCPCS-Q4404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cst hgh nble mtl inlay >=3sr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6603","description":"Cst hgh nble mtl inlay >=3sr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o coronary artery stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4562F","description":"Pt w/o coronary artery stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us bone density measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76977","description":"Us bone density measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGC0","description":"ICD-NCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICF0","description":"ICD-FICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rilonacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2793","description":"Rilonacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc type nsm lung ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9289","description":"Doc type nsm lung ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDF0","description":"ICD-MCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA1","description":"ICD-HAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDB1","description":"ICD-NKDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYE1","description":"ICD-HGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGE1","description":"ICD-BIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECF0","description":"ICD-CECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOD1","description":"ICD-DEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calcium glycer & lact/10 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0620","description":"Calcium glycer & lact/10 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 7-8 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95910","description":"Nrv cndj test 7-8 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA144","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stoma cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5055","description":"Stoma cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTC1","description":"ICD-IDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD0","description":"ICD-NKAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEQC1","description":"ICD-OEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMF1","description":"ICD-KDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELA0","description":"ICD-OELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVD1","description":"ICD-JGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF1","description":"ICD-NEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15241","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJE0","description":"ICD-ODJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBB0","description":"ICD-FHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neurostim arrays","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61886","description":"Implant neurostim arrays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYE0","description":"ICD-GHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFF0","description":"ICD-NLFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth sternal debridement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55051","description":"Anesth sternal debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86005","description":"Allergen specific IgE; qualitative_ multiallergen screen (eg_ disk_ sponge_ card)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin ext jnts fld swg e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5726","description":"Knee-shin ext jnts fld swg e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA21","description":"Low Rehab_ ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA16","description":"Medium Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHB0","description":"ICD-JAHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDB1","description":"ICD-AGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth cabg w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56752","description":"Anesth cabg w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3347","description":"Retreat root canal bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODRC0","description":"ICD-ODRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amitriptyline injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1320","description":"Amitriptyline injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1300","description":"Influenza immunization was not administered for reasons documented by clinician (e.g._ patient allergy or other medical reasons_ patient declined or other patient reasons_ vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAB0","description":"ICD-CHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX10","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMA1","description":"ICD-CAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTB1","description":"ICD-KCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQE0","description":"ICD-DGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10C","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion catheter artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36640","description":"Insertion catheter artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKD0","description":"ICD-GFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55899","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES22D","description":"Extensive Services _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23071","description":"Exc shoulder les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA0","description":"ICD-NFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDE1","description":"ICD-ECDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam dressing wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6215","description":"Foam dressing wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML51","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHB1","description":"ICD-EAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi-axial rotation unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5986","description":"Multi-axial rotation unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFD1","description":"ICD-KHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPD0","description":"ICD-NJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy bronch stents","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31636","description":"Bronchoscopy bronch stents","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj w/fluor eval cv device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36598","description":"Inj w/fluor eval cv device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE140","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc esoph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43289","description":"Laparoscope proc esoph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAA1","description":"ICD-KFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRF1","description":"ICD-DCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2246","description":"Injection_ micafungin in sodium (Baxter)_ not therapeutically equivalent to J2248_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow imaging ltd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78102","description":"Bone marrow imaging ltd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTD1","description":"ICD-OCTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD0","description":"ICD-CBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD254","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOC0","description":"ICD-LFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Edetate disodium per 150 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3520","description":"Edetate disodium per 150 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX5D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NEURO MUSC DYS DMD SEQ ALYS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0218U","description":"NEURO MUSC DYS DMD SEQ ALYS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc scr uter mal or us/samp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9618","description":"Doc scr uter mal or us/samp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd w/thrml txmnt gerd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43257","description":"Egd w/thrml txmnt gerd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD1","description":"ICD-GCRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Underarm crutch pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4635","description":"Underarm crutch pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUC0","description":"ICD-AGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8C","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOF0","description":"ICD-CGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBB1","description":"ICD-IBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWB1","description":"ICD-KFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA0","description":"ICD-FEXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB0","description":"ICD-KGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breathing capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94010","description":"Breathing capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9064","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dna antibody single strand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86226","description":"Dna antibody single strand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF0","description":"ICD-JAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA1","description":"ICD-PCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0956T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","description":"CPT-0956T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERE1","description":"ICD-DERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD1","description":"ICD-BHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD0","description":"ICD-NADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2372","description":"Injection_ phenylephrine hydrochloride (biorphen)_ 20 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWE1","description":"ICD-GGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWB0","description":"ICD-PFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJD1","description":"ICD-KGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01670","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","description":"CPT-01670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAF1","description":"ICD-KIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJC1","description":"ICD-BDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSF0","description":"ICD-CHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICB0","description":"ICD-BICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of neck muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21700","description":"Revision of neck muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXD1","description":"ICD-BIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA0","description":"ICD-OEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASB0","description":"ICD-LASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0083","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished w/in a bene home)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE1","description":"ICD-PHSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKA1","description":"ICD-GGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD0","description":"ICD-GCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD0","description":"ICD-MHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFD0","description":"ICD-KIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC150","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9616","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","description":"HCPCS-A9616","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30310","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA0","description":"ICD-JIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNC0","description":"ICD-BFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUB0","description":"ICD-OKUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKF1","description":"ICD-NHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOB1","description":"ICD-KEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIE0","description":"ICD-KEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat sesamoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28530","description":"Treat sesamoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cell function assay w/stim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86352","description":"Cell function assay w/stim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair biceps tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23430","description":"Repair biceps tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD0","description":"ICD-HIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRF0","description":"ICD-HHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVC1","description":"ICD-FCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE1","description":"ICD-GCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQE1","description":"ICD-HAQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCE0","description":"ICD-NHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0565","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0565","description":"HCPCS-G0565","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRA1","description":"ICD-OCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD215","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","description":"HCPCS-A2027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD217","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33600","description":"Closure of valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHA0","description":"ICD-IGHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQA1","description":"ICD-PKQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMD1","description":"ICD-KCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCF0","description":"ICD-NDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","description":"CPT-37288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD1","description":"ICD-FGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD0","description":"ICD-OGQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD1","description":"ICD-OEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNF0","description":"ICD-FFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","description":"HCPCS-Q4406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA1","description":"ICD-NKXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA30","description":"Ultra High Rehab _ ADL Index 0-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2183","description":"Injection_ meropenem (WG Critical Care)_ not therapeutically equivalent to J2185_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIC0","description":"ICD-MBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLB0","description":"ICD-NGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92636","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","description":"CPT-92636","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPC0","description":"ICD-FHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQD0","description":"ICD-PIQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC1","description":"ICD-GANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA1","description":"ICD-NJPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose/water","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7060","description":"5% dextrose/water","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of folic acid serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82746","description":"Assay of folic acid serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc expectant management pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9053","description":"Onc expectant management pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transthor cath for stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33621","description":"Transthor cath for stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44100","description":"Biopsy of bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC226","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAA1","description":"ICD-AFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF1","description":"ICD-CEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF1","description":"ICD-OBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAB1","description":"ICD-IGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITB1","description":"ICD-FITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB135","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGA1","description":"ICD-JEGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dihydromorphinone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6046","description":"Dihydromorphinone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exfoliative cytolog collect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7287","description":"Exfoliative cytolog collect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD0","description":"ICD-FGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTE1","description":"ICD-EBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGD0","description":"ICD-NFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHD1","description":"ICD-FAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ammonia test strips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4774","description":"Ammonia test strips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti-rheum thxpy ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4195F","description":"Pt rcvng anti-rheum thxpy ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJA1","description":"ICD-GEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIE1","description":"ICD-OBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKB0","description":"ICD-KCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB1","description":"ICD-DEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5124","description":"Injection_ ranibizumab-nuna_ biosimilar_ (Byooviz)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTD1","description":"ICD-FFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB0","description":"ICD-CCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9781","description":"Arthroscopy_ shoulder_ surgical; with implantation of subacromial spacer (e.g._ balloon)_ includes debridement (e.g._ limited or extensive)_ subacromial decompression_ acromio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18C","description":"Special Care Low _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMA0","description":"ICD-NDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0481U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","description":"CPT-0481U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOB0","description":"ICD-LEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score le >= 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8655","description":"Fun stat score le >= 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27786","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE1","description":"ICD-OBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0204","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0204","description":"HCPCS-B0204","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87913","description":"Severe acute respiratory syndrome coronavirus (SARS-CoV-2) (coronavirus disease [COVID-19]) mutation identification in targeted region(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81232","description":"DPYD (dihydropyrimidine dehydrogenase) (eg_ 5-fluorouracil/5-FU and capecitabine drug metabolism)_ gene analysis_ common variant(s) (eg_ *2A_ *4_ *5_ *6)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACE1","description":"ICD-CACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care age 2-5 subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99476","description":"Ped crit care age 2-5 subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/2.12-4d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2108","description":"Spherocylinder 4.25d/2.12-4d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB15","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest auto stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38206","description":"Harvest auto stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUB0","description":"ICD-ADUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB1","description":"ICD-BEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID1","description":"ICD-NEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abut support crown titanium","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6094","description":"Abut support crown titanium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin alfa_ non-esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0885","description":"Epoetin alfa_ non-esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLA0","description":"ICD-GBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAA1","description":"ICD-BAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDPE1","description":"ICD-GDPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1612","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","description":"HCPCS-J1612","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYA1","description":"ICD-KAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0793T","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries_ including right heart catheterization_ pulmonary artery angiography_ and all imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEF1","description":"ICD-CFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDA0","description":"ICD-OBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0568","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","description":"HCPCS-G0568","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01940","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","description":"CPT-01940","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQC0","description":"ICD-PLQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRA0","description":"ICD-OHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","description":"HCPCS-M1428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC230","description":"Special Care High _ ADL Index 6-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE0","description":"ICD-NGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRE1","description":"ICD-DDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBA1","description":"ICD-MLBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB0","description":"ICD-NHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24D","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFB0","description":"ICD-OCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC136","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md doc_ door to punc tm >2hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9581","description":"Md doc_ door to punc tm >2hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB0","description":"ICD-PBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHF0","description":"ICD-AGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01272","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","description":"CPT-01272","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB1","description":"ICD-JCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0173","description":"Injection_ epinephrine (belcher) not therapeutically equivalent to j0171_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89257","description":"Sperm identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44382","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMB0","description":"ICD-OLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD0","description":"ICD-JFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC1","description":"ICD-BFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86413","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECF0","description":"ICD-OECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33517","description":"Cabg artery-vein single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE10B","description":"Special Care High _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOC0","description":"ICD-PFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHMX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDA1","description":"ICD-JBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9962","description":"Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve pedicle transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64907","description":"Nerve pedicle transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTC0","description":"ICD-MLTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB0","description":"ICD-GHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control hip heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2620","description":"Pelvic control hip heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFB1","description":"ICD-FDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBE1","description":"ICD-JDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd sftwre prgrm for pc/pda","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2511","description":"Sgd sftwre prgrm for pc/pda","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA210","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDF0","description":"ICD-OGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eculizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1300","description":"Eculizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJE1","description":"ICD-CEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asympt carot/vrtbrbas sten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9005F","description":"Asympt carot/vrtbrbas sten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD1","description":"ICD-KBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC1","description":"ICD-BAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSD0","description":"ICD-OBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthesis_ breast_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1789","description":"Prosthesis_ breast_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBA1","description":"ICD-AEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part mand lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5761","description":"Denture reln part mand lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNA1","description":"ICD-FCNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQF1","description":"ICD-HBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5841","description":"Addition_ endoskeletal knee-shin system_ polycentric_ pneumatic swing_ and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF1","description":"ICD-JBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD1","description":"ICD-FCHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supply/ext inf pump syr type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0552","description":"Supply/ext inf pump syr type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6218","description":"Non-sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF0","description":"ICD-AFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC0","description":"ICD-BEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC1","description":"ICD-EBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJE1","description":"ICD-JEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDA1","description":"ICD-FEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJB1","description":"ICD-NBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1095T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1095T","description":"CPT-1095T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDB1","description":"ICD-MJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVA0","description":"ICD-GIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVD1","description":"ICD-CHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCA0","description":"ICD-ABCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSC0","description":"ICD-CDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl tip cane/crutch/walker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4637","description":"Repl tip cane/crutch/walker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF0","description":"ICD-KBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj anticoag diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9372","description":"Ht inj anticoag diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDE1","description":"ICD-GHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBA1","description":"ICD-FIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14C","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHAC0","description":"ICD-CHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58410","description":"Suspension of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJA1","description":"ICD-NAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1034","description":"Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for OUD without a gap of more than","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0981T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","description":"CPT-0981T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE0","description":"ICD-KCGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01962","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","description":"CPT-01962","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0604","description":"Cinacalcet_ oral_ 1 mg_ (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXF0","description":"ICD-GDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62328","description":"Spinal Puncture_ Lumbar_ Diagnostic; With Fluoroscopic Or Ct Guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC144","description":"Special Care Low _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQC0","description":"ICD-PAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB0","description":"ICD-JGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5D","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAD1","description":"ICD-GHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVF1","description":"ICD-FEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01112","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","description":"CPT-01112","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5121","description":"Injection_ infliximab-axxq_ biosimilar_ (AVSOLA)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2001","description":"HCPCS-B2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXB0","description":"ICD-CEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8002","description":"HCPCS-C8002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXE1","description":"ICD-JCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Synthetic graft facial bones","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7995","description":"Synthetic graft facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23C","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBA0","description":"ICD-AFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHF1","description":"ICD-BDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand/finger surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26989","description":"Hand/finger surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Io rad tx delivery by x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77424","description":"Io rad tx delivery by x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHC1","description":"ICD-EHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0677T","description":"Laparoscopic Repositioning Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function_ Including Connec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs/chest4/> vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71111","description":"X-ray exam ribs/chest4/> vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIB1","description":"ICD-KIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant gabapentin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80171","description":"Drug screen quant gabapentin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70310","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24D","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPF0","description":"ICD-GFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF0","description":"ICD-PGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who screened positive for at least 1 of the 5 hrsns","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1320","description":"Patients who screened positive for at least 1 of the 5 hrsns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91319","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 10 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGE0","description":"ICD-OHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGD0","description":"ICD-OIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJE0","description":"ICD-NFJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9792","description":"Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) Class II_ III_ IVA heart failure; transcatheter implantation of left atrial to coronary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHE0","description":"ICD-ADHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIB0","description":"ICD-JCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB231","description":"Clinically Complex _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62280","description":"Treat spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC1","description":"ICD-BANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB1","description":"ICD-OIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15221","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALA0","description":"ICD-KALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7548","description":"Exchange nephrostomy catheter_ percutaneous_ with ureteral stricture balloon dilation_ including diagnostic nephrostogram and/or ureterogram when performed_ imaging guidance (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone intra implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7312","description":"Dexamethasone intra implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8421","description":"Ready gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35905","description":"Excision graft thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy cerv/thor facet jnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64633","description":"Destroy cerv/thor facet jnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21244","description":"Reconstruction of lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rehab thxpy options w/pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4400F","description":"Rehab thxpy options w/pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHC1","description":"ICD-CHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELC1","description":"ICD-BELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALC1","description":"ICD-OALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96168","description":"Health Behavior Intervention_ Family (With The Patient Present)_ Face-To-Face; Each Additional 15 Minutes (List Separately In Addition To Code For Primary Service)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB225","description":"Reduced Physical Function _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBC1","description":"ICD-CGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSE1","description":"ICD-PFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVB0","description":"ICD-BBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC1","description":"ICD-PDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVA0","description":"ICD-NLVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFN3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1713","description":"Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose (SARSCOV2 COVID-19 VAC mRNA 10mcg/0.2mL tris-sucrose IM DOSE 1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOF1","description":"ICD-OIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPD1","description":"ICD-NKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8033","description":"Nipple Prosthesis_ Custom Fabricated_ Reusable_ Any Material_ Any Type_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARF0","description":"ICD-HARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHND1","description":"ICD-CHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGE1","description":"ICD-NCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syph scrng docd as done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3512F","description":"Syph scrng docd as done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0884","description":"Injection_ argatroban_ 1 mg (for ESRD on dialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical site infection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9312","description":"Surgical site infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01380","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","description":"CPT-01380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9734","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx sclc/nsclc ext unknwn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9070","description":"Onc dx sclc/nsclc ext unknwn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","description":"CPT-01484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD0","description":"ICD-KAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8502","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","description":"HCPCS-J8502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28D","description":"Special Care High _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWC0","description":"ICD-GCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doppler echo exam heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93320","description":"Doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEB1","description":"ICD-JFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology gynecologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81536","description":"Oncology gynecologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHB1","description":"ICD-MCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGD0","description":"ICD-BGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC0","description":"ICD-BBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frame depth 22 to 25 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2204","description":"Frame depth 22 to 25 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIDC1","description":"ICD-OIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1067","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUE1","description":"ICD-NJUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0668","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","description":"HCPCS-J0668","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35363","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSE0","description":"ICD-DCSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLC0","description":"ICD-BFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADD1","description":"ICD-GADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESB1","description":"ICD-GESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28234","description":"Incision of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGAE0","description":"ICD-FGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARF0","description":"ICD-CARF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDAB1","description":"ICD-NDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1611","description":"Injection_ glucagon hydrochloride (fresenius kabi)_ not therapeutically equivalent to j1610_ per 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHC1","description":"ICD-IHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOC0","description":"ICD-PDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cncr 0/ia melan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3321F","description":"Ajcc cncr 0/ia melan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF1","description":"ICD-BEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22D","description":"Special Care Low _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME1","description":"ICD-BHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post chmbr intraocular lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2632","description":"Post chmbr intraocular lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analys amniotic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88269","description":"Chromosome analys amniotic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMF1","description":"ICD-CIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0405U","description":"Oncology (pancreatic)_ 59 methylation haplotype block markers_ next-generation sequencing_ plasma_ reported as cancer signal detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC2A","description":"Ultra High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0762T","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry_ per specimen_ each multiplex antibody stain procedure (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag and followup no rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9550","description":"Abd imag and followup no rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJGA1","description":"ICD-OJGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC0","description":"ICD-MGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Md inr test revie inter mgmt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0250","description":"Md inr test revie inter mgmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99412","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOC1","description":"ICD-HGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep c rna done prior to med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9203","description":"Hep c rna done prior to med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA0","description":"ICD-CGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDD1","description":"ICD-NIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHTF0","description":"ICD-NHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPB1","description":"ICD-KAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC1","description":"ICD-ICHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACF0","description":"ICD-EACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE1","description":"ICD-AAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRA0","description":"ICD-CFRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF0","description":"ICD-OFFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 21-30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99448","description":"Interprof phone/online 21-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0799T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEF1","description":"ICD-KEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND1","description":"ICD-CBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Locm 200-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9966","description":"Locm 200-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0754T","description":"Digitization of glass microscope slides for level V_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74000","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEID0","description":"ICD-OEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWA0","description":"ICD-HGWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKA0","description":"ICD-CIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No unpln rup post cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9390","description":"No unpln rup post cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID0","description":"ICD-CGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0590T","description":"Electronic Analysis With Complex Programming Of Implanted Integrated Neurostimulation System (Eg_ Electrode Array And Receiver)_ Including Contact Group(S)_ Amplitude_ Pulse W","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445T","description":"Sbsq Plmt Drug Eluting Ocular Insert Uni/Bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln cmplt maxil ch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5730","description":"Denture reln cmplt maxil ch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGXA1","description":"ICD-FGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPB0","description":"ICD-OJPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMD0","description":"ICD-JGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolong clincl staff svc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99415","description":"Prolong clincl staff svc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX43","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBB0","description":"ICD-GBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23B","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0524","description":"Management of established patient-caregiver dyad with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55862","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB28H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE1","description":"ICD-JFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKC0","description":"ICD-OHKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBB1","description":"ICD-BHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0421U","description":"Oncology (colorectal) screening_ quantitative real-time target and signal amplification of 8 RNA markers (GAPDH_ SMAD4_ ACY1_ AREG_ CDH1_ KRAS_ TNFRSF10B_ EGLN2) and fecal hem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetaminophen injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0131","description":"Acetaminophen injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC201","description":"Special Care High _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97161","description":"Physical therapy evaluation: low complexity_ requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDB1","description":"ICD-BGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQA0","description":"ICD-CHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB0","description":"ICD-FBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm ear level receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5284","description":"Ald fm/dm ear level receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB20A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAB0","description":"ICD-KFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKB0","description":"ICD-KDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27454","description":"Realignment of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21510","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYA0","description":"ICD-PFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFEF1","description":"ICD-NFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFE0","description":"ICD-NEFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMC0","description":"ICD-CHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation maxillary sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31000","description":"Irrigation maxillary sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin suppression panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80432","description":"Insulin suppression panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA240","description":"Reduced Physical Function _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQB1","description":"ICD-GIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB0","description":"ICD-CBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBED0","description":"ICD-NBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36200","description":"Place catheter in aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYC0","description":"ICD-KAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGF1","description":"ICD-NKGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJC1","description":"ICD-BBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radio/surgical implant index","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6190","description":"Radio/surgical implant index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41800","description":"Drainage of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9697","description":"Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAE1","description":"ICD-BBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD1","description":"ICD-AIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10A","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQC1","description":"ICD-LFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVF1","description":"ICD-BDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF1","description":"ICD-OKFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEE0","description":"ICD-BGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot insert plastazote or eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3002","description":"Foot insert plastazote or eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB1","description":"ICD-CFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90371","description":"Hep b ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB155","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remv&replc pm gen dual lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33228","description":"Remv&replc pm gen dual lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOD0","description":"ICD-GCOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE0","description":"ICD-AAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thromblytic art/ven therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37213","description":"Thromblytic art/ven therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGB1","description":"ICD-JBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0285U","description":"Oncology_ Response To Radiation_ Cell-Free Dna_ Quantitative Branched Chain Dna Amplification_ Plasma_ Reported As A Radiation Toxicity Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGED0","description":"ICD-AGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4015","description":"Neurology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo prolong infuse w/pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96416","description":"Chemo prolong infuse w/pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPE0","description":"ICD-JAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXF0","description":"ICD-KHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBOE0","description":"ICD-OBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE1","description":"ICD-GGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWE1","description":"ICD-PIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIE0","description":"ICD-IGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA1","description":"ICD-KEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18C","description":"Clinically Complex _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE0","description":"ICD-OGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Permanent tear duct plug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4263","description":"Permanent tear duct plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interventional Radiology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4012","description":"Interventional Radiology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuragen nerve guide_ per cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9352","description":"Neuragen nerve guide_ per cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBME0","description":"ICD-MBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control of nosebleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30901","description":"Control of nosebleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fx growth plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27519","description":"Treat thigh fx growth plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUD0","description":"ICD-BDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWA1","description":"ICD-OCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFF0","description":"ICD-GBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESD0","description":"ICD-GESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"T3 reverse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84482","description":"T3 reverse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33901","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; normal native connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEF1","description":"ICD-KIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUA0","description":"ICD-EBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEC0","description":"ICD-KHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28312","description":"Revision of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHA1","description":"ICD-BAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA134","description":"Clinically Complex _ ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1490","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","description":"HCPCS-M1490","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC1","description":"ICD-OLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ep & ablate supravent arrhyt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93653","description":"Ep & ablate supravent arrhyt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80416","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reusable nipple prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8032","description":"Reusable nipple prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trac stand free stand pelvic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0900","description":"Trac stand free stand pelvic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE0","description":"ICD-GHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX54","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","description":"HCPCS-J0738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA1","description":"ICD-ADBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Odontics repr abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6095","description":"Odontics repr abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37290","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","description":"CPT-37290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389T","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv infusion 1 hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96413","description":"Chemo iv infusion 1 hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair prosthesis per 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7520","description":"Repair prosthesis per 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tooth root removal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7250","description":"Tooth root removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB1","description":"ICD-OICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBF0","description":"ICD-IGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBF0","description":"ICD-AHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on salivary glands_ including biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0113U","description":"Anesthesia for procedures on salivary glands_ including biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQC1","description":"ICD-GGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOD0","description":"ICD-CHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Htlv/hiv confirmj antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86689","description":"Htlv/hiv confirmj antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg tech supp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93229","description":"Remote 30 day ecg tech supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOB0","description":"ICD-CFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81373","description":"Hla i typing 1 locus lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous methb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88741","description":"Transcutaneous methb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUB1","description":"ICD-AHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKF1","description":"ICD-NGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0115U","description":"Infectious disease (bacterial)_ strain typing by whole genome sequencing_ p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE0","description":"ICD-OGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTE1","description":"ICD-ABTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis addl spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22216","description":"Incis addl spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd demo bundle level i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9013","description":"Esrd demo bundle level i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWF0","description":"ICD-PAWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amphetamines 5 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80326","description":"Amphetamines 5 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECA1","description":"ICD-CECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIB1","description":"ICD-JHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx bipol_ death_ nhres_ hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9394","description":"Dx bipol_ death_ nhres_ hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGIF1","description":"ICD-CGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAD0","description":"ICD-OHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOA0","description":"ICD-OHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop oct brst/node spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351T","description":"Intraop oct brst/node spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUD0","description":"ICD-GGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1501","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1501","description":"HCPCS-C1501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAYB1","description":"ICD-CAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHF0","description":"ICD-KFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programmer for transient_ orally ingested capsule","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9268","description":"Programmer for transient_ orally ingested capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAC1","description":"ICD-AHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLE0","description":"ICD-ABLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESA0","description":"ICD-GESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEC1","description":"ICD-FAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo-myomectomy complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58546","description":"Laparo-myomectomy complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB1","description":"ICD-FGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD0","description":"ICD-GAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQA1","description":"ICD-PCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYB1","description":"ICD-OEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB1","description":"ICD-KCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity low","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3470F","description":"Ra disease activity low","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD1","description":"ICD-ODOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUC1","description":"ICD-IDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBED0","description":"ICD-EBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MACA0","description":"ICD-MACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD1","description":"ICD-ODPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cltx medial ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27760","description":"Cltx medial ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC0","description":"ICD-GDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB1","description":"ICD-KEIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0A","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper gi endo shows barrtts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3140F","description":"Upper gi endo shows barrtts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPE0","description":"ICD-KDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASC0","description":"ICD-OASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPE0","description":"ICD-CCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-inhalation drug for dme","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7799","description":"Non-inhalation drug for dme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote dx retinal imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92227","description":"Remote dx retinal imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC1","description":"ICD-OCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair great vessels defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33774","description":"Repair great vessels defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary rehab w exer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0424","description":"Pulmonary rehab w exer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYD0","description":"ICD-PJYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDBE1","description":"ICD-NDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCA1","description":"ICD-EHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIE0","description":"ICD-FIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEQD1","description":"ICD-CEQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22C","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76882","description":"Ultrasound_ limited_ joint or other nonvascular extremity structure(s) (eg_ joint space_ peri-articular tendon[s]_ muscle[s]_ nerve[s]_ other soft tissue structure[s]_ or soft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sciatic nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64786","description":"Remove sciatic nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF0","description":"ICD-NGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX36","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9173","description":"HCPCS-C9173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ekg for initial prevent exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0403","description":"Ekg for initial prevent exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRF0","description":"ICD-KDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKA0","description":"ICD-NGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0630T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; Each Additional Le","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic acrylic soc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5631","description":"Ak/knee disartic acrylic soc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB0","description":"ICD-NCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA4A","description":"Low Rehab_ ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Basic life disability exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99450","description":"Basic life disability exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES12B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3472","description":"Surgical repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of forearm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73090","description":"X-ray exam of forearm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac rehab/monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93798","description":"Cardiac rehab/monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Locm 300-399mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9967","description":"Locm 300-399mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0634U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0634U","description":"CPT-0634U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKE1","description":"ICD-OKKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTB1","description":"ICD-NGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc death after cas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9256","description":"Doc death after cas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTB1","description":"ICD-IFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYD0","description":"ICD-PKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMF0","description":"ICD-JDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE1","description":"ICD-KFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33289","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring_ including deployment and calibration of the sensor_ right heart c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXA1","description":"ICD-BBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYB1","description":"ICD-CGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation sphenoid sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31002","description":"Irrigation sphenoid sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAB1","description":"ICD-KCAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56634","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHE1","description":"ICD-MFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFE1","description":"ICD-JEFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB0","description":"ICD-FDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCD0","description":"ICD-BDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0070","description":"Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4358","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","description":"HCPCS-Q4358","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC1","description":"ICD-BFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid 5.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4172","description":"Parenteral sol amino acid 5.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF0","description":"ICD-BBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX35","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove groin lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38760","description":"Remove groin lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD0","description":"ICD-OBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE0","description":"ICD-PCOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX32","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIF0","description":"ICD-EEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91320","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ 30 mcg/0.3 mL dosage_ tris-sucrose formulation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABB0","description":"ICD-BABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOD1","description":"ICD-CCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXD0","description":"ICD-OGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24640","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC1","description":"ICD-GFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83718","description":"Assay of lipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1806","description":"Injection_ esmolol hydrochloride (wg critical care) not therapeutically equivalent to j1805_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSC1","description":"ICD-LCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB06","description":"High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ic inf pbw 2501-5000 g subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99480","description":"Ic inf pbw 2501-5000 g subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAB0","description":"ICD-OCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARF1","description":"ICD-GARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCC0","description":"ICD-MCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB1","description":"ICD-NJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBF1","description":"ICD-IFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNB0","description":"ICD-OBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalists Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4009","description":"Hospitalists Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA0","description":"ICD-FFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHA1","description":"ICD-MAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMC1","description":"ICD-IDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLF1","description":"ICD-KFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENB1","description":"ICD-OENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIF1","description":"ICD-EDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-covered item or service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9270","description":"Non-covered item or service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symp aaa urgent repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9600","description":"Symp aaa urgent repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise thumb tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26490","description":"Revise thumb tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5941","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5941","description":"CDT-D5941","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suture bile duct injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47900","description":"Suture bile duct injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXE1","description":"ICD-FAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00797","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","description":"CPT-00797","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGB1","description":"ICD-JIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35092","description":"Repair artery rupture aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNE0","description":"ICD-CDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9745","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0566U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","description":"CPT-0566U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF0","description":"ICD-OFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC1","description":"ICD-IITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBA0","description":"ICD-IHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGC0","description":"ICD-FBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIA0","description":"ICD-CBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDC0","description":"ICD-AIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not have the retina attached after 6 months following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9377","description":"Patient did not have the retina attached after 6 months following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/ather","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37229","description":"Tib/per revasc w/ather","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX30","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD1","description":"ICD-FHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1056T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1056T","description":"CPT-1056T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC1","description":"ICD-OHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45100","description":"Biopsy of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBD1","description":"ICD-MBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraor complete film series","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0210","description":"Intraor complete film series","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15956","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gi protein loss exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78282","description":"Gi protein loss exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGC1","description":"ICD-FHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce skull implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61210","description":"Pierce skull implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINB0","description":"ICD-GINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMA1","description":"ICD-ECMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEC0","description":"ICD-GAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transtemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61595","description":"Transtemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Escharotomy addl incision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16036","description":"Escharotomy addl incision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD0","description":"ICD-KDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQE1","description":"ICD-GIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOB1","description":"ICD-PLOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQC0","description":"ICD-HBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ear and throat examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92502","description":"Ear and throat examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES116","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swing p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5824","description":"Endo knee-shin fluid swing p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain/ceramic","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6740","description":"Crown porcelain/ceramic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRC1","description":"ICD-KBRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACC0","description":"ICD-FACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0164","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","description":"HCPCS-J0164","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDD0","description":"ICD-OHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1084T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1084T","description":"CPT-1084T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52290","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9996","description":"teledentistry - asynchronous; information stored and forwarded to dentist for subse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC113","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCA0","description":"ICD-MFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWA0","description":"ICD-KBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DA11","description":"ICD-3DA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUA1","description":"ICD-MGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus immune globulin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1670","description":"Tetanus immune globulin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Volun service at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9476","description":"Volun service at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","description":"HCPCS-M1378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44365","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0920T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","description":"CPT-0920T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPC1","description":"ICD-BCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","description":"HCPCS-M1432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEE1","description":"ICD-AAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CROM GNOTYP CD55 EXONS 1-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0182U","description":"CROM GNOTYP CD55 EXONS 1-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBD0","description":"ICD-KCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBC1","description":"ICD-KDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB12A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAA0","description":"ICD-MCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-33882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","description":"CPT-33882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrafraction track motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6017","description":"Intrafraction track motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA1","description":"ICD-NGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE0","description":"ICD-FDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGC1","description":"ICD-GDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD1","description":"ICD-CFSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Azacitidine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9025","description":"Azacitidine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPD1","description":"ICD-CFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJA1","description":"ICD-OBJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81347","description":"Sf3B1 (Splicing Factor [3B] Subunit B1) (Eg_ Myelodysplastic Syndrome/Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ A672T_ E622D_ L833F_ R625C_ R625L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift bathroom or toi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0625","description":"Patient lift bathroom or toi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24B","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIA1","description":"ICD-CIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00102","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","description":"CPT-00102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exercise equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9300","description":"Exercise equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUF1","description":"ICD-KFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF1","description":"ICD-CBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB255","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCD0","description":"ICD-IHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIA1","description":"ICD-KAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thymus gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60520","description":"Removal of thymus gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELE1","description":"ICD-CELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA0","description":"ICD-BIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9943","description":"Occlusal guard adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore orbit/remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61333","description":"Explore orbit/remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95144","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy thru stoma spx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44388","description":"Colonoscopy thru stoma spx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sugars multiple qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84377","description":"Sugars multiple qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test indirect qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86885","description":"Coombs test indirect qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50070","description":"Incision of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5926","description":"Addition to lower extremity prosthesis_ endoskeletal_ knee disarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4365","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","description":"HCPCS-Q4365","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50365","description":"Transplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB1","description":"ICD-LCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50555","description":"Kidney endoscopy & biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPA0","description":"ICD-KGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC0","description":"ICD-MGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD1","description":"ICD-BIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQD1","description":"ICD-CBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIF1","description":"ICD-JCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9935","description":"Adenoma(s) or colorectal cancer not detected during screening colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABLD1","description":"ICD-ABLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITE0","description":"ICD-BITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4B","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC11","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93621","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIB1","description":"ICD-NJIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc leg/ankle tum dep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27634","description":"Exc leg/ankle tum dep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTB1","description":"ICD-ICTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8566","description":"Pt inelig ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7528","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thiethylperazine maleate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3280","description":"Thiethylperazine maleate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long qt syn gene dup/dlt var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81282","description":"Long qt syn gene dup/dlt var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAXF1","description":"ICD-FAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLA1","description":"ICD-KHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJF1","description":"ICD-NDJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNB0","description":"ICD-GBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD0","description":"ICD-DDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small disposable underpad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4542","description":"Small disposable underpad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic pancreatoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43273","description":"Endoscopic pancreatoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6024","description":"Colonoscopy_ flexible; proximal to splenic flexure; with ablation of tumor(s)_ polyp(s)_ or other lesion(s) not amenable to removal by hot biopsy forceps_ bipolar cautery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD115","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9807","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9807","description":"HCPCS-C9807","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls daily mgmt-venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33948","description":"Ecmo/ecls daily mgmt-venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA1","description":"ICD-FIKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEC0","description":"ICD-MEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt c/t 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64492","description":"Inj paravert f jnt c/t 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chore services per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5121","description":"Chore services per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo_ walk boot type_ cus fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4631","description":"Afo_ walk boot type_ cus fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD1","description":"ICD-CBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEC0","description":"ICD-FFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNB0","description":"ICD-OLNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GC11","description":"ICD-3GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbt/fac/nck w/o &w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70543","description":"MRI orbt/fac/nck w/o &w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trh stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80438","description":"Trh stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary hvy plstc pch w/o fp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4382","description":"Urinary hvy plstc pch w/o fp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipid panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80061","description":"Lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF1","description":"ICD-OFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISC0","description":"ICD-HISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gs mg composite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9235","description":"Gs mg composite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1201","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g._ pregnancy_ history of angioedema to ace-i_ oth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8573","description":"Stk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHC1","description":"ICD-OEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2621","description":"Pmkr_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOC0","description":"ICD-GBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert non-tunnel cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36556","description":"Insert non-tunnel cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKF1","description":"ICD-JGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9296","description":"Doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBC0","description":"ICD-GDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lambswool sheepskin pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0189","description":"Lambswool sheepskin pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAB1","description":"ICD-IIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0849T","description":"Digitization of glass microscope slides for in situ hybridization (eg_ FISH)_ per specimen; each additional single probe stain procedure (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBME1","description":"ICD-KBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMC1","description":"ICD-FCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2004","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBE1","description":"ICD-MCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB0","description":"ICD-ACMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ot evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97003","description":"Ot evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID1","description":"ICD-OLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supprelin la implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9226","description":"Supprelin la implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC31","description":"ICD-3LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCA1","description":"ICD-NBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGD1","description":"ICD-JGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANE1","description":"ICD-NANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14B","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tear gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68510","description":"Biopsy of tear gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0639T","description":"Wireless Skin Sensor Thermal Anisotropy Measurement(S) And Assessment Of Flow In Cerebrospinal Fluid Shunt_ Including Ultrasound Guidance_ When Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAB1","description":"ICD-MIAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEF0","description":"ICD-NBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body fluid cell count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89050","description":"Body fluid cell count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3405","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3405","description":"HCPCS-J3405","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRE0","description":"ICD-LDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status performed once in the last 12 months","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9916","description":"Functional status performed once in the last 12 months","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9015","description":"Injection_ C1 esterase inhibitor (human)_ Haegarda_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHED0","description":"ICD-NHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAC0","description":"ICD-IEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKE0","description":"ICD-KFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress fingers/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26035","description":"Decompress fingers/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQC0","description":"ICD-PBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24101","description":"Explore/treat elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB0","description":"ICD-PGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5276","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378U","description":"RFC1 (replication factor C subunit 1)_ repeat expansion variant analysis by traditional and repeat-primed PCR_ blood_ saliva_ or buccal swab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICF1","description":"ICD-IICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA0","description":"ICD-AGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGFF1","description":"ICD-GGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Igk rearrangeabn clonal pop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81264","description":"Igk rearrangeabn clonal pop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFD1","description":"ICD-OKFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXA0","description":"ICD-GGXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACB0","description":"ICD-IACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD1","description":"ICD-ADHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"West nile virus ab igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86788","description":"West nile virus ab igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calc bmi abv up param f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8417","description":"Calc bmi abv up param f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso flex w/rigid stays cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0629","description":"Lso flex w/rigid stays cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99427","description":"Principal Care Management Services_ For A Single High-Risk Disease_ With The Following Required Elements: One Complex Chronic Condition Expected To Last At Least 3 Months_ And","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUB0","description":"ICD-NHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRE1","description":"ICD-LFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVF1","description":"ICD-KCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHTD1","description":"ICD-EHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD1","description":"ICD-GDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJE1","description":"ICD-CIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Igg 1 2 3 or 4 each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82787","description":"Igg 1 2 3 or 4 each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01402","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","description":"CPT-01402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7299","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","description":"HCPCS-J7299","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise prosth vag graft lap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57426","description":"Revise prosth vag graft lap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo knee-shin fluid swg/sta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5828","description":"Endo knee-shin fluid swg/sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0785T","description":"Revision or removal of neurostimulator electrode array_ spinal_ with integrated neurostimulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF0","description":"ICD-PFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Consult inc prep of slides","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0485","description":"Consult inc prep of slides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTA1","description":"ICD-CHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34705","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74445","description":"X-ray exam of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cold agglutinin titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86157","description":"Cold agglutinin titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDB1","description":"ICD-NEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB1","description":"ICD-NCVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaccine toxoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90749","description":"Vaccine toxoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHID1","description":"ICD-AHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEA0","description":"ICD-GDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paraffin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4265","description":"Paraffin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31760","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELF0","description":"ICD-CELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric unresectable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9102","description":"Onc dx gastric unresectable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCA1","description":"ICD-KDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMD1","description":"ICD-MHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBC1","description":"ICD-JDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKD1","description":"ICD-GBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47785","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20A","description":"Special Care Low _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL31","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTE1","description":"ICD-JGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21088","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXC0","description":"ICD-JCXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448T","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor_ including system ac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures maxill part resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5211","description":"Dentures maxill part resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8A","description":"Very High Rehab _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of upper nose/throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42806","description":"Biopsy of upper nose/throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAF1","description":"ICD-BEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAE0","description":"ICD-ADAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIB0","description":"ICD-EHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIE0","description":"ICD-BHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clean rem part denture max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9934","description":"Clean rem part denture max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECC1","description":"ICD-CECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETD1","description":"ICD-KETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRB0","description":"ICD-CDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLB0","description":"ICD-MFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBYC1","description":"ICD-HBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9408","description":"Iodine I-131 iobenguane_ therapeutic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB1","description":"ICD-DFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2JC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2JC31","description":"ICD-2JC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex custom fab thoraci","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0452","description":"Tlso flex custom fab thoraci","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29871","description":"Knee arthroscopy/drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam pituitary saddle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70240","description":"X-ray exam pituitary saddle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBF0","description":"ICD-GGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0854T","description":"Digitization of glass microscope slides for blood smear_ peripheral_ interpretation by physician with written report (List separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFC0","description":"ICD-KHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE0","description":"ICD-NEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC0","description":"ICD-KHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQD1","description":"ICD-PFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/attach implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65105","description":"Remove eye/attach implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNB1","description":"ICD-KGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUB0","description":"ICD-ICUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp subclav-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35616","description":"Art byp subclav-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHE0","description":"ICD-OCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung artery emboli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33910","description":"Remove lung artery emboli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAB0","description":"ICD-NHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBF1","description":"ICD-AGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIC1","description":"ICD-IEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAB0","description":"ICD-FIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARC1","description":"ICD-LARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHE0","description":"ICD-KCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXE1","description":"ICD-KAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWA0","description":"ICD-PFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX22","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC0","description":"ICD-NKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL10","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNC0","description":"ICD-NBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted procedure_ intestine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6021","description":"Unlisted procedure_ intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD206","description":"Special Care High _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDLE0","description":"ICD-IDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB1","description":"ICD-AIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tantalum ring application","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8030","description":"Tantalum ring application","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8H","description":"Low Rehab_ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFID0","description":"ICD-JFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is using hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9714","description":"Patient is using hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRB1","description":"ICD-PKRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKC1","description":"ICD-KIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert heart pm ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33207","description":"Insert heart pm ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDB1","description":"ICD-ADDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOB1","description":"ICD-HEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-elastic extremity binder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4465","description":"Non-elastic extremity binder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD221","description":"Clinically Complex _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal over 12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2314","description":"Lens sphcyl trifocal over 12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qual life tool 2x same/impr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9634","description":"Qual life tool 2x same/impr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture belly","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35122","description":"Repair artery rupture belly","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Miglustat_ oral_ 65 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1202","description":"Miglustat_ oral_ 65 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJB0","description":"ICD-NGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64681","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUB1","description":"ICD-JDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54100","description":"Biopsy of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC0","description":"ICD-OGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE0","description":"ICD-GEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLB1","description":"ICD-CHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMD1","description":"ICD-OIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINE0","description":"ICD-CINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone graft time of implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6104","description":"Bone graft time of implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSB1","description":"ICD-GHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA11","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOA1","description":"ICD-DEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVB1","description":"ICD-CDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDB1","description":"ICD-MCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA23","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQE1","description":"ICD-LGQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMB1","description":"ICD-IFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDEF1","description":"ICD-CDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No reason for no hep c rna","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9204","description":"No reason for no hep c rna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD154","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQD1","description":"ICD-LAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1444","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","description":"HCPCS-M1444","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ampho b cholesteryl sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0288","description":"Ampho b cholesteryl sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC0","description":"ICD-ECIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQA0","description":"ICD-HEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC1","description":"ICD-NJAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNE0","description":"ICD-FCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF0","description":"ICD-GAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33238","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXF0","description":"ICD-JAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C7564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C7564","description":"HCPCS-C7564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADE0","description":"ICD-JADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial excision of lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40500","description":"Partial excision of lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Underarm springassist crutch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0117","description":"Underarm springassist crutch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHA1","description":"ICD-FEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCF1","description":"ICD-AFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61514","description":"Removal of brain abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMB0","description":"ICD-OIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAC1","description":"ICD-OIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPF1","description":"ICD-KCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0065U","description":"Syphilis test_ non-treponemal antibody_ immunoassay_ qualitative (RPR)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00548","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","description":"CPT-00548","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63278","description":"Bx/exc xdrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28H","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6925","description":"Wrist disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped critical care subsq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99472","description":"Ped critical care subsq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB1","description":"ICD-NCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB216","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-auto graft addl tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4285","description":"Non-auto graft addl tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISB1","description":"ICD-KISB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX17","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific igg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86001","description":"Allergen specific igg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUC0","description":"ICD-GGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE1","description":"ICD-BIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assistive Technology","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0138","description":"Assistive Technology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHB0","description":"ICD-FIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2032","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","description":"HCPCS-A2032","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construct bowel bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50825","description":"Construct bowel bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thigh length surg stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4495","description":"Thigh length surg stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF1","description":"ICD-JIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVA0","description":"ICD-KIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27075","description":"Resect hip tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECD1","description":"ICD-MECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAB1","description":"ICD-EFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB1","description":"ICD-KGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCB1","description":"ICD-FFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol 52-73 gm prot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4193","description":"Parenteral sol 52-73 gm prot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98002","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","description":"CPT-98002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXC0","description":"ICD-GEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Daily cont lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0512","description":"Daily cont lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECD1","description":"ICD-CECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA115","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUD1","description":"ICD-OLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bh ltc res r&b_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2048","description":"Bh ltc res r&b_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX45","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA0","description":"ICD-OGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36565","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual audiometry (vra)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92579","description":"Visual audiometry (vra)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amino acids single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82131","description":"Amino acids single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBD1","description":"ICD-KEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01830","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","description":"CPT-01830","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81551","description":"Oncology (prostate)_ promoter methylation profiling by real-time PCR of 3 genes (GSTP1_ APC_ RASSF1)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inter active grp psych parti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0411","description":"Inter active grp psych parti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0648U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0648U","description":"CPT-0648U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQE0","description":"ICD-LCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHC0","description":"ICD-GEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA35","description":"Very High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKE1","description":"ICD-OEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD1","description":"ICD-FCLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJB1","description":"ICD-OEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of toes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28280","description":"Fusion of toes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87469","description":"Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNC0","description":"ICD-JCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFA1","description":"ICD-CBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap paraesoph her rpr w/mesh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43282","description":"Lap paraesoph her rpr w/mesh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA0","description":"ICD-NKAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pancreatic stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48020","description":"Removal of pancreatic stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB156","description":"Special Care High _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPB1","description":"ICD-JEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBD0","description":"ICD-JBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB1","description":"ICD-BCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF1","description":"ICD-GFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laiv3 vaccine intranasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90660","description":"Laiv3 vaccine intranasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vantas implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9225","description":"Vantas implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFA0","description":"ICD-OGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD0","description":"ICD-ACLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0494U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","description":"CPT-0494U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cath xtrnl carotid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36227","description":"Place cath xtrnl carotid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYF0","description":"ICD-HIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6074","description":"Abutment supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFC0","description":"ICD-JCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESC1","description":"ICD-CESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE0","description":"ICD-NGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class ii semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86835","description":"Hla class ii semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLE1","description":"ICD-OKLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXD0","description":"ICD-BAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of digit nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64831","description":"Repair of digit nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic prop tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2212","description":"Pneumatic prop tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGF1","description":"ICD-JFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCAE0","description":"ICD-NCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB150","description":"Special Care High _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEID1","description":"ICD-CEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEE1","description":"ICD-FIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFF0","description":"ICD-KIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCC1","description":"ICD-FBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43124","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPD0","description":"ICD-BCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPE0","description":"ICD-CIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15013","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","description":"CPT-15013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9282","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","description":"HCPCS-J9282","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUD1","description":"ICD-IBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0800T","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker_?including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventriculog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNB1","description":"ICD-NFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplt allo lymphocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38242","description":"Transplt allo lymphocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIWA0","description":"ICD-LIWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 4999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4725","description":"Dialys sol fld vol > 4999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB10B","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDQD0","description":"ICD-HDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE0","description":"ICD-IIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNF0","description":"ICD-OHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLF1","description":"ICD-IHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01740","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","description":"CPT-01740","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Min hd traum gcs=15 w/ct ed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9530","description":"Min hd traum gcs=15 w/ct ed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBDD0","description":"ICD-NBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0105","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0105","description":"CDT-D0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no tx sys bio rx 6 mths","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9653","description":"Pt no tx sys bio rx 6 mths","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA1","description":"ICD-NACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHCE1","description":"ICD-EHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYF1","description":"ICD-GDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMD1","description":"ICD-OFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Angina absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1012F","description":"Angina absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BICC0","description":"ICD-BICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14A","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22318","description":"Treat odontoid fx w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15920","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/mediast exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32662","description":"Thoracoscopy w/mediast exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic art therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37211","description":"Thrombolytic art therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD0","description":"ICD-KHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF1","description":"ICD-FDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQF0","description":"ICD-DFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD24D","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAYF0","description":"ICD-KAYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amniply_ for topical use only_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4249","description":"Amniply_ for topical use only_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symes type ptb brim design s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5632","description":"Symes type ptb brim design s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xenograft implantation into the articular surface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0737T","description":"Xenograft implantation into the articular surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0146U","description":"Drug assay_ definitive_ 80 or more drugs or metabolites_ urine_ by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitori","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57105","description":"Biopsy of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBF1","description":"ICD-EHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVD1","description":"ICD-BAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph imped function test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91037","description":"Esoph imped function test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHA0","description":"ICD-ODHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHF1","description":"ICD-MEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUE1","description":"ICD-OIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF0","description":"ICD-FDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD136","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMD1","description":"ICD-EFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx rectal t1-3_n1-2noprg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9092","description":"Onc dx rectal t1-3_n1-2noprg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation thru metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28805","description":"Amputation thru metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21147","description":"Lefort i-3/> piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHD1","description":"ICD-GBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD101","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB1","description":"ICD-GGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEMF1","description":"ICD-KEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9156","description":"Oral mucoadhesive_ any type (liquid_ gel_ paste_ etc.)_ per 1 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0384U","description":"Nephrology (chronic kidney disease)_ carboxymethyllysine_ methylglyoxal hydroimidazolone_ and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1B","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33010","description":"Drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKB1","description":"ICD-CEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck m1 mets rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9111","description":"Onc dx head/neck m1 mets rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSA1","description":"ICD-PDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lab pathology consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80502","description":"Lab pathology consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit enzyme replace diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9357","description":"Hit enzyme replace diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQC1","description":"ICD-GIQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB0","description":"ICD-NLVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC0","description":"ICD-GCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB34","description":"Low Rehab_ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7524","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_ w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID1","description":"ICD-JDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Door to punc time >2hr_ nrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9582","description":"Door to punc time >2hr_ nrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXD0","description":"ICD-OKXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1026","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMF1","description":"ICD-IIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUF1","description":"ICD-FBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPF1","description":"ICD-OJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3B","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA1","description":"ICD-BIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IB21","description":"ICD-4IB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF1","description":"ICD-OHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA0","description":"ICD-KDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE134","description":"Reduced Physical Function _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAGB0","description":"ICD-BAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHC0","description":"ICD-FIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 vst p mo 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90959","description":"Esrd serv 1 vst p mo 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ldl-c <100 mg/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3048F","description":"Ldl-c <100 mg/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQA1","description":"ICD-CFQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC255","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27236","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC0","description":"ICD-JIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOC0","description":"ICD-HBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE0","description":"ICD-KBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC0","description":"ICD-NLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXE0","description":"ICD-JEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 2-3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72040","description":"X-ray exam neck spine 2-3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC0","description":"ICD-OGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKC1","description":"ICD-GEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC1","description":"ICD-HIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJC1","description":"ICD-FDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCYB0","description":"ICD-HCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57289","description":"Repair bladder & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD115","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXD0","description":"ICD-BEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hcg free betachain test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84704","description":"Hcg free betachain test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA4A","description":"Ultra High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXD0","description":"ICD-CDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral infusion pump w/ ala","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B9002","description":"Enteral infusion pump w/ ala","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA105","description":"Clinically Complex _ ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7503","description":"Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg_ mapping) of sentinel lymph node(s) including injection of non-radioactive dye when per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16377","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16377","description":"CPT-16377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLE0","description":"ICD-FGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX25","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01938","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","description":"CPT-01938","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21825","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AB31","description":"ICD-1AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD0","description":"ICD-BBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOF1","description":"ICD-LGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9080","description":"Injection_ melphalan flufenamide hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAD0","description":"ICD-NGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMA0","description":"ICD-EEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSB1","description":"ICD-PDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peg interferon alfa-2b/10","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0148","description":"Peg interferon alfa-2b/10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMF0","description":"ICD-OIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE120","description":"Special Care High _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGF0","description":"ICD-GIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC0","description":"ICD-FCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69705","description":"Nasopharyngoscopy_ Surgical_ With Dilation Of Eustachian Tube (Ie_ Balloon Dilation); Unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE1","description":"ICD-MEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0370T","description":"Family adaptive behavior treatment guidance_ administered by physician or other qualified health care professional (without the patient present)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAA0","description":"ICD-GGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYD1","description":"ICD-KIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Augmentation lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21125","description":"Augmentation lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF0","description":"ICD-BCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD1","description":"ICD-NDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADE0","description":"ICD-AADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood ketone test or strip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4252","description":"Blood ketone test or strip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE105","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECF0","description":"ICD-KECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVF1","description":"ICD-FBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genitourinary nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78799","description":"Genitourinary nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frontier extended stay demo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9140","description":"Frontier extended stay demo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA0","description":"ICD-BDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFF1","description":"ICD-OGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBWF1","description":"ICD-OBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC1","description":"ICD-JBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLE1","description":"ICD-OJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBA1","description":"ICD-JGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEID0","description":"ICD-JEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILD0","description":"ICD-OILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXB1","description":"ICD-OLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTB0","description":"ICD-OFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8C","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIC0","description":"ICD-KHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBF0","description":"ICD-IBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDF0","description":"ICD-MDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd balloon dil esoph30 mm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43233","description":"Egd balloon dil esoph30 mm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA51","description":"Default_ /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of bradykinin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82286","description":"Assay of bradykinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve remov init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31648","description":"Bronchial valve remov init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRE1","description":"ICD-DIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Igh gene rearrang dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81262","description":"Igh gene rearrang dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWE0","description":"ICD-GHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29847","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29520","description":"Strapping of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1253","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA0","description":"ICD-PJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0805T","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie_ caval valve implantation [CAVI]); percutaneous femoral vein approach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAC0","description":"ICD-FIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stat lab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3600","description":"Stat lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDF0","description":"ICD-IFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA0","description":"ICD-JDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJF0","description":"ICD-JIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C/o for orthotic/prosth use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97762","description":"C/o for orthotic/prosth use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBD0","description":"ICD-ACBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collection of microorganisms","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0415","description":"Collection of microorganisms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILB1","description":"ICD-CILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC11C","description":"Clinically Complex _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDED0","description":"ICD-BDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo by both infusion and o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0085","description":"Chemo by both infusion and o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mult mech switches","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2322","description":"Mult mech switches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCC0","description":"ICD-GBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE213","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21435","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJA1","description":"ICD-KFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81194","description":"Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1_ 2_ And 3) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77280","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJC0","description":"ICD-FGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20938","description":"Sp bone agrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication athletic guard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9941","description":"Fabrication athletic guard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabeculostomy Ab Interno By Laser;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0621T","description":"Trabeculostomy Ab Interno By Laser;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0989T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","description":"CPT-0989T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92652","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery cables","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4612","description":"Battery cables","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB0","description":"ICD-MKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARC0","description":"ICD-PARC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIA1","description":"ICD-KGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of eyelid abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67700","description":"Drainage of eyelid abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRE0","description":"ICD-OHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQE1","description":"ICD-PKQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID0","description":"ICD-MEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay porc 3/more sur","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2630","description":"Dental onlay porc 3/more sur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF1","description":"ICD-CHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFA0","description":"ICD-OAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neostim dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4267","description":"Neostim dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hard protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8001","description":"Hard protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37247","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMA0","description":"ICD-JEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2097","description":"Children With A Competing Diagnosis For Upper Respiratory Infection Within Three Days Of Diagnosis Of Pharyngitis (E.G._ Intestinal Infection_ Pertussis_ Bacterial Infection_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFC0","description":"ICD-JAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16372","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16372","description":"CPT-16372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient with diagnosis of osteoporosis on date of encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1153","description":"Patient with diagnosis of osteoporosis on date of encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd control bleeding any","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43255","description":"Egd control bleeding any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDBD0","description":"ICD-JDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9073","description":"Brexucabtagene autoleucel_ up to 200 million autologous anti-cd19 car positive viable t cells_ including leukapheresis and dose preparation procedures_ per therapeutic dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB0","description":"ICD-OLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIB1","description":"ICD-NDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chimerism anal no cell selec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81267","description":"Chimerism anal no cell selec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXA0","description":"ICD-NKXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA0","description":"ICD-BHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB0","description":"ICD-IIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRD0","description":"ICD-DHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0973T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","description":"CPT-0973T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBC1","description":"ICD-MDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRB0","description":"ICD-OKRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cathepsin-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82387","description":"Assay of cathepsin-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1171","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTF0","description":"ICD-AHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77066","description":"Diagnostic mammography_ including computer-aided detection (CAD) when performed; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF0","description":"ICD-NEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD0","description":"ICD-GHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ny heart assoc class docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3118F","description":"Ny heart assoc class docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLB0","description":"ICD-MHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVF1","description":"ICD-JAVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKTC0","description":"ICD-NKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWA1","description":"ICD-HBWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUD1","description":"ICD-AHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC52","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lacosamide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9254","description":"Injection_ lacosamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALB1","description":"ICD-OALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKD1","description":"ICD-CFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLF1","description":"ICD-AFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vasopressin_ 1 unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2598","description":"Injection_ vasopressin_ 1 unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein byp fem-tibial peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35585","description":"Vein byp fem-tibial peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev soft tiss add imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10036","description":"Perq dev soft tiss add imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time activated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85347","description":"Coagulation time activated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC0","description":"ICD-NBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB18I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aldolase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82085","description":"Assay of aldolase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic wrist rotator any","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7259","description":"Electronic wrist rotator any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINC0","description":"ICD-JINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9993","description":"Injection_ triamcinolone acetonide_ preservative-free_ extended-release_ microsphere formulation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAD0","description":"ICD-EIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 7 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP07","description":"Auto.test pane pricing code_ 7 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0553T","description":"Percutaneous transcatheter placement of iliac arteriovenous anastomosis implant_ inclusive of all radiological supervision and interpretation_ intraprocedural roadmapping_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD0","description":"ICD-JFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23625","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBD0","description":"ICD-BFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARB1","description":"ICD-PARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prothrombin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85611","description":"Prothrombin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB0","description":"ICD-JIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA0","description":"ICD-KFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD1","description":"ICD-AGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKF0","description":"ICD-OIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYC0","description":"ICD-HDYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSB1","description":"ICD-DHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFF1","description":"ICD-KDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD0","description":"ICD-OBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone srgry cmptr fluor image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0054T","description":"Bone srgry cmptr fluor image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD0","description":"ICD-GHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance half arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0655","description":"Pneumatic appliance half arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mesentery lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44820","description":"Excision of mesentery lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ret dev_ insertable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1773","description":"Ret dev_ insertable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC0","description":"ICD-FBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF0","description":"ICD-KDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC1","description":"ICD-CEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90638","description":"Influenza virus vaccine_ quadrivalent (qIRV)_ mRNA; 60 mcg/0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKD0","description":"ICD-KHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRF0","description":"ICD-DFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ dual chamber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1721","description":"Aicd_ dual chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No postop ren fail","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8576","description":"No postop ren fail","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i typing 1 locus hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81380","description":"Hla i typing 1 locus hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJB1","description":"ICD-CGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQF0","description":"ICD-ODQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0912T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","description":"CPT-0912T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUC0","description":"ICD-BIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0417U","description":"Rare diseases (constitutional/heritable disorders)_ whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis_ nuclear-encoded mitochondrial gene a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ propofol_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2704","description":"Inj_ propofol_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMC1","description":"ICD-MGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add le poly knee custom kafo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2387","description":"Add le poly knee custom kafo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISD0","description":"ICD-DISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRC1","description":"ICD-OCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ thrombectomy/embolect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1757","description":"Cath_ thrombectomy/embolect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWA1","description":"ICD-OHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation by ocularist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9150","description":"Evaluation by ocularist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0833","description":"Injection_ cosyntropin_ not otherwise specified_ 0.25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pten gene full sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81321","description":"Pten gene full sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEE0","description":"ICD-NEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHF1","description":"ICD-KBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKA0","description":"ICD-OCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFHD0","description":"ICD-OFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKF1","description":"ICD-NAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epifix_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4145","description":"Epifix_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXF1","description":"ICD-NKXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RenoGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4321","description":"RenoGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRE0","description":"ICD-LBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIC1","description":"ICD-IDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitoring/videorecord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95951","description":"Eeg monitoring/videorecord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7513","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD221","description":"Special Care High _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0904","description":"HCPCS-A0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKE1","description":"ICD-BEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test 3 limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95863","description":"Muscle test 3 limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGE1","description":"ICD-BDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAE1","description":"ICD-GEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59121","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD0","description":"ICD-OFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOF0","description":"ICD-GAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlh uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58572","description":"Tlh uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEF1","description":"ICD-NCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUE1","description":"ICD-JGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEE1","description":"ICD-EFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1055T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1055T","description":"CPT-1055T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCD0","description":"ICD-NHCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of skin abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10061","description":"Drainage of skin abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE0","description":"ICD-FCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD0","description":"ICD-OFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hc pro phone call 5-10 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98966","description":"Hc pro phone call 5-10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0803T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINB0","description":"ICD-KINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA10","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKA1","description":"ICD-FAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHC1","description":"ICD-NKHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQE1","description":"ICD-LHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53010","description":"Incision of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft protect helmet prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8000","description":"Soft protect helmet prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF1","description":"ICD-DGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC MTC MRNA XPRSN ALYS 108","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0208U","description":"ONC MTC MRNA XPRSN ALYS 108","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trg gene rearrangement anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81342","description":"Trg gene rearrangement anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWF1","description":"ICD-KFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microprcsr cu elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0481","description":"Microprcsr cu elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACA1","description":"ICD-IACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48000","description":"Drainage of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HB31","description":"ICD-4HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOB1","description":"ICD-PBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHC1","description":"ICD-JGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64480","description":"Inj foramen epidural add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7211","description":"Injection_ Factor VIII_ (antihemophilic factor_ recombinant)_ (Kovaltry)_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCD0","description":"ICD-MJCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTF1","description":"ICD-OFTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC1","description":"ICD-NDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA1","description":"ICD-AHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonpneumatic sequential compression garment_ full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1032","description":"Nonpneumatic sequential compression garment_ full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB55","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7637","description":"Dexamethasone comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYF1","description":"ICD-GBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARB1","description":"ICD-CARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTB1","description":"ICD-KFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB12","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray urinary tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74400","description":"Contrst x-ray urinary tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBD0","description":"ICD-CGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQA1","description":"ICD-KEQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44955","description":"Appendectomy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEA0","description":"ICD-OKEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHQD0","description":"ICD-DHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auricular replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5927","description":"Auricular replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat mouth roof fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21421","description":"Treat mouth roof fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bcr/abl1 gene major bp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81206","description":"Bcr/abl1 gene major bp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEAA0","description":"ICD-IEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enlarge breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19324","description":"Enlarge breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resuscitation bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8999","description":"Resuscitation bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQF1","description":"ICD-KIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo partial colectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44204","description":"Laparo partial colectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEE0","description":"ICD-MGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBD1","description":"ICD-FGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC21A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALE1","description":"ICD-CALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWA1","description":"ICD-OFWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYE0","description":"ICD-KFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96574","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie_ targeted curettage_ abrasion) followed with photodynamic therapy by external application of light to destroy premalig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC21","description":"ICD-2LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cane adjust/fixed with tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0100","description":"Cane adjust/fixed with tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPA0","description":"ICD-JHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ovarian tube(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58752","description":"Revise ovarian tube(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVC0","description":"ICD-KBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHMB1","description":"ICD-GHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWF0","description":"ICD-CHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1020T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","description":"CPT-1020T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF1","description":"ICD-KCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syst corticosteroids not rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4136F","description":"Syst corticosteroids not rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39010","description":"Exploration of chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot single axis ankle/foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5974","description":"Foot single axis ankle/foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238U","description":"Oncology (Lynch syndrome)_ genomic DNA sequence analysis of MLH1_ MSH2_ MSH6_ PMS2_ and EPCAM_ including small sequence changes in exonic and intronic regions_ deletions_ dupl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25490","description":"Reinforce radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGHE0","description":"ICD-CGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal trnspl endothelial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65756","description":"Corneal trnspl endothelial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0059U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1)_ serum_ reported as positive or negative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXB0","description":"ICD-NGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75870","description":"Vein x-ray skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA1","description":"ICD-JFXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med abortion inc all ex drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0199","description":"Med abortion inc all ex drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOF1","description":"ICD-LCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abatacept injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0129","description":"Abatacept injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retainer Crown 3/4 - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6784","description":"Retainer Crown 3/4 - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin pneum/hydra pneum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5780","description":"Knee-shin pneum/hydra pneum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84154","description":"Assay of psa free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVC1","description":"ICD-GEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient receiving an anti-TNF agent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9914","description":"Patient receiving an anti-TNF agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echocardiography contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9700","description":"Echocardiography contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemical cauterization of granulation tissue (ie_ proud flesh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17250","description":"Chemical cauterization of granulation tissue (ie_ proud flesh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sunglass frames","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0518","description":"Sunglass frames","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD0","description":"ICD-NLLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD0","description":"ICD-OITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHA1","description":"ICD-CHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAC1","description":"ICD-EAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable unilateral partial denture - one piece cast metal_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5283","description":"Removable unilateral partial denture - one piece cast metal_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJB1","description":"ICD-CCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHLV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASD1","description":"ICD-LASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CT/MRI chest/neck no thy nod","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9557","description":"CT/MRI chest/neck no thy nod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert w/o lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5679","description":"Socket insert w/o lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQB1","description":"ICD-LDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWE0","description":"ICD-HCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1185","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA1","description":"ICD-CBLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSF1","description":"ICD-LCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of progesterone 17-d","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83498","description":"Assay of progesterone 17-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power operated vehicle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1230","description":"Power operated vehicle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOC0","description":"ICD-KBOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC1","description":"ICD-EIAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCB0","description":"ICD-CFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHD0","description":"ICD-AFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGB1","description":"ICD-BIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00794","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","description":"CPT-00794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRC0","description":"ICD-LIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLA0","description":"ICD-NDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXA1","description":"ICD-OBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHB0","description":"ICD-OCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fluoride","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82735","description":"Assay of fluoride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","description":"CPT-01730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHB1","description":"ICD-EHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood clot retraction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85170","description":"Blood clot retraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0804","description":"HCPCS-A0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repr of anal fistula w/glue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46706","description":"Repr of anal fistula w/glue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDC0","description":"ICD-IIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWB0","description":"ICD-OHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gammagard liquid injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1569","description":"Gammagard liquid injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF0","description":"ICD-FBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMA1","description":"ICD-MHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99459","description":"Pelvic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA0","description":"ICD-PHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEC0","description":"ICD-CGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALA0","description":"ICD-MALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKE0","description":"ICD-NHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gingivectomy/plasty per toot","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4211","description":"Gingivectomy/plasty per toot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAA1","description":"ICD-BHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-reflective coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2750","description":"Anti-reflective coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0629T","description":"Percutaneous Injection Of Allogeneic Cellular And/Or Tissue-Based Product_ Intervertebral Disc_ Unilateral Or Bilateral Injection_ With Ct Guidance_ Lumbar; First Level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81283","description":"IFNL3 (interferon_ lambda 3) (eg_ drug response)_ gene analysis_ rs12979860 variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJE0","description":"ICD-JIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart chambers","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33670","description":"Repair of heart chambers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fo nontorsion joint cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3935","description":"Fo nontorsion joint cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymph vessel x-ray arm/leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75801","description":"Lymph vessel x-ray arm/leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWA1","description":"ICD-DIWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCD0","description":"ICD-OGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt lft inpt fac w/in 60 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1110F","description":"Pt lft inpt fac w/in 60 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elastic garment/covering","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4466","description":"Elastic garment/covering","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Odontics endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6010","description":"Odontics endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown porcelain base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6751","description":"Crown porcelain base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd w multi methods msg/accs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2510","description":"Sgd w multi methods msg/accs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEF1","description":"ICD-FFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5C","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise & repair chest wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32906","description":"Revise & repair chest wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLA1","description":"ICD-MKLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sacrum pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15931","description":"Remove sacrum pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE1","description":"ICD-EBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELB0","description":"ICD-JELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDA0","description":"ICD-MHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/enterocele repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58270","description":"Vag hyst w/enterocele repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVE1","description":"ICD-CDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD1","description":"ICD-BFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJE1","description":"ICD-FCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOE1","description":"ICD-CAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBBB1","description":"ICD-KBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360T","description":"Observational behavioral follow-up assessment_ includes physician or other qualified health care professional direction with interpretation and report_ administered by one tec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove sling repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57287","description":"Revise/remove sling repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJD1","description":"ICD-OBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9708","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0104","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0104","description":"CDT-D0104","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admin influenza virus vac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0008","description":"Admin influenza virus vac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser in situ keratomileusis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0800","description":"Laser in situ keratomileusis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUE1","description":"ICD-AFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCF1","description":"ICD-JHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA0","description":"ICD-GDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASF0","description":"ICD-KASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC0","description":"ICD-JEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUB1","description":"ICD-MFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHM1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0309","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 180 day implantable sensor_ including s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0522U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","description":"CPT-0522U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFF0","description":"ICD-KEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1001","description":"HCPCS-C1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA3C","description":"High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph optical endomicroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43206","description":"Esoph optical endomicroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWA0","description":"ICD-HAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1484","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","description":"HCPCS-M1484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAF0","description":"ICD-NEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0704","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0704","description":"CDT-D0704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLB1","description":"ICD-BGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF0","description":"ICD-OIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQA0","description":"ICD-OIQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36800","description":"Insertion of cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARF1","description":"ICD-DARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC0","description":"ICD-OBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44370","description":"Small bowel endoscopy/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD0","description":"ICD-CFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOD0","description":"ICD-HBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/fb removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29861","description":"Hip arthro w/fb removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFPD1","description":"ICD-GFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGC1","description":"ICD-BDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct uppr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73202","description":"Ct uppr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig neg scrn depres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8510","description":"Pt inelig neg scrn depres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alginate drsg >16 <=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6197","description":"Alginate drsg >16 <=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCF1","description":"ICD-BHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Devise bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44316","description":"Devise bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILC0","description":"ICD-FILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB250","description":"Clinically Complex _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77067","description":"Screening mammography_ bilateral (2-view study of each breast)_ including computer-aided detection (CAD) when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iv oct for proc init vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291T","description":"Iv oct for proc init vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASC1","description":"ICD-CASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX2C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC0","description":"ICD-EBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHA1","description":"ICD-MHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0016M","description":"Oncology (bladder)_ mRNA_ microarray gene expression profiling of 209 genes_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm reported as molecular subtype (lumina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscp rig trnso biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43193","description":"Esophagoscp rig trnso biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB156","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGC1","description":"ICD-JDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLF1","description":"ICD-CFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUA0","description":"ICD-MDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEC0","description":"ICD-EAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNC0","description":"ICD-OCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0241","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection_ and post administration monitoring in the home or residence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB31","description":"ICD-4JB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQC0","description":"ICD-DFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHA1","description":"ICD-OGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB22D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESD0","description":"ICD-OESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNF1","description":"ICD-FGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGF1","description":"ICD-CGGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC1","description":"ICD-AECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unspecified oral anti-emetic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0181","description":"Unspecified oral anti-emetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQB1","description":"ICD-CCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVE0","description":"ICD-FAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPA0","description":"ICD-OKPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2 pc drainable ost pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4413","description":"2 pc drainable ost pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC0","description":"ICD-GBYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBD0","description":"ICD-NJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8698","description":"Re-Cement Or Re-Bond Fixed Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fats/lipids feces quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82710","description":"Fats/lipids feces quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJE0","description":"ICD-OEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJA0","description":"ICD-CEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eardrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69610","description":"Repair of eardrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33410","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMB1","description":"ICD-AGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWD0","description":"ICD-GDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0488T","description":"Preventive behavior change_ online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMC0","description":"ICD-IEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28546","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTF0","description":"ICD-ODTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA33","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHB1","description":"ICD-FGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF1","description":"ICD-AICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHID0","description":"ICD-MHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trim nail(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0127","description":"Trim nail(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTB0","description":"ICD-MKTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE136","description":"Special Care Low _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC1","description":"ICD-OFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emr pwr source combo vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0491","description":"Emr pwr source combo vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aicd_ other than sing/dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1882","description":"Aicd_ other than sing/dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB1","description":"ICD-OIIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKB0","description":"ICD-JBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGC1","description":"ICD-NGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penis study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54250","description":"Penis study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clean & inspect rem dent man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9933","description":"Clean & inspect rem dent man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA15D","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA1","description":"ICD-EHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain to peritoneal cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49062","description":"Drain to peritoneal cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF0","description":"ICD-BFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pozelimab-bbfg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9376","description":"Injection_ pozelimab-bbfg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1401","description":"HCPCS-C1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHD0","description":"ICD-IFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1474","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","description":"HCPCS-M1474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD1","description":"ICD-MGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiograph neck w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70549","description":"Mr angiograph neck w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9909","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External bleaching home app","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9975","description":"External bleaching home app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEF0","description":"ICD-JIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score hip < 0","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8652","description":"Fun stat score hip < 0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95145","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair major blood vessel(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33320","description":"Repair major blood vessel(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cartilage for graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20912","description":"Remove cartilage for graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1041","description":"Medicaid certified community behavioral health clinic services_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC60","description":"Medium Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJA0","description":"ICD-BEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA5C","description":"Default_ /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64702","description":"Revise finger/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD1","description":"ICD-MIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary compliance study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94750","description":"Pulmonary compliance study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneum compres w/cal pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0652","description":"Pneum compres w/cal pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00918","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","description":"CPT-00918","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB31","description":"ICD-3BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVD1","description":"ICD-OIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin alfa_ 100 units esrd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4081","description":"Epoetin alfa_ 100 units esrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair non-electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0171","description":"Commode chair non-electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLB0","description":"ICD-NKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX43","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9882","description":"Two Medica re Diabetes Prevention Program (MDPP) ongoing maintenance se ss ions (MS) were attended by an MDPP beneficiary in months (mo) 13-15 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008U","description":"Helicobacter pylori detection and antibiotic resistance_ DNA_ 16S and 23S rRNA_ gyrA_ pbp1_ rdxA and rpoB_ next generation sequencing_ formalin-fixed paraffin embedded or fres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA53","description":"Default_ /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 50-100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88248","description":"Chromosome analysis 50-100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD1","description":"ICD-GGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43284","description":"Laparoscopy_ surgical_ esophageal sphincter augmentation procedure_ placement of sphincter augmentation device (ie_ magnetic band)_ including cruroplasty when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27814","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aorcel/aormesen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35531","description":"Art byp grft aorcel/aormesen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD1","description":"ICD-JFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove aorta constriction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33851","description":"Remove aorta constriction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE0","description":"ICD-OLWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHD0","description":"ICD-NLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc < 1.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28043","description":"Exc foot/toe tum sc < 1.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRA0","description":"ICD-GCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95705","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; Unmonitored","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC1","description":"ICD-MHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18X","description":"Special Care Low _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia removal pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54251","description":"Anesthesia removal pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES110","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22C","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA256","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF0","description":"ICD-FGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis uni","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77061","description":"Breast tomosynthesis uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of transferrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84466","description":"Assay of transferrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no 7d f/u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9406","description":"Doc reas no 7d f/u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEC1","description":"ICD-CIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC160","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0407","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0407","description":"HCPCS-A0407","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLA0","description":"ICD-NGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6594","description":"Gradient compression bandaging supply_ bandage liner_ lower extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQC0","description":"ICD-DDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4184","description":"Cellesta_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90704","description":"Mumps virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLF1","description":"ICD-KDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD1","description":"ICD-AFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1069T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1069T","description":"CPT-1069T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj sulf hexa lipid microsph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9950","description":"Inj sulf hexa lipid microsph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage board postural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0606","description":"Drainage board postural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Personal care ser per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1020","description":"Personal care ser per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC1","description":"ICD-HIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aldesleukin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9015","description":"Aldesleukin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMF1","description":"ICD-MHMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54699","description":"Laparoscope proc testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHA1","description":"ICD-GIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fulvestrant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9395","description":"Injection_ fulvestrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD215","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVC1","description":"ICD-KFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKE1","description":"ICD-NLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEID0","description":"ICD-GEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOE1","description":"ICD-PGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFA0","description":"ICD-GIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAED1","description":"ICD-BAED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWE0","description":"ICD-PJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cangrelor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9460","description":"Injection_ cangrelor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHF0","description":"ICD-IGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUB1","description":"ICD-OBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2217","description":"Foam filled caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKD1","description":"ICD-OCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fern test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0114","description":"Fern test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q2057","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","description":"HCPCS-Q2057","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen Test For Platelets","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9987","description":"Pathogen Test For Platelets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/fam w/e&m 60 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90838","description":"Psytx pt&/fam w/e&m 60 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone algrft struct add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20931","description":"Sp bone algrft struct add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB0","description":"ICD-IDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic custom fa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0480","description":"Tlso rigid plastic custom fa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-op service lvrs 1-9 dos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0304","description":"Pre-op service lvrs 1-9 dos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEF1","description":"ICD-BEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC0","description":"ICD-DFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF0","description":"ICD-FBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test hippel-lindau","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3842","description":"Gene test hippel-lindau","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGAA1","description":"ICD-CGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sperm pouch lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55680","description":"Remove sperm pouch lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1361","description":"Suicide risk based on their clinician_s evaluation or a clinician-rated tool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asp therp used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8598","description":"Asp therp used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDA1","description":"ICD-AHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA0","description":"ICD-PEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD0","description":"ICD-OBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDD0","description":"ICD-IGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180T","description":"64 lead ecg w/i&r only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9341","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","description":"HCPCS-J9341","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA0","description":"ICD-KGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSB1","description":"ICD-DGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUA0","description":"ICD-ODUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGD0","description":"ICD-GDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADF1","description":"ICD-FADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary rubber pouch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4380","description":"Urinary rubber pouch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKE0","description":"ICD-OIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0303T","description":"Icar ischm mntrng sys eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy finger joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26110","description":"Biopsy finger joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic anoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46601","description":"Diagnostic anoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQD1","description":"ICD-CIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLE1","description":"ICD-MLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCA0","description":"ICD-MBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4380","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","description":"HCPCS-Q4380","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tagraxofusp-erzs_ 10 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9269","description":"Injection_ tagraxofusp-erzs_ 10 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultralightweight wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0005","description":"Ultralightweight wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo cholecystectomy/explr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47564","description":"Laparo cholecystectomy/explr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95146","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse pancreas and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48548","description":"Fuse pancreas and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLA1","description":"ICD-GCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip tum w/innom bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27077","description":"Resect hip tum w/innom bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepc measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8545","description":"Hepc measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUA0","description":"ICD-BHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUF0","description":"ICD-AFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital bed var ht w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0256","description":"Hospital bed var ht w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC0","description":"ICD-BHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWE1","description":"ICD-CCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEF0","description":"ICD-AGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHCA0","description":"ICD-NHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0467","description":"Home ventilator_ multi-function respiratory device_ also performs any or all of the additional functions of oxygen concentratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADC1","description":"ICD-BADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD146","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXF0","description":"ICD-NIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFE0","description":"ICD-GCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration for testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54560","description":"Exploration for testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTB0","description":"ICD-ADTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE0","description":"ICD-NKGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intro/sheath_ laser","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2629","description":"Intro/sheath_ laser","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of theophylline","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80198","description":"Assay of theophylline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIPE0","description":"ICD-JIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHMC1","description":"ICD-OHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inlay porcelain/ceramic 2 su","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2620","description":"Inlay porcelain/ceramic 2 su","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33814","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWA0","description":"ICD-PDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIA1","description":"ICD-MEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQF0","description":"ICD-OJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21603","description":"Excision Of Chest Wall Tumor Involving Rib(S)_ With Plastic Reconstruction; With Mediastinal Lymphadenectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECC0","description":"ICD-MECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC25D","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTE0","description":"ICD-KDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50783","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doxepin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6034","description":"Doxepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCA0","description":"ICD-ICCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQE1","description":"ICD-DCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBC0","description":"ICD-AEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9681","description":"Onsite Ac C Tx Nsg Fac Res Copd/As Bill Sid-Bnef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXE1","description":"ICD-KBXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC0","description":"ICD-FAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEC1","description":"ICD-JIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25445","description":"Reconstruct wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARB0","description":"ICD-KARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD15C","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTF1","description":"ICD-MKTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSC0","description":"ICD-LDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1445","description":"Injection_ ferric pyrophosphate citrate solution (TrifericAVNU)_ 0.1 mg of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAD0","description":"ICD-GBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA1","description":"ICD-KHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj sciatic sng","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64445","description":"N block inj sciatic sng","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical revision procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4268","description":"Surgical revision procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excisional biopsy of minor salivary glands","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7284","description":"Excisional biopsy of minor salivary glands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvotomy pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33471","description":"Valvotomy pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX5B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92977","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18A","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF0","description":"ICD-GDLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRD1","description":"ICD-CBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7551","description":"Excision of major peripheral nerve neuroma_ except sciatic_ with implantation of nerve end into bone or muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8X","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC0","description":"ICD-FBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct midface w/graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7949","description":"Reconstruct midface w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther fostercare child /month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5146","description":"Ther fostercare child /month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7320","description":"Hyaluronan or derivitive_ genvisc 850_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9243","description":"intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYF0","description":"ICD-KFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple surgery abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49220","description":"Multiple surgery abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC24A","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASC1","description":"ICD-LASC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUE0","description":"ICD-CFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAD1","description":"ICD-NBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glasses cros hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5190","description":"Glasses cros hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Head control proximity switc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2330","description":"Head control proximity switc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYE1","description":"ICD-HAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repr pul art unifocal w/cpb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33926","description":"Repr pul art unifocal w/cpb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Probe nl duct w/balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68816","description":"Probe nl duct w/balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTB1","description":"ICD-NDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCC1","description":"ICD-MHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy for treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31527","description":"Laryngoscopy for treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagomyotomy abdominal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43330","description":"Esophagomyotomy abdominal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAVA1","description":"ICD-BAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0A","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMD1","description":"ICD-EEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHNE0","description":"ICD-OHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHC1","description":"ICD-MFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Res care_ nos waiver/month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2032","description":"Res care_ nos waiver/month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDF1","description":"ICD-EHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue in-situ hybridization","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0479","description":"Tissue in-situ hybridization","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-38227","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","description":"CPT-38227","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPD1","description":"ICD-BIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3KA11","description":"ICD-3KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE0","description":"ICD-OLXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSF0","description":"ICD-OLSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD0","description":"ICD-KBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATC0","description":"ICD-KATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECB0","description":"ICD-MECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy removal of clots","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52001","description":"Cystoscopy removal of clots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDB0","description":"ICD-CEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPC1","description":"ICD-GEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMD0","description":"ICD-ICMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWA1","description":"ICD-PJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA0","description":"ICD-PLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound closure by adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0168","description":"Wound closure by adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRB0","description":"ICD-LHRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c dpth 22-25 in seat frame","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2343","description":"W/c dpth 22-25 in seat frame","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIE0","description":"ICD-KAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HA31","description":"ICD-1HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYE1","description":"ICD-OBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC0","description":"ICD-CHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger/hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26356","description":"Repair finger/hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echograp trans r pros study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76873","description":"Echograp trans r pros study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0055U","description":"Cardiology (heart transplant)_ cell-free DNA_ PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets)_ plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 15-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86300","description":"Immunoassay tumor ca 15-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSB0","description":"ICD-LDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"teledentistry synchronous real time encounter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9995","description":"teledentistry synchronous real time encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIE1","description":"ICD-NCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC0","description":"ICD-HESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vertebroplasty addl inject","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22512","description":"Vertebroplasty addl inject","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB0","description":"ICD-ACUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA20","description":"Ultra High Rehab _ ADL Index 0-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIF1","description":"ICD-AEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISE0","description":"ICD-LISE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGLB0","description":"ICD-CGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8D","description":"Low Rehab_ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1354","description":"Patients who did not have a suicide safety plan initiated_ reviewed_ or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or wit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace denture teeth complt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5520","description":"Replace denture teeth complt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCC1","description":"ICD-MGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVD1","description":"ICD-FGVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of stomach lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43610","description":"Excision of stomach lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAD1","description":"ICD-EEAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD0","description":"ICD-JECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBC1","description":"ICD-BGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81005","description":"Urinalysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAD0","description":"ICD-MDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28160","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC1","description":"ICD-BHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUE0","description":"ICD-ABUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea sen ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425T","description":"Insj/rplc nstim apnea sen ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78266","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC1","description":"ICD-OGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cid transmit coil and cable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8629","description":"Cid transmit coil and cable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKA1","description":"ICD-OLKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRE0","description":"ICD-HFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB0","description":"ICD-NLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE0","description":"ICD-GCQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of airways","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31720","description":"Clearance of airways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9058","description":"Injection_ bendamustine hydrochloride (apotex)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEB1","description":"ICD-FIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQE1","description":"ICD-PIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast tomosynthesis bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77063","description":"Breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sup fee antiem_antica_immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0511","description":"Sup fee antiem_antica_immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCF1","description":"ICD-OHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWC0","description":"ICD-HIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQD1","description":"ICD-PHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEE0","description":"ICD-BDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flexible metal hinge pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6610","description":"Flexible metal hinge pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBF0","description":"ICD-JFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGLA1","description":"ICD-IGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE0","description":"ICD-CFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCF1","description":"ICD-FHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLB1","description":"ICD-EFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB0","description":"ICD-KHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBC0","description":"ICD-FEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown full base metal cast","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6791","description":"Crown full base metal cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIF0","description":"ICD-ICIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian stg1a-b or 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9114","description":"Onc dx ovarian stg1a-b or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEXE0","description":"ICD-BEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD1","description":"ICD-ODWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAA1","description":"ICD-NKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHF1","description":"ICD-FFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHD1","description":"ICD-NIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ initial rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9001","description":"Mccd_ initial rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE0","description":"ICD-NKEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE1","description":"ICD-ADDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low frequency non-thermal us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97610","description":"Low frequency non-thermal us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDND0","description":"ICD-CDND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9363","description":"Duration of monitored anesthesia care(mac)or peripheral nerve block(pnb)without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC0","description":"ICD-MADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 4 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34844","description":"Endovasc visc aorta 4 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93585","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; azygos/hemiazygos venous system (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal foreign body mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40805","description":"Removal foreign body mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74150","description":"Ct abdomen w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE14A","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC1","description":"ICD-BCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18D","description":"Clinically Complex _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPD1","description":"ICD-KAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nickel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83885","description":"Assay of nickel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE221","description":"Special Care High _ ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als routine disposble suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0398","description":"Als routine disposble suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL20","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10C","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFMD1","description":"ICD-CFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOB1","description":"ICD-LIOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA33","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIC1","description":"ICD-NEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKF0","description":"ICD-NBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61605","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNE0","description":"ICD-JHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28202","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 4.00d/12-2.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2103","description":"Spherocylindr 4.00d/12-2.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICC1","description":"ICD-OICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE212","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIC0","description":"ICD-NFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE0","description":"ICD-NJPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus surgery for veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43401","description":"Esophagus surgery for veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD141","description":"Special Care High _ ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHB0","description":"ICD-MLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALB1","description":"ICD-JALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst base mtl 2 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6612","description":"Onlay cst base mtl 2 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBE0","description":"ICD-EHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0006","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mdd severe w/psych","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3091F","description":"Mdd severe w/psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYB1","description":"ICD-GGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1251","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL35","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18H","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYE1","description":"ICD-LGYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFD1","description":"ICD-OFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1360","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"John cunningham antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86711","description":"John cunningham antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEED1","description":"ICD-KEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB104","description":"Clinically Complex _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCTC0","description":"ICD-FCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA31","description":"Medium Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA0","description":"ICD-NABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIME0","description":"ICD-FIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB225","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51575","description":"Removal of bladder & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF1","description":"ICD-GEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98976","description":"Remote Therapeutic Monitoring (Eg_ Respiratory System Status_ Musculoskeletal System Status_ Therapy Adherence_ Therapy Response); Device(S) Supply With Scheduled (Eg_ Daily)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of sternum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21740","description":"Reconstruction of sternum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPF0","description":"ICD-CFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGF0","description":"ICD-NLGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPD0","description":"ICD-NAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolysins screen i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85390","description":"Fibrinolysins screen i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC36","description":"High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPD1","description":"ICD-GBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA0","description":"ICD-FHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHA1","description":"ICD-JHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRE1","description":"ICD-DCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB1","description":"ICD-IBCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LC21","description":"ICD-4LC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CB11","description":"ICD-3CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB1","description":"ICD-AEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQD1","description":"ICD-GCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine porphyrins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84120","description":"Assay of urine porphyrins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hsv dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87528","description":"Hsv dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chct for mal hyperthermia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89049","description":"Chct for mal hyperthermia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy shoulder tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23066","description":"Biopsy shoulder tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit longterm infusion diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9347","description":"Hit longterm infusion diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ctrl dose inh drug deliv sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0730","description":"Ctrl dose inh drug deliv sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB0","description":"ICD-HEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace lensshield cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4257","description":"Replace lensshield cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPE0","description":"ICD-JDPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAE1","description":"ICD-EGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33020","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUA0","description":"ICD-CFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF1","description":"ICD-BEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate esophagus 1/mult pass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43450","description":"Dilate esophagus 1/mult pass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGD0","description":"ICD-BHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMC0","description":"ICD-NJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8010","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8010","description":"HCPCS-C8010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA1","description":"ICD-KHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD0","description":"ICD-FAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33420","description":"Revision of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB1","description":"ICD-CBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sheath above knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8410","description":"Sheath above knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp mal+marg 0.5/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11620","description":"Exc h-f-nk-sp mal+marg 0.5/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls repos perph cnula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33958","description":"Ecmo/ecls repos perph cnula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC0","description":"ICD-EDUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES20C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documented reason for not screening or recommending a follow-up for high blood pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1288","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient treatment and final evaluation complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1010","description":"Patient treatment and final evaluation complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25574","description":"Treat fracture radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAE1","description":"ICD-MBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24D","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscope us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45391","description":"Colonoscopy w/endoscope us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB1","description":"ICD-JGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95930","description":"Visual evoked potential (VEP) checkerboard or flash testing_ central nervous system except glaucoma_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0264U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So 8 ab rstr can/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3660","description":"So 8 ab rstr can/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHF1","description":"ICD-JDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHB1","description":"ICD-BCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDC1","description":"ICD-FHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc reas no rh-immuno","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8810","description":"Doc reas no rh-immuno","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHND1","description":"ICD-BHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0666U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0666U","description":"CPT-0666U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES256","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1002","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1002","description":"HCPCS-C1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appendectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44960","description":"Appendectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38D","description":"Extensive Services _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1076","description":"Radiation Therapy For Bone Metastases Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA11","description":"ICD-4KA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPB1","description":"ICD-KFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 4/5 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72083","description":"X-ray exam entire spi 4/5 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSE1","description":"ICD-CFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD0","description":"ICD-FHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","description":"CPT-00860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLE0","description":"ICD-KDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCD1","description":"ICD-ACCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXB0","description":"ICD-KIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPF1","description":"ICD-FHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of knuckle joints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26518","description":"Fusion of knuckle joints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC0","description":"ICD-MABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem odontogen cyst > 1.25 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7451","description":"Rem odontogen cyst > 1.25 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF1","description":"ICD-MGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture ulnar styloid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25652","description":"Treat fracture ulnar styloid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0141A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alatrofloxacin mesylate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0200","description":"Alatrofloxacin mesylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGB0","description":"ICD-CFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0084U","description":"Red blood cell antigen typing_ DNA_ genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF1","description":"ICD-DBQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pp eval/edu perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9357","description":"Pp eval/edu perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDF1","description":"ICD-IDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB35","description":"High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic source imaging","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8035","description":"Magnetic source imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCRD0","description":"ICD-OCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01630","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","description":"CPT-01630","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 25-28 wks","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2265","description":"Induced abortion 25-28 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spine & skull spinal fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22590","description":"Spine & skull spinal fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepressants class 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80334","description":"Antidepressants class 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam neck spine 4/5vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72050","description":"X-ray exam neck spine 4/5vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC14D","description":"Special Care Low _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE114","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICA0","description":"ICD-AICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB217","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEB0","description":"ICD-IHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99493","description":"Subsequent psychiatric collaborative care management_ first 60 minutes in a subsequent month of behavioral health care manager activities_ in consultation with a psychiatric c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family training & counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1027","description":"Family training & counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair cleft lip/nasal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40701","description":"Repair cleft lip/nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0163U","description":"Oncology (colorectal) screening_ biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1_ Cripto-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20604","description":"Drain/inj joint/bursa w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC1","description":"ICD-KFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65273","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJB0","description":"ICD-CAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imuglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1786","description":"Imuglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB144","description":"Clinically Complex _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF1","description":"ICD-CIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open drainage liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47010","description":"Open drainage liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMA1","description":"ICD-FEMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATF0","description":"ICD-GATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artacent AC_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4190","description":"Artacent AC_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWB0","description":"ICD-CFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bed board","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0273","description":"Bed board","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce shoulder bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23491","description":"Reinforce shoulder bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFF1","description":"ICD-FHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML02","description":"Medium Rehab plus Extensive_ ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED0","description":"ICD-CCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUE1","description":"ICD-MKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRD1","description":"ICD-HBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines 13 or more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80347","description":"Benzodiazepines 13 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGOD1","description":"ICD-CGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc oviduct-ovary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58679","description":"Laparo proc oviduct-ovary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ abdominal_ with contrast","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9744","description":"Ultrasound_ abdominal_ with contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYE1","description":"ICD-GBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC1","description":"ICD-DHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAC1","description":"ICD-OBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOE1","description":"ICD-PKOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cptr dbs alys car elec dta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206T","description":"Cptr dbs alys car elec dta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF1","description":"ICD-CBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVB0","description":"ICD-CEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMC0","description":"ICD-EBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIE0","description":"ICD-AFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXE0","description":"ICD-FFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary leg or abdomen bag","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4358","description":"Urinary leg or abdomen bag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyse chest fibrin subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32562","description":"Lyse chest fibrin subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAA1","description":"ICD-IAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTB1","description":"ICD-CHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQD0","description":"ICD-PDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIB1","description":"ICD-FHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch urine w barrier/tapv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4431","description":"Ost pch urine w barrier/tapv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko swedish type pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1850","description":"Ko swedish type pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106U","description":"Red blood cell antigen typing_ DNA_ human erythrocyte antigen gene analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYC1","description":"ICD-DIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt lithium 4.5 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0605","description":"Repl batt lithium 4.5 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev resin rest_ perm tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1352","description":"Prev resin rest_ perm tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37261","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","description":"CPT-37261","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87185","description":"Microbe susceptible enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPE0","description":"ICD-KFPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA1","description":"ICD-JDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0041","description":"Fos c chld non-ther per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICB1","description":"ICD-EICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2003","description":"CDT-D2003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBB1","description":"ICD-OGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUE1","description":"ICD-CHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18B","description":"Clinically Complex _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBE0","description":"ICD-JHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETE1","description":"ICD-OETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB31","description":"ICD-2DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIE0","description":"ICD-GEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18D","description":"Special Care High _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0425U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ rapid sequence analysis_ each comparator genome (eg_ parents_ siblings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1108","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w iv ab not given on time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8917","description":"Pt w iv ab not given on time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIGF1","description":"ICD-BIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABC1","description":"ICD-BABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF1","description":"ICD-OBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable rubber pch w fcplt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4376","description":"Drainable rubber pch w fcplt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC1","description":"ICD-OIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGD1","description":"ICD-CCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chloroquine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0390","description":"Chloroquine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak univ multiplex sys frict","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5616","description":"Ak univ multiplex sys frict","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9804","description":"HCPCS-C9804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICE0","description":"ICD-MICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF1","description":"ICD-BHHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knee 1 or 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73560","description":"X-ray exam of knee 1 or 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58210","description":"Extensive hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for tobacco use and identified as a tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9903","description":"Patient screened for tobacco use and identified as a tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cortisol free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82530","description":"Cortisol free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle(s) add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67320","description":"Revise eye muscle(s) add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA31","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDA0","description":"ICD-GGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1301","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1301","description":"HCPCS-C1301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-RUC01","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"RUC01","description":"ICD-RUC01","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7506","description":"Arthrodesis_ interphalangeal joints_ with or without internal fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":">=50% of total number of a patient_s outpatient RA encounters assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1007","description":">=50% of total number of a patient_s outpatient RA encounters assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA0","description":"ICD-JHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB155","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent hemoglobin a1c level > 9.0%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1211","description":"Most recent hemoglobin a1c level > 9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mediskin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4135","description":"Mediskin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0434","description":"Drug Screen_ Other Than Chromatographic; Any Number Of Drug Classes_ By Clia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA13B","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB22B","description":"Clinically Complex _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA1","description":"ICD-JEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFID1","description":"ICD-FFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion bil rot straps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2040","description":"Hkafo torsion bil rot straps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF1","description":"ICD-PIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC40","description":"High Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28H","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWE1","description":"ICD-CDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF0","description":"ICD-MEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC0","description":"ICD-CFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHE1","description":"ICD-FIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGB0","description":"ICD-NJGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEF1","description":"ICD-AFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1109","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESD1","description":"ICD-KESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXB0","description":"ICD-JBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWA1","description":"ICD-ODWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral con def mod palat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5959","description":"Intraoral con def mod palat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB25","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18E","description":"Special Care Low _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC0","description":"ICD-HHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neg pres wound ther drsg set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6550","description":"Neg pres wound ther drsg set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Promethazine hcl 12.5mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0169","description":"Promethazine hcl 12.5mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0484T","description":"Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg_ thoracotomy_ transapical)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIDC1","description":"ICD-FIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC0","description":"ICD-EHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE0","description":"ICD-CIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0554T","description":"Bone strength and fracture risk using finite element analysis of functional data_ and bone-mineral density_ utilizing data from a computed tomography scan; retrieval and trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69604","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJE0","description":"ICD-BIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXF0","description":"ICD-BBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADE0","description":"ICD-IADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATD1","description":"ICD-IATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limb nerve surgery add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64783","description":"Limb nerve surgery add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADA1","description":"ICD-KADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITA0","description":"ICD-FITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWC0","description":"ICD-OLWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNF1","description":"ICD-GDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uvl pnl 2 sq ft or less","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0691","description":"Uvl pnl 2 sq ft or less","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq plmt bile duct stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47539","description":"Perq plmt bile duct stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAB1","description":"ICD-JAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair hand joint with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26541","description":"Repair hand joint with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mon anesth care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9654","description":"Mon anesth care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ alfentanil hydrochloride_ 500 micrograms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0216","description":"Injection_ alfentanil hydrochloride_ 500 micrograms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUB1","description":"ICD-MDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62323","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual cell count each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85032","description":"Manual cell count each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular instrumnt screen bil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99174","description":"Ocular instrumnt screen bil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB136","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht muscle image planar sing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78453","description":"Ht muscle image planar sing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTC0","description":"ICD-OKTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult foster care per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5141","description":"Adult foster care per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0240","description":"Intravenous infusion or subcutaneous injection_ casirivimaband imdevimab_ includes infusion or injection and post administration monitoring_ subsequent repeat doses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0578","description":"Injection_ buprenorphine extended release (brixadi)_ greater than 7 days and up to 28 days of therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1065T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1065T","description":"CPT-1065T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAA0","description":"ICD-MAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVD0","description":"ICD-BIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAB0","description":"ICD-FHAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13C","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHF0","description":"ICD-JAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGE0","description":"ICD-JGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC0","description":"ICD-JAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0642U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0642U","description":"CPT-0642U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUD0","description":"ICD-BHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 1-2 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98925","description":"Osteopath manj 1-2 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject pulm art hrt cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93568","description":"Inject pulm art hrt cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1504","description":"HCPCS-C1504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJC1","description":"ICD-GDJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDF0","description":"ICD-CDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95977","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg_ contact group[s]_ interleaving_ amplitude_ pulse width_ frequency [Hz]_ on/off cycling_ burst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valrubicin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9357","description":"Valrubicin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOA1","description":"ICD-OAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKB0","description":"ICD-OLKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIF1","description":"ICD-CIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSF1","description":"ICD-LDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate bone tumor(s) perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20982","description":"Ablate bone tumor(s) perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microslide consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88321","description":"Microslide consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHB1","description":"ICD-MHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29876","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE1","description":"ICD-OCIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISB0","description":"ICD-CISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bckdhb gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81205","description":"Bckdhb gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJA0","description":"ICD-OEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing serologic abo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86900","description":"Blood typing serologic abo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix recombinant nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7195","description":"Factor ix recombinant nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1477","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","description":"HCPCS-M1477","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCD1","description":"ICD-EBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX51","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOF0","description":"ICD-KCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlmyd/gonrh tsts docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3511F","description":"Chlmyd/gonrh tsts docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITD1","description":"ICD-OITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAQD1","description":"ICD-CAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD144","description":"Special Care Low _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051U","description":"Prescription drug monitoring_ evaluation of drugs present by LC-MS/MS_ urine_ 31 drug panel_ reported as quantitative results_ detected or not detected_ per date of service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXE0","description":"ICD-KHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKMA1","description":"ICD-OKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFF0","description":"ICD-CAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change stent via transureth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50385","description":"Change stent via transureth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHC1","description":"ICD-GAHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXC1","description":"ICD-BFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF1","description":"ICD-CBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA0","description":"ICD-PEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXA1","description":"ICD-FCXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE0","description":"ICD-GAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEA0","description":"ICD-CEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLE1","description":"ICD-MHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alveoplasty w/o extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7320","description":"Alveoplasty w/o extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEC1","description":"ICD-BHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTB0","description":"ICD-BFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin thxpy for 6 mos/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4220F","description":"Digoxin thxpy for 6 mos/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF1","description":"ICD-GACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKA1","description":"ICD-FHKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID0","description":"ICD-BCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB45","description":"Low Rehab_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSC1","description":"ICD-LHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD0","description":"ICD-KDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57288","description":"Repair bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w ex wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4391","description":"Urinary pouch w ex wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAC0","description":"ICD-CFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQB0","description":"ICD-HFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKX","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIB0","description":"ICD-BAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFID1","description":"ICD-MFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOC1","description":"ICD-OJOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief (20 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-appro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2001","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. For use only in a Medicare-appro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADD1","description":"ICD-FADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGA1","description":"ICD-OKGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGF1","description":"ICD-BBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interferon beta-1b / .25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1830","description":"Interferon beta-1b / .25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision gum each quadrant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41820","description":"Excision gum each quadrant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos microalbuminuria rev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3060F","description":"Pos microalbuminuria rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto test panel pricing code_ 19 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP19","description":"Auto test panel pricing code_ 19 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTF0","description":"ICD-NBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9895","description":"Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g._ salvage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G9871","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","description":"HCPCS-G9871","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove forearm bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25145","description":"Remove forearm bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abduction bar jointed adjust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2300","description":"Abduction bar jointed adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF1","description":"ICD-CFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCWC0","description":"ICD-PCWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUD1","description":"ICD-MAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0766T","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse_ peripheral nerve_ initial treatment_ with identification and marking of the treatment locat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HA31","description":"ICD-3HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB1","description":"ICD-BDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFB0","description":"ICD-NFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD1","description":"ICD-OGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX23","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visualization of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31615","description":"Visualization of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA1","description":"ICD-PKYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise two eye muscles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67316","description":"Revise two eye muscles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init eval for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1119F","description":"Init eval for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD1","description":"ICD-OKHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDD1","description":"ICD-GFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA35","description":"Default_ /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHE1","description":"ICD-GBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPF1","description":"ICD-NJPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPE0","description":"ICD-GGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE1","description":"ICD-OAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4195","description":"PuraPly_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFHE1","description":"ICD-FFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGD1","description":"ICD-CHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB121","description":"Special Care High _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLB0","description":"ICD-JDLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDC1","description":"ICD-IFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagosc dilate balloon 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43214","description":"Esophagosc dilate balloon 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKC0","description":"ICD-KFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serum immunoelectrophoresis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86320","description":"Serum immunoelectrophoresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF0","description":"ICD-AHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis nonauto w/o scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81002","description":"Urinalysis nonauto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDC0","description":"ICD-FDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACA0","description":"ICD-NACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Varicella-zoster ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90396","description":"Varicella-zoster ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGF0","description":"ICD-CHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCA0","description":"ICD-EGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYC1","description":"ICD-OJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No rec cortico>60d 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9470","description":"No rec cortico>60d 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA14","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94621","description":"Cardiopulmonary exercise testing_ including measurements of minute ventilation_ CO2 production_ O2 uptake_ and electrocardiographic recordings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED1","description":"ICD-IFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iris Prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1839","description":"Iris Prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC12B","description":"Reduced Physical Function _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBC0","description":"ICD-FGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis equipment noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1699","description":"Dialysis equipment noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVF1","description":"ICD-BFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE250","description":"Special Care High _ ADL Index 15-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77787","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; Over 12 Channels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWD0","description":"ICD-ODWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYD1","description":"ICD-OFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transport chair pt wt<=300lb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1038","description":"Transport chair pt wt<=300lb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIA0","description":"ICD-EGIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIF0","description":"ICD-FIIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0C","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCE1","description":"ICD-JBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTA0","description":"ICD-MCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBB0","description":"ICD-JFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKE0","description":"ICD-BIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KINE0","description":"ICD-KINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDC1","description":"ICD-GIDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35141","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE220","description":"Reduced Physical Function _ ADL Index 15-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAC1","description":"ICD-AAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPD0","description":"ICD-BGPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA1","description":"ICD-NENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCC1","description":"ICD-NFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin and muscle repair face","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15845","description":"Skin and muscle repair face","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPE0","description":"ICD-GCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9077","description":"Injection_ cabotegravir and rilpivirine_ 2mg/3mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX30","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay rbc cholinesterase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82482","description":"Assay rbc cholinesterase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAGD1","description":"ICD-JAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFA0","description":"ICD-CAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61592","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of shoulder joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23802","description":"Fusion of shoulder joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEB0","description":"ICD-MDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENE1","description":"ICD-KENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE0","description":"ICD-DFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD1","description":"ICD-AATD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE1","description":"ICD-KILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81320","description":"PLCG2 (phospholipase C gamma 2) (eg_ chronic lymphocytic leukemia) gene analysis_ common variants (eg_ R665W_ S707F_ L845F)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78483","description":"Heart first pass multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBAC1","description":"ICD-BBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFF1","description":"ICD-JHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Oritavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9444","description":"Injection_ Oritavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKC0","description":"ICD-FCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD11C","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the foll","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEE0","description":"ICD-NGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt no ther chg or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9650","description":"Doc pt no ther chg or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLE1","description":"ICD-OLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tun ip cath perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49418","description":"Insert tun ip cath perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temp anchorage dev w/o flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7294","description":"Temp anchorage dev w/o flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB20A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVD0","description":"ICD-NGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00542","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","description":"CPT-00542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj aspiration joint fluid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7870","description":"Tmj aspiration joint fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compression bandage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8431","description":"Compression bandage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISB0","description":"ICD-HISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28X","description":"Special Care Low _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA60","description":"Very High Rehab _ ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"P32 na phosphate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9563","description":"P32 na phosphate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25B","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD217","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYC1","description":"ICD-GCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX24","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bevacizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9257","description":"Bevacizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB1","description":"ICD-DIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EB21","description":"ICD-2EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87564","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","description":"CPT-87564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQF0","description":"ICD-PIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELA0","description":"ICD-CELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2043","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","description":"HCPCS-A2043","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2215","description":"Take-home supply of nasal naloxone (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFMA0","description":"ICD-AFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21552","description":"Exc neck les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC0","description":"ICD-BBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMB1","description":"ICD-KGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB1","description":"ICD-MKBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCCA0","description":"ICD-NCCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTB0","description":"ICD-ODTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood volume","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78122","description":"Blood volume","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bladder wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51865","description":"Repair of bladder wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUA0","description":"ICD-GHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26844","description":"Fusion/graft of hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96121","description":"Neurobehavioral status exam (clinical assessment of thinking_ reasoning and judgment_ [eg_ acquired knowledge_ attention_ language_ memory_ planning and problem solving_ and v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB28E","description":"Special Care Low _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTB1","description":"ICD-IDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2008","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic belt/harness/boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0944","description":"Pelvic belt/harness/boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC1","description":"ICD-BEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1200","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRD0","description":"ICD-PHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUC1","description":"ICD-IIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA0","description":"ICD-GCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52234","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDC1","description":"ICD-OJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gsc >15 & hd ct by ed md","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9594","description":"Gsc >15 & hd ct by ed md","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAEF0","description":"ICD-KAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUD1","description":"ICD-FAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8E","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA11","description":"ICD-2GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7530","description":"Dialysis circuit_ introduction of needle(s) and/or catheter(s)_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompressive craniotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61322","description":"Decompressive craniotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHE1","description":"ICD-BHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA25","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD1","description":"ICD-CBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD1","description":"ICD-MCAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGD1","description":"ICD-OBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD150","description":"Clinically Complex _ ADL Index 11-14/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC0","description":"ICD-JBNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI angio abdom w orw/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74185","description":"MRI angio abdom w orw/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWA0","description":"ICD-DFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE1","description":"ICD-EGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair prosth valve clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33496","description":"Repair prosth valve clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABC0","description":"ICD-EABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWF1","description":"ICD-DGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHD0","description":"ICD-IIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair mouth laceration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40831","description":"Repair mouth laceration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRC0","description":"ICD-DCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9479","description":"Pharmacist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hand or foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64835","description":"Repair of hand or foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9328","description":"Dicom format image data availability not documented in final report due to medical reasons (eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA51","description":"Medium Rehab _ ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1010","description":"Indwelling intraurethral drainage device with valve_ patient inserted_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC0","description":"ICD-NCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99212","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33305","description":"Repair of heart wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lap enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83670","description":"Assay of lap enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69550","description":"Remove ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0490U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","description":"CPT-0490U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat craniofacial fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21432","description":"Treat craniofacial fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vagotomy & pylorus repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43640","description":"Vagotomy & pylorus repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us leiomyomata ablate <200","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071T","description":"Us leiomyomata ablate <200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC226","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 4-8","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0102","description":"Residential Habilitation 4-8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLSA0","description":"ICD-PLSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnio or biodmatrix_ inj 1cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4139","description":"Amnio or biodmatrix_ inj 1cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE1","description":"ICD-BBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPC0","description":"ICD-OGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of external ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69105","description":"Biopsy of external ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRE0","description":"ICD-GBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen test marrow b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3155F","description":"Cytogen test marrow b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31587","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA17","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgraft tl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4263","description":"Surgraft tl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD231","description":"Special Care High _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITF1","description":"ICD-NITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAF0","description":"ICD-KEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise lip or cheek fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40819","description":"Excise lip or cheek fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove extra spine segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22116","description":"Remove extra spine segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBB0","description":"ICD-GEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITD1","description":"ICD-IITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea stm ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426T","description":"Insj/rplc nstim apnea stm ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diathermy eg microwave","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97024","description":"Diathermy eg microwave","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDE0","description":"ICD-NHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair detachable foot r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1070","description":"Wheelchair detachable foot r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGA1","description":"ICD-KFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDED0","description":"ICD-JDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD0","description":"ICD-EGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF0","description":"ICD-GBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUE0","description":"ICD-GGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQE1","description":"ICD-OLQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAA1","description":"ICD-FBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil three surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2430","description":"Dental gold foil three surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA0","description":"ICD-AGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood Component Or Product Not Otherwise Classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9099","description":"Blood Component Or Product Not Otherwise Classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74251","description":"X-ray exam of small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29889","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald blu tooth fm/dm receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5286","description":"Ald blu tooth fm/dm receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Punch biopsy of skin (including simple closure_ when performed); single lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11104","description":"Punch biopsy of skin (including simple closure_ when performed); single lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/sutures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61557","description":"Incise skull/sutures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert levonorgestrel ius","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4981","description":"Insert levonorgestrel ius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap inc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49654","description":"Lap inc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anogenital exam child w imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99170","description":"Anogenital exam child w imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF1","description":"ICD-ABEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Msh6 gene known variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81299","description":"Msh6 gene known variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Folding ped wc tilt-in-space","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1232","description":"Folding ped wc tilt-in-space","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEAF0","description":"ICD-GEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAC0","description":"ICD-FAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJC1","description":"ICD-OJJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBME1","description":"ICD-JBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way silcne","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4315","description":"Cath w/drainage 2-way silcne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35121","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22B","description":"Clinically Complex _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography l-s spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72265","description":"Myelography l-s spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4033","description":"Cast sup lng leg cylinder pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resp virus 3-5 targets","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87631","description":"Resp virus 3-5 targets","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML06","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQF0","description":"ICD-PJQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD130","description":"Special Care Low _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult day center_ 8-hour unit_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0530","description":"Adult day center_ 8-hour unit_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6084","description":"Implant Supported Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUF1","description":"ICD-CFUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAC0","description":"ICD-NEAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE1","description":"ICD-LGSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFA1","description":"ICD-JHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nose allergy test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95065","description":"Nose allergy test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAF0","description":"ICD-MHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKA0","description":"ICD-JIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove eye/revise socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65112","description":"Remove eye/revise socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELE1","description":"ICD-MELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDYB1","description":"ICD-KDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYB1","description":"ICD-PEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAE1","description":"ICD-OKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58558","description":"Hysteroscopy biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL53","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKE0","description":"ICD-OJKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC0","description":"ICD-NKAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1456","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","description":"HCPCS-M1456","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC121","description":"Clinically Complex _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWF1","description":"ICD-LAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYD1","description":"ICD-HDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lens material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66852","description":"Removal of lens material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43135","description":"Removal of esophagus pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cecostomy tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49442","description":"Place cecostomy tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETC1","description":"ICD-GETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mon cable elec/pneum vad rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0486","description":"Mon cable elec/pneum vad rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5A","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromatrix nerve cuff_ cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9355","description":"Neuromatrix nerve cuff_ cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammogram both breasts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77056","description":"Mammogram both breasts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99460","description":"Init nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl& replc pulse gen 1 lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33262","description":"Rmvl& replc pulse gen 1 lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKE0","description":"ICD-JBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE255","description":"Special Care Low _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISD1","description":"ICD-CISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat trigeminal tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61791","description":"Treat trigeminal tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hot/cold h2obot/cap/col/wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9273","description":"Hot/cold h2obot/cap/col/wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA20A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWC1","description":"ICD-HCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CB11","description":"ICD-2CB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF1","description":"ICD-BAFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCA0","description":"ICD-BHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITD1","description":"ICD-KITD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm isolation simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89260","description":"Sperm isolation simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD12C","description":"Special Care Low _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surface emg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3900","description":"Surface emg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m >30.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12018","description":"Rpr f/e/e/n/l/m >30.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRC1","description":"ICD-PIRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00904","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","description":"CPT-00904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0260U","description":"Rare diseases (constitutional/heritable disorders)_ identification of copy number variations_ inversions_ insertions_ translocations_ and other structural variants by optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other pt/ot d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8992","description":"Other pt/ot d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGME1","description":"ICD-OGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No hist type doc on report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9284","description":"No hist type doc on report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB1","description":"ICD-PERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB1","description":"ICD-BIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0603","description":"HCPCS-C0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITE0","description":"ICD-CITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBC0","description":"ICD-NEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTB1","description":"ICD-GDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLE1","description":"ICD-MFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXA1","description":"ICD-CBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage abdom abscess open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49020","description":"Drainage abdom abscess open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Symes type poster opening so","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5634","description":"Symes type poster opening so","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJD1","description":"ICD-JFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKA0","description":"ICD-JCKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional brain mapping","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96020","description":"Functional brain mapping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA13","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Candida antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86628","description":"Candida antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDF0","description":"ICD-ECDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIC0","description":"ICD-AIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95170","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEB0","description":"ICD-NEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0120U","description":"Oncology (solid organ neoplasia)_ gene rearrangement detection by whole gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGYF1","description":"ICD-OGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB1","description":"ICD-NKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADF1","description":"ICD-NADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC0","description":"ICD-OBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of knees","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73565","description":"X-ray exam of knees","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHGB1","description":"ICD-CHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD0","description":"ICD-BHVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA1","description":"ICD-KAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34834","description":"Open brachial artery exposure for delivery of endovascular prosthesis_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALF0","description":"ICD-FALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig med check","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8430","description":"Pt inelig med check","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport wheelch van","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0130","description":"Noner transport wheelch van","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ necitumumab_ 1mg (Portrazza)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9475","description":"Injection_ necitumumab_ 1mg (Portrazza)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28660","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37237","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin therapy rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4012F","description":"Warfarin therapy rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0109U","description":"Osteoarthritis assessed (OA) Includes assessment of all the following compo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast bath therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97034","description":"Contrast bath therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENB1","description":"ICD-KENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermacyte Amniotic Membrane Allograft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4248","description":"Dermacyte Amniotic Membrane Allograft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC02","description":"Ultra High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEC1","description":"ICD-MDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDF0","description":"ICD-AIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLA1","description":"ICD-BGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGVD0","description":"ICD-GGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC131","description":"Clinically Complex _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flotufolastat f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9608","description":"Flotufolastat f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF1","description":"ICD-LASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWB0","description":"ICD-PBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8C","description":"Low Rehab_ ADL Index 0-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHA1","description":"ICD-FHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ remimazolam_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2249","description":"Injection_ remimazolam_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA1","description":"ICD-EBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKF0","description":"ICD-CAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy ablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58563","description":"Hysteroscopy ablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reposition vad diff session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33993","description":"Reposition vad diff session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB0","description":"ICD-ADBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCE0","description":"ICD-KFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB0","description":"ICD-MBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip disart canadian sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5331","description":"Hip disart canadian sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBXF1","description":"ICD-JBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removable prosthodontic proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5899","description":"Removable prosthodontic proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYD1","description":"ICD-PLYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip/pelv tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27045","description":"Exc hip/pelv tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPE1","description":"ICD-NAPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid sup/access/dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5267","description":"Hearing aid sup/access/dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC23B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99401","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYB0","description":"ICD-CHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35013","description":"Repair artery rupture arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKC0","description":"ICD-ODKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC205","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15B","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10A","description":"Special Care High _ ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCF1","description":"ICD-CHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVC0","description":"ICD-FAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICC1","description":"ICD-EICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9970","description":"Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0943T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","description":"CPT-0943T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition of walker to cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29440","description":"Addition of walker to cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOE1","description":"ICD-OCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23B","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD125","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So vest canvas/web pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3675","description":"So vest canvas/web pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0401","description":"HCPCS-C0401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis glass test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81020","description":"Urinalysis glass test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUE1","description":"ICD-EBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXC1","description":"ICD-NHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERC0","description":"ICD-LERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF0","description":"ICD-BGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90691","description":"Typhoid vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCE0","description":"ICD-FHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Topical fluoride varnish","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1206","description":"Topical fluoride varnish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronary art/grft angio s&i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93455","description":"Coronary art/grft angio s&i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0904","description":"HCPCS-B0904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASE0","description":"ICD-CASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28C","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF1","description":"ICD-CENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1250","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4359","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","description":"HCPCS-Q4359","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEF0","description":"ICD-EEEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90678","description":"Respiratory syncytial virus vaccine_ preF_ subunit_ bivalent_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace chst cmprss sys hose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7026","description":"Replace chst cmprss sys hose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct head of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24366","description":"Reconstruct head of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE1","description":"ICD-KBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK3","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEB1","description":"ICD-BIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAE0","description":"ICD-OIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integrated filter & holder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7507","description":"Integrated filter & holder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytal_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4166","description":"Cytal_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF0","description":"ICD-OINF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthovisc inj per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7324","description":"Orthovisc inj per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61548","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYB1","description":"ICD-KIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIC1","description":"ICD-EIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exercise w/hemodynamic meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93464","description":"Exercise w/hemodynamic meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shwr cov elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0501","description":"Shwr cov elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF1","description":"ICD-NFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADF1","description":"ICD-KADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNF1","description":"ICD-BCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE11A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEC0","description":"ICD-EDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA1","description":"ICD-NGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair calf rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0995","description":"Wheelchair calf rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen concentrator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1390","description":"Oxygen concentrator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD0","description":"ICD-MLAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0757T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group II_ all other (eg_ iron_ trichrome)_ except stain for microorganisms_ sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0646T","description":"Transcatheter tricuspid valve implantation/replacement (TTVI) with prosthetic valve_ percutaneous approach_ including right heart catheterization_ temporary pacemaker insertio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair ruptd popliteal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35152","description":"Repair ruptd popliteal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99452","description":"Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional_ 30 m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEB0","description":"ICD-JHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGA0","description":"ICD-KIGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0656U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0656U","description":"CPT-0656U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGUD1","description":"ICD-IGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"VEKLURY - Injection_ remdesivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0248","description":"VEKLURY - Injection_ remdesivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0529U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","description":"CPT-0529U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asthma measures grp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8645","description":"Asthma measures grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo partial nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50543","description":"Laparo partial nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBA0","description":"ICD-ICBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBUE0","description":"ICD-MBUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0108","description":"Stroke with Motor <26.15 & Age >84.5_ comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-rad contrast materialnoc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9698","description":"Non-rad contrast materialnoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","description":"HCPCS-A9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF0","description":"ICD-FAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL11","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMC0","description":"ICD-FEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited motion knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2184","description":"Limited motion knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDMD1","description":"ICD-IDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21080","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FADE0","description":"ICD-FADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm procure init visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4030","description":"Sperm procure init visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbo simultaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7181","description":"Electronic elbo simultaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fos c chld non-ther per mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0042","description":"Fos c chld non-ther per mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC1","description":"ICD-PAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy management","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77499","description":"Radiation therapy management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behind ear hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5060","description":"Behind ear hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died from cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9846","description":"Patients who died from cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHK3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Im admin each addl component","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90461","description":"Im admin each addl component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27448","description":"Incision of thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDTD0","description":"ICD-CDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/o dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3761F","description":"Pt w/o dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPE1","description":"ICD-FEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE1","description":"ICD-LBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB0","description":"ICD-OAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPD0","description":"ICD-ODPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t2no progres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9078","description":"Onc dx prostate t2no progres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMB0","description":"ICD-EAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dm meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8494","description":"Dm meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSF1","description":"ICD-KDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFUD0","description":"ICD-KFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSA0","description":"ICD-LBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas inv disp sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1035","description":"Art pancreas inv disp sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNC0","description":"ICD-JDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWD0","description":"ICD-GEWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit7.6-12.5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12044","description":"Intmd rpr n-hf/genit7.6-12.5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental skin graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7920","description":"Dental skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj beta interferon im 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q3027","description":"Inj beta interferon im 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOF1","description":"ICD-CEOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31553","description":"Laryngoplasty; for laryngeal stenosis_ with graft_ with indwelling stent placement_ younger than 12 years of age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA1","description":"ICD-HCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITF1","description":"ICD-OITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw < 3 yrs fem/jugular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36400","description":"Bl draw < 3 yrs fem/jugular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD110","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92312","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain aneurysm repr complx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61697","description":"Brain aneurysm repr complx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78709","description":"K flow/funct image multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDA1","description":"ICD-FGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUF0","description":"ICD-KHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEUE0","description":"ICD-JEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0514U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","description":"CPT-0514U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0901","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0901","description":"HCPCS-B0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLID1","description":"ICD-MLID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7541","description":"Diagnostic endoscopic retrograde cholangiopancreatography (ercp)_ including collection of specimen(s) by brushing or washing_ when performed_ with endoscopic cannulation of pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90382","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","description":"CPT-90382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD1","description":"ICD-FFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43634","description":"Removal of stomach partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGA1","description":"ICD-KDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINE1","description":"ICD-JINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF0","description":"ICD-JHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt/caregiver queried falls","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6080F","description":"Pt/caregiver queried falls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA1","description":"ICD-BFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Modification diabetic shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5507","description":"Modification diabetic shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWC0","description":"ICD-OGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63281","description":"Bx/exc idrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped hospital bed_ manual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0328","description":"Ped hospital bed_ manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWD1","description":"ICD-CEWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct abdomen w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74160","description":"Ct abdomen w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA0","description":"ICD-MABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85415","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTC1","description":"ICD-NFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKD1","description":"ICD-OEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDFD1","description":"ICD-KDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3C","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFA0","description":"ICD-KGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1062T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1062T","description":"CPT-1062T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cell cryopreserve/storage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88240","description":"Cell cryopreserve/storage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glucagon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82943","description":"Assay of glucagon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als esophageal intub suppls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0396","description":"Als esophageal intub suppls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRD0","description":"ICD-LFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38745","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD0","description":"ICD-ODQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1307","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","description":"HCPCS-J1307","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRF0","description":"ICD-PDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath abd/l-ext art 3rd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36247","description":"Ins cath abd/l-ext art 3rd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BANC0","description":"ICD-BANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTB0","description":"ICD-MLTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was a permanent nursing home resident at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1058","description":"Patient was a permanent nursing home resident at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8704","description":"Replacement Of Lost Or Broken Retainer - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYE1","description":"ICD-HEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vestronidase alfa-vjbk_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3397","description":"Injection_ vestronidase alfa-vjbk_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECD0","description":"ICD-GECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD1","description":"ICD-OAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNC0","description":"ICD-CCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQD1","description":"ICD-KBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYF0","description":"ICD-LHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA0","description":"ICD-ACIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen based wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6010","description":"Collagen based wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Menacwy vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90734","description":"Menacwy vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCC0","description":"ICD-BHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC1","description":"ICD-FDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF0","description":"ICD-OASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE217","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Req ret or w/in 90d of surg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9514","description":"Req ret or w/in 90d of surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61591","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autonomic nrv parasym inervj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95921","description":"Autonomic nrv parasym inervj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct perfusion w/contrast cbf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0042T","description":"Ct perfusion w/contrast cbf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHB0","description":"ICD-CHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1085T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1085T","description":"CPT-1085T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","description":"HCPCS-Q4375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKB0","description":"ICD-OEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHD0","description":"ICD-MAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFF1","description":"ICD-CFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE0","description":"ICD-GHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMD1","description":"ICD-NFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB0","description":"ICD-NEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD0","description":"ICD-KAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Final refract +/- 1.0 in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9519","description":"Final refract +/- 1.0 in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA1","description":"ICD-KBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stocking sup grips 4 pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0982","description":"Stocking sup grips 4 pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam breastbone 2/>vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71120","description":"X-ray exam breastbone 2/>vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXC1","description":"ICD-NLXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant cochlear device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69930","description":"Implant cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plastic mod low ext pad/line","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2275","description":"Plastic mod low ext pad/line","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGA0","description":"ICD-KBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNE1","description":"ICD-KBNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36563","description":"Insert tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB0A","description":"Ultra High Rehab _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attach ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65140","description":"Attach ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDE0","description":"ICD-JEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","description":"HCPCS-J3376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27052","description":"Biopsy of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking waistlngth 30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6540","description":"Gc stocking waistlngth 30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50957","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUF1","description":"ICD-JCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA0","description":"ICD-NKJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0564U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","description":"CPT-0564U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCA1","description":"ICD-NGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB0","description":"ICD-FEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC0","description":"ICD-EECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIB0","description":"ICD-CDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject hrt congntl art/grft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93564","description":"Inject hrt congntl art/grft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SUPRATHEL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2012","description":"SUPRATHEL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5D","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJB1","description":"ICD-CBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reposition pacing-defib lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33215","description":"Reposition pacing-defib lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins bone device for rsa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0347T","description":"Ins bone device for rsa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJD0","description":"ICD-NFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA1","description":"ICD-EBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVE1","description":"ICD-FHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA1A","description":"High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILF0","description":"ICD-KILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA1","description":"ICD-CFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXE1","description":"ICD-CFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace cvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36580","description":"Replace cvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl imed lesn thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63287","description":"Bx/exc idrl imed lesn thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRA0","description":"ICD-DHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBC0","description":"ICD-KCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for procedures on external_ middle_ and inner ear including biop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0117U","description":"Anesthesia for procedures on external_ middle_ and inner ear including biop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKB0","description":"ICD-NCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28D","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acth stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80400","description":"Acth stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx bronchoscope/wash","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31622","description":"Dx bronchoscope/wash","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB124","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serial salivary imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78231","description":"Serial salivary imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EA11","description":"ICD-4EA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1028","description":"Documentation of patients with primary headache diagnosis and imaging other than CT or MRI obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVC1","description":"ICD-OKVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDF1","description":"ICD-ABDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 4 visits p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90960","description":"Esrd srv 4 visits p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQA1","description":"ICD-GDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDB1","description":"ICD-ECDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25535","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTF1","description":"ICD-CBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBED0","description":"ICD-JBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isolation- tooth w rubb dam","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3910","description":"Isolation- tooth w rubb dam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lang comp current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9159","description":"Lang comp current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8G","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Systemic antimicrobials not prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9959","description":"Systemic antimicrobials not prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFA0","description":"ICD-FAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMD1","description":"ICD-IIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0432U","description":"Kelch-like protein 11 (KLHL11) antibody_ serum or cerebrospinal fluid (CSF)_ cell-binding assay_ qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLC1","description":"ICD-ADLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIC1","description":"ICD-IBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01782","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","description":"CPT-01782","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRA0","description":"ICD-CBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF1","description":"ICD-FGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLF0","description":"ICD-NHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF0","description":"ICD-JBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISE1","description":"ICD-PISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB0","description":"ICD-NIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVD0","description":"ICD-CEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPE0","description":"ICD-NCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNE0","description":"ICD-OLNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA1","description":"ICD-GBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKE1","description":"ICD-FCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISD0","description":"ICD-OISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC0","description":"ICD-KBWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28I","description":"Special Care Low _ ADL Index 11-14/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSA0","description":"ICD-OBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITA0","description":"ICD-IITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKSD0","description":"ICD-PKSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB1","description":"ICD-CBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain bladder by needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51100","description":"Drain bladder by needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","description":"HCPCS-G0545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient transfer system <300","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1035","description":"Patient transfer system <300","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWE0","description":"ICD-DHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iliac bone graft microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20956","description":"Iliac bone graft microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGED0","description":"ICD-NGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0574T","description":"Repositioning Of Previously Implanted Substernal Implantable Defibrillator-Pacing Electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB121","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOF0","description":"ICD-KGOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump_ programmable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1772","description":"Infusion pump_ programmable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDXB0","description":"ICD-BDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE1","description":"ICD-PHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain open lung lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32200","description":"Drain open lung lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38102","description":"Removal of spleen total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0537","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","description":"HCPCS-G0537","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHC0","description":"ICD-ACHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat tail bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27202","description":"Treat tail bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28737","description":"Revision of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0592T","description":"Health And Well-Being Coaching Face-To-Face; Individual_ Follow-Up Session_ At Least 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood methemoglobin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83045","description":"Blood methemoglobin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA21","description":"ICD-2CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coll-e-Derm_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4193","description":"Coll-e-Derm_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUB0","description":"ICD-EAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesion barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1765","description":"Adhesion barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPA0","description":"ICD-BCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPD1","description":"ICD-CGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUD0","description":"ICD-GEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracardiac ecg (ice)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93662","description":"Intracardiac ecg (ice)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEIB0","description":"ICD-KEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for bladder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51610","description":"Injection for bladder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam hip uni 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73501","description":"X-ray exam hip uni 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiographic procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76499","description":"Radiographic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6609","description":"Gradient compression bandaging supply_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLB1","description":"ICD-EDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA31","description":"ICD-1IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrodes_ pair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4556","description":"Electrodes_ pair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eteplirsen_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1428","description":"Injection_ eteplirsen_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTD0","description":"ICD-FBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of glucosidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82963","description":"Assay of glucosidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obinutuzumab inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9301","description":"Obinutuzumab inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision pericoronal gingiva","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7971","description":"Excision pericoronal gingiva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4003","description":"Emergency Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperbaric oxygen therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99183","description":"Hyperbaric oxygen therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Activated carbon filter_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4680","description":"Activated carbon filter_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTB0","description":"ICD-BBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD117","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prednisone ir or dr oral 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7512","description":"Prednisone ir or dr oral 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIRB0","description":"ICD-PIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD245","description":"Special Care High _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFE0","description":"ICD-KGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD1","description":"ICD-CAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKB1","description":"ICD-NLKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOC0","description":"ICD-KDOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX44","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC51","description":"Medium Rehab _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF0","description":"ICD-NBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRF1","description":"ICD-DBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy for aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31515","description":"Laryngoscopy for aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWB1","description":"ICD-CBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess susp docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3344F","description":"Mammo assess susp docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bed safety enclosure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0316","description":"Bed safety enclosure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBB1","description":"ICD-JIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKB1","description":"ICD-FIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEF0","description":"ICD-MJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assist living waiver/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2031","description":"Assist living waiver/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDIF0","description":"ICD-MDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA0","description":"ICD-GBFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDE1","description":"ICD-NGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIA0","description":"ICD-BDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cgh test developmental delay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3870","description":"Cgh test developmental delay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood typing patient serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86904","description":"Blood typing patient serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDME1","description":"ICD-CDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC53","description":"Very High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81348","description":"Srsf2 (Serine And Arginine-Rich Splicing Factor 2) (Eg_ Myelodysplastic Syndrome_ Acute Myeloid Leukemia) Gene Analysis_ Common Variants (Eg_ P95H_ P95L)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKA0","description":"ICD-FIKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPF0","description":"ICD-OIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA54","description":"High Rehab _ ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurectomy popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27326","description":"Neurectomy popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0901","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0901","description":"CDT-D0901","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBIC0","description":"ICD-CBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0243","description":"Intravenous infusion_ casirivimab and imdevimab includes infusion and post administration monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETC1","description":"ICD-JETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PelloGraft_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4320","description":"PelloGraft_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC0","description":"ICD-HAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD1","description":"ICD-FIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28405","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUF1","description":"ICD-IHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFC1","description":"ICD-CEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audiology mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0062","description":"Audiology mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Holster elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0498","description":"Holster elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNA0","description":"ICD-NHNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSB1","description":"ICD-LFSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUA0","description":"ICD-KGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD1","description":"ICD-LDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX3B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF1","description":"ICD-GHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test sock elbw disart/above","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6682","description":"Test sock elbw disart/above","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAD0","description":"ICD-IGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00352","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","description":"CPT-00352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation handling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77790","description":"Radiation handling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin b-12","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82607","description":"Vitamin b-12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA0","description":"ICD-KFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24615","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD28A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIB1","description":"ICD-KBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIKD1","description":"ICD-FIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70360","description":"X-ray exam of neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRA1","description":"ICD-KDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPA1","description":"ICD-GIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rna tstng hep c docd done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3218F","description":"Rna tstng hep c docd done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVB1","description":"ICD-CIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4343","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","description":"HCPCS-Q4343","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","description":"HCPCS-M1425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAB1","description":"ICD-EDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Charger elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0495","description":"Charger elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF1","description":"ICD-OHYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMA0","description":"ICD-GFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9056","description":"Blood_ l/r_ irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urgent Care Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4036","description":"Urgent Care Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTD0","description":"ICD-JCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle localization by xray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77002","description":"Needle localization by xray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aor ane 5.5-5.9 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9598","description":"Aor ane 5.5-5.9 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD14C","description":"Special Care High _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEF1","description":"ICD-MGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILE1","description":"ICD-NILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct lower jaw bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21247","description":"Reconstruct lower jaw bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQB0","description":"ICD-PIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIC1","description":"ICD-OFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLE1","description":"ICD-NHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC126","description":"Clinically Complex _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement impl pump cathet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0785","description":"Replacement impl pump cathet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHNC1","description":"ICD-KHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us guide intraop","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76998","description":"Us guide intraop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA0","description":"ICD-FIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXE1","description":"ICD-KCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEGD1","description":"ICD-NEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C-1 esterase_ berinert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0597","description":"C-1 esterase_ berinert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXB0","description":"ICD-BCXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood smear interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85060","description":"Blood smear interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62326","description":"Injection(s)_ including indwelling catheter placement_ continuous infusion or intermittent bolus_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0522","description":"Management of a new patient with dementia_ low complexity_ for use in CMMI model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc order anti-plat or p2y12","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9609","description":"Doc order anti-plat or p2y12","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDE0","description":"ICD-FCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC0","description":"ICD-GDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test for urine cystines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82615","description":"Test for urine cystines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCB0","description":"ICD-ADCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYE0","description":"ICD-PLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAA1","description":"ICD-AAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for spleen x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38200","description":"Injection for spleen x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF0","description":"ICD-FEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruct premalg les 2-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17003","description":"Destruct premalg les 2-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaginectomy partial w/nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57109","description":"Vaginectomy partial w/nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86362","description":"Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Antibody; Cell-Based Immunofluorescence Assay (Cba)_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAD0","description":"ICD-IHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0014","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay caffeine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80155","description":"Drug assay caffeine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE0","description":"ICD-KIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUD0","description":"ICD-MHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHUC1","description":"ICD-BHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of wrist prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25251","description":"Removal of wrist prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCB1","description":"ICD-IDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXF0","description":"ICD-KCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBED0","description":"ICD-OBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWB1","description":"ICD-HFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVE0","description":"ICD-GAVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and replacement of total replacement heart system (artificial heart)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33928","description":"Removal and replacement of total replacement heart system (artificial heart)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMD1","description":"ICD-NJMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 1.1-2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11602","description":"Exc tr-ext mal+marg 1.1-2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Str markers specimen anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81265","description":"Str markers specimen anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF1","description":"ICD-PHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDF0","description":"ICD-MEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1079T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1079T","description":"CPT-1079T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE1","description":"ICD-IAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy irrigation set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4400","description":"Ostomy irrigation set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPE0","description":"ICD-OAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47620","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEME0","description":"ICD-IEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECID1","description":"ICD-ECID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBE0","description":"ICD-BBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone scn b/4 txmnt/aftr dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3269F","description":"Bone scn b/4 txmnt/aftr dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWD0","description":"ICD-OAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMD0","description":"ICD-BIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVF0","description":"ICD-OKVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLF0","description":"ICD-KGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUE0","description":"ICD-IAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWE0","description":"ICD-OJWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA1","description":"ICD-MDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMD0","description":"ICD-GBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aminocaproic acid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0017","description":"Injection_ aminocaproic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB16","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vitolarsen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1427","description":"Injection_ vitolarsen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIB1","description":"ICD-GCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKCB1","description":"ICD-OKCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5926","description":"Replacement nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg cong cyst malf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2402","description":"Fetal surg cong cyst malf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIF0","description":"ICD-NJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYD1","description":"ICD-GEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHA0","description":"ICD-KCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMB1","description":"ICD-AEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBC0","description":"ICD-JHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bifoc prscp lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0506","description":"Bifoc prscp lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDD0","description":"ICD-IIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIA0","description":"ICD-MJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2091","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFA0","description":"ICD-FIFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD244","description":"Special Care High _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA245","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8B","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJA1","description":"ICD-GAJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYB1","description":"ICD-OAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC0","description":"ICD-BAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQD0","description":"ICD-GFQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacotherapy for OUD initiated after June 30th of performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1033","description":"Pharmacotherapy for OUD initiated after June 30th of performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef <40%","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8694","description":"Lvef <40%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not admitted to the ICU in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9854","description":"Patient was not admitted to the ICU in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.25-7/ov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2210","description":"Lens sphcy bifocal 4.25-7/ov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy with biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44389","description":"Colonoscopy with biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC21","description":"ICD-4EC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEID1","description":"ICD-IEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUB1","description":"ICD-MAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethro cut ejacul duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52402","description":"Cystourethro cut ejacul duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch clsd w/o bar w filtr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4418","description":"Ost pch clsd w/o bar w filtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cholera vaccine live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90625","description":"Cholera vaccine live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGB0","description":"ICD-CAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4378","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","description":"HCPCS-Q4378","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy remove adnexa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58661","description":"Laparoscopy remove adnexa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMC1","description":"ICD-OBMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDJE1","description":"ICD-JDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ disp_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5262","description":"Hearing aid_ disp_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYA1","description":"ICD-PLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE234","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEA0","description":"ICD-CGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD0","description":"ICD-BCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTF0","description":"ICD-OLTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC1","description":"ICD-GGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC1","description":"ICD-GELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release encircling material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67115","description":"Release encircling material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJB1","description":"ICD-JGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mech hip extension assist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5855","description":"Mech hip extension assist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dysphag test done b/4 eating","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6010F","description":"Dysphag test done b/4 eating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optical endomicroscpy interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88375","description":"Optical endomicroscpy interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2041","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","description":"HCPCS-A2041","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDE1","description":"ICD-FDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGD1","description":"ICD-NDGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOF1","description":"ICD-HAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0305","description":"HCPCS-A0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical home level 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9148","description":"Medical home level 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61863","description":"Implant neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise lwr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21047","description":"Excise lwr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAB0","description":"ICD-BDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEMD0","description":"ICD-BEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bumetanide 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0171","description":"Bumetanide 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85097","description":"Bone marrow interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBF0","description":"ICD-MCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJEA1","description":"ICD-MJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home vent invasive interface","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0465","description":"Home vent invasive interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20693","description":"Adjust bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD1","description":"ICD-FCGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJF0","description":"ICD-CEJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELE1","description":"ICD-JELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop app non-wgt bear dsg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5460","description":"Postop app non-wgt bear dsg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMB1","description":"ICD-ACMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repositioning of phrenic nerve stimulator transvenous lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33281","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asser com tx face-face/15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0039","description":"Asser com tx face-face/15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electro-uroflowmetry first","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51741","description":"Electro-uroflowmetry first","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF0","description":"ICD-CGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imaging study ordered (bkp)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3330F","description":"Imaging study ordered (bkp)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKB0","description":"ICD-KIKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADC1","description":"ICD-OADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBUB0","description":"ICD-FBUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA21B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE0","description":"ICD-GEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA05","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHVE1","description":"ICD-GHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sig w/tndsc balloon dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45340","description":"Sig w/tndsc balloon dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF1","description":"ICD-CEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUB1","description":"ICD-MKUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDC1","description":"ICD-JBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBB1","description":"ICD-FIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVF1","description":"ICD-JHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAA0","description":"ICD-MLAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8918","description":"Mra w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33427","description":"Repair of mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta pres or already taking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9189","description":"Beta pres or already taking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYE1","description":"ICD-GIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFDF0","description":"ICD-AFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEB0","description":"ICD-CGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01967","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","description":"CPT-01967","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel new leather standa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3455","description":"Shoe heel new leather standa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroretinography with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92275","description":"Electroretinography with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCF1","description":"ICD-NGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMD0","description":"ICD-BFMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC0","description":"ICD-JIUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18E","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE1","description":"ICD-OKJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC1","description":"ICD-KEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAC0","description":"ICD-NJAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHME1","description":"ICD-EHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine or metabolite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6044","description":"Cocaine or metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9302","description":"HCPCS-C9302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSD0","description":"ICD-PHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA1","description":"ICD-LEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEB1","description":"ICD-OBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kras gene addl variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81276","description":"Kras gene addl variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Appendico-vesicostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50845","description":"Appendico-vesicostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy for foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44390","description":"Colonoscopy for foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Not all data norsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9324","description":"Not all data norsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID0","description":"ICD-OCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot plas heel stabi pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3170","description":"Foot plas heel stabi pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm procure subs visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4031","description":"Sperm procure subs visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHA1","description":"ICD-ADHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAF1","description":"ICD-FAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18A","description":"Special Care High _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEB1","description":"ICD-JCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37605","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJED0","description":"ICD-MJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77047","description":"Magnetic resonance imaging_ breast_ without contrast material; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLA1","description":"ICD-ACLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUC0","description":"ICD-BAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRE1","description":"ICD-GCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0083A","description":"Immunization adm by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vac_ mRNA\u0002LNP_ spike_ third dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capture limited","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0380","description":"Cone beam ct capture limited","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef assess planpost dschrge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3019F","description":"Lvef assess planpost dschrge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject/treat eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67505","description":"Inject/treat eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lt compres band >=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6449","description":"Lt compres band >=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDB1","description":"ICD-NJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES151","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLB0","description":"ICD-AGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB0","description":"ICD-OLSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bld glucose monitor w voice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2100","description":"Bld glucose monitor w voice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unplnd ret to surg w in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9308","description":"Unplnd ret to surg w in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemical peel nonfacial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15792","description":"Chemical peel nonfacial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE1","description":"ICD-MKTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBB0","description":"ICD-BFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1475","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","description":"HCPCS-M1475","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat skull fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62005","description":"Treat skull fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clonidine hydrochloride","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0735","description":"Clonidine hydrochloride","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transvaginal us obstetric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76817","description":"Transvaginal us obstetric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQE0","description":"ICD-OGQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEEC0","description":"ICD-JEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAE0","description":"ICD-MIAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria w/o bypass ext","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33255","description":"Ablate atria w/o bypass ext","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC0","description":"ICD-CANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEIA0","description":"ICD-EEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPB1","description":"ICD-JDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt not on statin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9508","description":"Doc pt not on statin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTD0","description":"ICD-IBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIKD1","description":"ICD-JIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71552","description":"MRI chest w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder lock actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6647","description":"Shoulder lock actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYF1","description":"ICD-GEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB46","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpt/tele follow up 35","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0408","description":"Inpt/tele follow up 35","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC17","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30000","description":"Drainage of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATF1","description":"ICD-AATF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0597U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","description":"CPT-0597U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE134","description":"Special Care High _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELD0","description":"ICD-OELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVE1","description":"ICD-JFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC1","description":"ICD-CENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF1","description":"ICD-BDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB11","description":"ICD-3LB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63191","description":"Incise spine accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8901","description":"Mra w/o cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUB1","description":"ICD-OFUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA26","description":"Very High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB230","description":"Clinically Complex _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00350","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","description":"CPT-00350","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo iv push addl drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96411","description":"Chemo iv push addl drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNA1","description":"ICD-KDNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust part maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5421","description":"Dentures adjust part maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB0","description":"ICD-IIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHE1","description":"ICD-AFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC21","description":"ICD-3FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent ea add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37239","description":"Open/perq place stent ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIF0","description":"ICD-FBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ estab pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0467","description":"Fqhc visit_ estab pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACA1","description":"ICD-AACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB130","description":"Special Care High _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49615","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ recurrent_ including implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB0","description":"ICD-MKLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB1","description":"ICD-IHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retinal prosth int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1841","description":"Retinal prosth int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMF0","description":"ICD-JGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEE0","description":"ICD-GGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB1","description":"ICD-DDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVD0","description":"ICD-CAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55650","description":"Remove sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA1","description":"ICD-FETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNE0","description":"ICD-OBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BB11","description":"ICD-2BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47362","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB24","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDAB0","description":"ICD-MDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso 2mod symphis-xipho pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0458","description":"Tlso 2mod symphis-xipho pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHME1","description":"ICD-CHME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31243","description":"Nasal/sinus endoscopy_ surgical; with destruction by cryoablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERE1","description":"ICD-HERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compre dental tx transition","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8070","description":"Compre dental tx transition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFC0","description":"ICD-FFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair anomaly w/conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33608","description":"Repair anomaly w/conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSD1","description":"ICD-PBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDB0","description":"ICD-NIDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90627","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBE0","description":"ICD-NJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of adrenal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86651","description":"Anesth removal of adrenal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMC1","description":"ICD-JAMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEE1","description":"ICD-OEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9967","description":"Children who were not screened for risk of developmental_ behavioral and social delays using a standardized tool with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFQE1","description":"ICD-DFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBF1","description":"ICD-MLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNB1","description":"ICD-GHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFB1","description":"ICD-CHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rb82 rubidium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9555","description":"Rb82 rubidium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVD1","description":"ICD-NBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTC0","description":"ICD-BCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1081","description":"Radiation Therapy For Breast Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFC0","description":"ICD-GIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-mgmt educ/train 2-4 pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98961","description":"Self-mgmt educ/train 2-4 pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin-based indirect","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2710","description":"Crown resin-based indirect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay three catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82384","description":"Assay three catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Placement of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9939","description":"Placement of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMD1","description":"ICD-CDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEA0","description":"ICD-AAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","description":"HCPCS-J7528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGB1","description":"ICD-OFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pw actuator replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2378","description":"Pw actuator replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18G","description":"Special Care Low _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELF0","description":"ICD-EELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITA1","description":"ICD-CITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGA0","description":"ICD-FDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped compr care pkg_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1025","description":"Ped compr care pkg_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual field examination(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92082","description":"Visual field examination(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFNC1","description":"ICD-GFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHIF0","description":"ICD-IHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUD1","description":"ICD-IHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIB0","description":"ICD-NGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOE1","description":"ICD-KIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE1","description":"ICD-OJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHB0","description":"ICD-NHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC32","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRF1","description":"ICD-DIRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAD1","description":"ICD-MJAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-99470","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","description":"CPT-99470","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX03","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chloramphenicol sodium injec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0720","description":"Chloramphenicol sodium injec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSF0","description":"ICD-CCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0303","description":"HCPCS-A0303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMD0","description":"ICD-EGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29882","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIC1","description":"ICD-CFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1145","description":"Most favored nation (mfn) model drug add-on amount_ per dose_ (do not bill with line items that have the jw modifier)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mans shoe oxford brace","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3225","description":"Mans shoe oxford brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQD0","description":"ICD-KCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCB0","description":"ICD-FCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOE1","description":"ICD-PCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0703","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0703","description":"HCPCS-C0703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQF1","description":"ICD-DAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0546T","description":"Radiofrequency spectroscopy_ real time_ intraoperative margin assessment_ at the time of partial mastectomy_ with report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFEE0","description":"ICD-KFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKA0","description":"ICD-NHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWF1","description":"ICD-ODWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78271","description":"Vitamin B-12 absorption study (eg_ Schilling test); with intrinsic factor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27530","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX4A","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSD1","description":"ICD-DHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAKE1","description":"ICD-GAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXD0","description":"ICD-FIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB1","description":"ICD-GAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6320","description":"Shoulder passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHA1","description":"ICD-NLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE0","description":"ICD-EAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Follow up care plan mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0545F","description":"Follow up care plan mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTE1","description":"ICD-MGTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95834","description":"Body muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA46","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFA1","description":"ICD-NJFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKF0","description":"ICD-JFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVE1","description":"ICD-KAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2162","description":"Patient Did Not Receive At Least One Dose Of The Herpes Zoster Live Vaccine Or Two Doses Of The Herpes Zoster Recombinant Vaccine (At Least 28 Days Apart) Anytime On Or After","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB151","description":"Reduced Physical Function _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA1","description":"ICD-OFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCD0","description":"ICD-ADCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXA1","description":"ICD-NGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBE0","description":"ICD-GBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCC0","description":"ICD-IHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Loop heel","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0951","description":"Loop heel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMB0","description":"ICD-NBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair ing hernia sliding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49525","description":"Repair ing hernia sliding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECB0","description":"ICD-JECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27894","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWB0","description":"ICD-HIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove mesh from abd wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11008","description":"Remove mesh from abd wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMF1","description":"ICD-BGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58300","description":"Insert intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-84394","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","description":"CPT-84394","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJE0","description":"ICD-OKJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYA0","description":"ICD-HHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSE0","description":"ICD-LGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29835","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nfct agent detection gi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87505","description":"Nfct agent detection gi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29894","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD0","description":"ICD-JGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18G","description":"Clinically Complex _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00563","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","description":"CPT-00563","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSE0","description":"ICD-DGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAA1","description":"ICD-MKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40816","description":"Excision of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostoma filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4481","description":"Tracheostoma filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEF1","description":"ICD-JFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair windpipe opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31614","description":"Repair windpipe opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear implt f/up exam <7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92601","description":"Cochlear implt f/up exam <7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMB1","description":"ICD-JGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33405","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1040","description":"Patients with a diagnosis of lumbar idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of free thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84439","description":"Assay of free thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUF0","description":"ICD-ACUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft carotid-brchial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35510","description":"Art byp grft carotid-brchial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATA0","description":"ICD-AATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSA0","description":"ICD-HCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm <=149 mg/ml iodine_ 1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9958","description":"Hocm <=149 mg/ml iodine_ 1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIF1","description":"ICD-MGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures rebase part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5721","description":"Dentures rebase part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Musc tst done w/nerv tst lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95885","description":"Musc tst done w/nerv tst lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUE1","description":"ICD-NDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEB1","description":"ICD-MBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBF0","description":"ICD-BHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orth dev repair/repl minor p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4210","description":"Orth dev repair/repl minor p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bp scrn perf rec interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8783","description":"Bp scrn perf rec interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intermittent urinary cath","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4353","description":"Intermittent urinary cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stoma absorptive cover","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5083","description":"Stoma absorptive cover","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11640","description":"Exc f/e/e/n/l mal+mrg 0.5cm<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHB1","description":"ICD-AAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPA0","description":"ICD-BAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deb bone 20 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11044","description":"Deb bone 20 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDB1","description":"ICD-MBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPC1","description":"ICD-OKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos airway pressure tubing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7037","description":"Pos airway pressure tubing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21B","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0230U","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation)_ full sequence analysis_ including small sequence changes in exonic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIC1","description":"ICD-NJIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLA1","description":"ICD-JHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace blood leak detector","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1560","description":"Replace blood leak detector","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYE0","description":"ICD-LEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier supplemental w/ i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0560","description":"Humidifier supplemental w/ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB0","description":"ICD-KBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJF1","description":"ICD-KFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWA1","description":"ICD-PHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKF1","description":"ICD-BCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD1","description":"ICD-JGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD1","description":"ICD-GGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c medial thigh support","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0957","description":"W/c medial thigh support","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOB1","description":"ICD-HDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLB0","description":"ICD-ECLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC1","description":"ICD-FAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol inhalation treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94642","description":"Aerosol inhalation treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romosozumab-aqqg_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3111","description":"Injection_ romosozumab-aqqg_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9468","description":"Injection_ Factor IX (antihemophilic factor_ recombinant)_ glycopegylated_ Rebinyn_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCND1","description":"ICD-CCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYA1","description":"ICD-GEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALC1","description":"ICD-JALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2015","description":"Comprehensive (60 mins) home care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest ho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDC1","description":"ICD-GCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGIC1","description":"ICD-KGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB205","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph scope w/submucous inj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43201","description":"Esoph scope w/submucous inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12001","description":"Rpr s/n/ax/gen/trnk 2.5cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILF1","description":"ICD-BILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sialic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84275","description":"Assay of sialic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Add ue prost a/e ultlite mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7401","description":"Add ue prost a/e ultlite mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB0","description":"ICD-MLAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF1","description":"ICD-GAXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEUD0","description":"ICD-AEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold outsid lock hinge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6200","description":"Elbow mold outsid lock hinge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAMB0","description":"ICD-IAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE1","description":"ICD-FAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ewhfo w/joint(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3766","description":"Ewhfo w/joint(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80305","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; capable of being read by direct optical observation only (eg_ utilizing immunoassay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHD1","description":"ICD-JAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIA1","description":"ICD-CDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF1","description":"ICD-JCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise sacral spine tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49215","description":"Excise sacral spine tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD0","description":"ICD-CBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUD1","description":"ICD-MGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Magnetic resonance imaging without contrast_ breast; bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8907","description":"Magnetic resonance imaging without contrast_ breast; bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoride applicator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5986","description":"Fluoride applicator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ toripalimab-tpzi_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3263","description":"Injection_ toripalimab-tpzi_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 hd mult pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0862","description":"Pwc gp3 hd mult pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGB1","description":"ICD-FFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVD0","description":"ICD-FEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyst eval trac inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9606","description":"Intraop cyst eval trac inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGHD0","description":"ICD-FGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81284","description":"FXN (frataxin) (eg_ Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mapcp demo physician","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9153","description":"Mapcp demo physician","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC0","description":"ICD-GDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1014","description":"Clinical decision support mechanism InveniQA semantic answers in medicine _ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPE1","description":"ICD-KGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0539","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","description":"HCPCS-G0539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise epiphyseal bar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20150","description":"Excise epiphyseal bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIB1","description":"ICD-CCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair Of Orthodontic Appliance - Mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8697","description":"Repair Of Orthodontic Appliance - Mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB0","description":"ICD-GACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFC1","description":"ICD-FDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 2vw frontal&latl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71020","description":"Chest x-ray 2vw frontal&latl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX4B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81353","description":"Tp53 (Tumor Protein 53) (Eg_ Li-Fraumeni Syndrome) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5783","description":"Addition to lower extremity_ user adjustable_ mechanical_ residual limb volume management system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31365","description":"Removal of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amiodarone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80151","description":"Amiodarone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAME1","description":"ICD-BAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETC1","description":"ICD-NETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEF0","description":"ICD-MLEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Receiving Palliative Care During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0034","description":"Patients Receiving Palliative Care During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCF0","description":"ICD-NFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFID0","description":"ICD-BFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUA0","description":"ICD-NJUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB231","description":"Special Care High _ ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9794","description":"Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g._ history of gastrointestinal bleed_ intra-cranial bleed_ idiopathic thrombocytopenic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA1","description":"ICD-FGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METD0","description":"ICD-METD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acid conc sol per gallon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4709","description":"Acid conc sol per gallon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec downld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94776","description":"Ped home apnea rec downld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF0","description":"ICD-NIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDC0","description":"ICD-MGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral periapical ea add","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0230","description":"Intraoral periapical ea add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQE1","description":"ICD-LIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17281","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCB1","description":"ICD-OJCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA0","description":"ICD-EEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSE0","description":"ICD-DFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQA0","description":"ICD-LGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPB1","description":"ICD-GIPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAFD0","description":"ICD-KAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remis 6m w/6mos phq-9 <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9573","description":"Remis 6m w/6mos phq-9 <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUF0","description":"ICD-OEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJF0","description":"ICD-OJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMF0","description":"ICD-JCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYE0","description":"ICD-HHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AA21","description":"ICD-4AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLC1","description":"ICD-OGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 25MCG/0.25ML2ND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0112A","description":"ADM SARSCOV2 25MCG/0.25ML2ND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHC0","description":"ICD-KGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC1","description":"ICD-JBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate leg at thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27592","description":"Amputate leg at thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid skin barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4362","description":"Solid skin barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDF1","description":"ICD-NDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYA1","description":"ICD-OEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01480","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","description":"CPT-01480","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjustment gastric band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2083","description":"Adjustment gastric band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0577U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","description":"CPT-0577U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBC1","description":"ICD-CBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body-worn hearing aid bone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5040","description":"Body-worn hearing aid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1051","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise/drain tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68420","description":"Incise/drain tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17286","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67040","description":"Laser treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGD1","description":"ICD-NAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHMD1","description":"ICD-NHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC0","description":"ICD-GECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECC0","description":"ICD-AECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOC0","description":"ICD-OFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Touch quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0106T","description":"Touch quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Halo cervical into body jack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0820","description":"Halo cervical into body jack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37255","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","description":"CPT-37255","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGF0","description":"ICD-FEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10008","description":"Fine needle aspiration biopsy_ including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCD1","description":"ICD-ODCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGAF1","description":"ICD-BGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0885T","description":"Colonoscopy_ flexible_ with initial transendoscopic mechanical dilation (eg_ nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of ankle joint open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27870","description":"Fusion of ankle joint open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"U0004","description":"2019-nCoV Coronavirus_ SARS-CoV-2/2019-nCoV (COVID-19)_ any technique_ multiple types or subtypes (includes all targets)_ non-CDC_ making use of high throughput technologies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVE1","description":"ICD-NGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGB1","description":"ICD-BHGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27626","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYF0","description":"ICD-CIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE1","description":"ICD-GAOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breathing circuits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4618","description":"Breathing circuits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE1","description":"ICD-PDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBB0","description":"ICD-AEBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit sing/m/fam couns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99510","description":"Home visit sing/m/fam couns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brca1&2 seq & full dup/del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81162","description":"Brca1&2 seq & full dup/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Current tobacco non-user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1316","description":"Current tobacco non-user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cysto impl 4 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9740","description":"Cysto impl 4 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain pancreatic pseudocyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48510","description":"Drain pancreatic pseudocyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA0","description":"ICD-JENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth heart surg w/o pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56051","description":"Anesth heart surg w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD146","description":"Clinically Complex _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUC0","description":"ICD-FHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE114","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0620","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA1","description":"ICD-NBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0688U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688U","description":"CPT-0688U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9804","description":"Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71550","description":"MRI chest w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX30","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCIE0","description":"ICD-OCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87516","description":"Hepatitis b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w st wear barr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4392","description":"Urinary pouch w st wear barr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2165","description":"Patient Did Not Receive An Influenza Vaccine On Or Between July 1 Of The Year Prior To The Measurement Period And June 30 Of The Measurement Period; Or Did Not Have A Prior In","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALC0","description":"ICD-CALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGF0","description":"ICD-NIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA45","description":"Low Rehab_ ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPE0","description":"ICD-FIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pin radioulnar dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25671","description":"Pin radioulnar dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of suture from anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46754","description":"Removal of suture from anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJE1","description":"ICD-KEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine incon characterized","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1091F","description":"Urine incon characterized","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES314","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX15","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mucus trap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8210","description":"Mucus trap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB213","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF0","description":"ICD-MCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALD1","description":"ICD-NALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIF1","description":"ICD-NHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40650","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPB1","description":"ICD-CHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGE0","description":"ICD-KBGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL44","description":"High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF0","description":"ICD-NIDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Donor hysterectomy (including cold preservation); open_ from living donor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0665T","description":"Donor hysterectomy (including cold preservation); open_ from living donor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tcranial magn stim tx deli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90868","description":"Tcranial magn stim tx deli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33015","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUB0","description":"ICD-CDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo plas sing free knee mol","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2037","description":"Kafo plas sing free knee mol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME1","description":"ICD-FFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES224","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOD1","description":"ICD-OFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imaging of the head (CT or MRI) was obtained","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1027","description":"Imaging of the head (CT or MRI) was obtained","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYA1","description":"ICD-OAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIB1","description":"ICD-ICIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC0","description":"ICD-FBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCC1","description":"ICD-FGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC0","description":"ICD-CABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC1","description":"ICD-CBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apexification/recalc final","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3353","description":"Apexification/recalc final","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD13D","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF0","description":"ICD-BDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCA1","description":"ICD-MLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 250-299mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9961","description":"Hocm 250-299mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE1","description":"ICD-MGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES30C","description":"Extensive Services _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUA0","description":"ICD-BGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracic passive restor cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6370","description":"Thoracic passive restor cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHD0","description":"ICD-OCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIB0","description":"ICD-OLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMD0","description":"ICD-JDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID0","description":"ICD-MCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLE0","description":"ICD-AHLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES21B","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE1","description":"ICD-IDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAE1","description":"ICD-AHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVE1","description":"ICD-FIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0857T","description":"Opto-acoustic imaging_ breast_ unilateral_ including axilla when performed_ real-time with image documentation_ augmentative analysis and report (List separately in addition t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34716","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass_ by infraclavicular or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMC0","description":"ICD-OAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINC1","description":"ICD-OINC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD1","description":"ICD-OEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSF1","description":"ICD-PCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge resin base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6251","description":"Bridge resin base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB05","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA24","description":"High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60200","description":"Remove thyroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTC0","description":"ICD-NJTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egfr gene com variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81235","description":"Egfr gene com variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD244","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immed man part denture resin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5222","description":"Immed man part denture resin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC10","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPF0","description":"ICD-BHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUA1","description":"ICD-BEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"K flow/funct image w/o drug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78707","description":"K flow/funct image w/o drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC24","description":"Very High Rehab _ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTC0","description":"ICD-GCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAD0","description":"ICD-BEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise stomach-bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43855","description":"Revise stomach-bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUC1","description":"ICD-MAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1003T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","description":"CPT-1003T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENC0","description":"ICD-CENC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFWC1","description":"ICD-CFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJE0","description":"ICD-GIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGUD1","description":"ICD-JGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43310","description":"Repair of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Statin presc disch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9441","description":"Statin presc disch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUD0","description":"ICD-NLUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFB0","description":"ICD-JDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNB1","description":"ICD-NJNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELA1","description":"ICD-FELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKE0","description":"ICD-ODKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMF1","description":"ICD-JBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJA1","description":"ICD-KDJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC1","description":"ICD-ACAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elb disart prosth tiss shap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6450","description":"Elb disart prosth tiss shap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFEA0","description":"ICD-FFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L5827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","description":"HCPCS-L5827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine4/>vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72074","description":"X-ray exam thorac spine4/>vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDB1","description":"ICD-AIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDVF0","description":"ICD-CDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-disposable underpads_ all sizes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4553","description":"Non-disposable underpads_ all sizes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI orbit/face/neck w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70540","description":"MRI orbit/face/neck w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy volvul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45321","description":"Proctosigmoidoscopy volvul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCC1","description":"ICD-FCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECED0","description":"ICD-ECED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXE0","description":"ICD-FIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCA0","description":"ICD-GDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bio imm resp mod presc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9506","description":"Bio imm resp mod presc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFID0","description":"ICD-AFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGB0","description":"ICD-NAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHF1","description":"ICD-NIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c vent tray fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1029","description":"W/c vent tray fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB10C","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bilobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32482","description":"Bilobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDA0","description":"ICD-MJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mrs discogenic pain i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0612T","description":"Mrs discogenic pain i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE1","description":"ICD-EBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE240","description":"Reduced Physical Function _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAB1","description":"ICD-MEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotx admn prtl cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96446","description":"Chemotx admn prtl cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVF1","description":"ICD-BEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCA0","description":"ICD-EDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE20C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plicamycin (mithramycin) inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9270","description":"Plicamycin (mithramycin) inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA31","description":"High Rehab _ ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy dose plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77300","description":"Radiation therapy dose plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified drug or biological used for ESRD on dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3591","description":"Unclassified drug or biological used for ESRD on dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90683","description":"Respiratory syncytial virus vaccine_ mRNA lipid nanoparticles_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDA0","description":"ICD-MFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87341","description":"IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDA0","description":"ICD-AIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBED1","description":"ICD-IBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32994","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension_ percutaneous_ including imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of choroid lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67220","description":"Treatment of choroid lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C motor evoked lwr limbs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95929","description":"C motor evoked lwr limbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA101","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt_ pn_ hist grade doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8721","description":"Pt_ pn_ hist grade doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Posaconazole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80187","description":"Posaconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29240","description":"Strapping of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB206","description":"Reduced Physical Function _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRF1","description":"ICD-CDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGE1","description":"ICD-NIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise bile duct sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47460","description":"Incise bile duct sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace/irrigate catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62225","description":"Replace/irrigate catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWF1","description":"ICD-HGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNA0","description":"ICD-KCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTC0","description":"ICD-GFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAE1","description":"ICD-KIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0588U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","description":"CPT-0588U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCF0","description":"ICD-MCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ dexamethasone acetate_ per 1mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1095","description":"Injection_ dexamethasone acetate_ per 1mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFD1","description":"ICD-KEFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMC1","description":"ICD-BDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75746","description":"Artery x-rays lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXB1","description":"ICD-GIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAF0","description":"ICD-OKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JALA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JALA0","description":"ICD-JALA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ casimersen_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1426","description":"Injection_ casimersen_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFB0","description":"ICD-GCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE1","description":"ICD-DHYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE1","description":"ICD-JANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEMF1","description":"ICD-FEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXD1","description":"ICD-BGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of tibia fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27752","description":"Treatment of tibia fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8D","description":"Medium Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolong e&m/psyctx serv o/p","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99354","description":"Prolong e&m/psyctx serv o/p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLA1","description":"ICD-EDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inhibin a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86336","description":"Inhibin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MECF0","description":"ICD-MECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce/graft eye wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67255","description":"Reinforce/graft eye wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKE1","description":"ICD-KCKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA220","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHC0","description":"ICD-ICHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5700","description":"Replace socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA1","description":"ICD-IDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto.test pane pricing code_ 6 tests","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ATP06","description":"Auto.test pane pricing code_ 6 tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE140","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx pancreatc p r1/r2 no","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9106","description":"Onc dx pancreatc p r1/r2 no","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography lumbar injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62302","description":"Myelography lumbar injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD1","description":"ICD-EGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acute venous thrombus image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78456","description":"Acute venous thrombus image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9809","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9809","description":"HCPCS-C9809","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKME1","description":"ICD-NKME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDMD0","description":"ICD-KDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rna tstng hepc vir ord/docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3265F","description":"Rna tstng hepc vir ord/docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc cur meds by prov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8427","description":"Doc cur meds by prov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meals when receive services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1010","description":"Meals when receive services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC0","description":"ICD-NBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF1","description":"ICD-KCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ra meas qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8499","description":"Ra meas qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy/removal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38510","description":"Biopsy/removal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression arm sleeve and glove combination_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6575","description":"Gradient compression arm sleeve and glove combination_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC0","description":"ICD-GAJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFCF1","description":"ICD-KFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMD1","description":"ICD-JAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LB21","description":"ICD-4LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA12B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx duod intub w/asp spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43756","description":"Dx duod intub w/asp spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tonsils and adenoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42820","description":"Remove tonsils and adenoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE10A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXE0","description":"ICD-GDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEME1","description":"ICD-MEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIF0","description":"ICD-BEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tooth reimplantation","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7270","description":"Tooth reimplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Organic acids qual each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83919","description":"Organic acids qual each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRE1","description":"ICD-LCRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29826","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA0","description":"ICD-EGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33268","description":"Exclusion Of Left Atrial Appendage_ Open_ Performed At The Time Of Other Sternotomy Or Thoracotomy Procedure(S)_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alarm symp assessed-absent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1070F","description":"Alarm symp assessed-absent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD0","description":"ICD-JHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop mucosal resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43211","description":"Esophagoscop mucosal resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD1","description":"ICD-AIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2074","description":"Medication Assisted Treatment_ Weekly Bundle Not Including The Drug_ Including Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Testing If Performed (Pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHD0","description":"ICD-MBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJF1","description":"ICD-ODJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Docrsn for catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9239","description":"Docrsn for catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0009","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNE0","description":"ICD-NJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ampicillin sodium per 1.5 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0295","description":"Ampicillin sodium per 1.5 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYE0","description":"ICD-OEYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC0","description":"ICD-ACEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replcmnt breastpump lok ring","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4286","description":"Replcmnt breastpump lok ring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cus elbo skt in not con/atyp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6697","description":"Cus elbo skt in not con/atyp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHE0","description":"ICD-IFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cervix/repair vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57555","description":"Remove cervix/repair vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAC1","description":"ICD-MGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26992","description":"Drainage of bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of hand bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25820","description":"Fusion of hand bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18G","description":"Clinically Complex _ ADL Index 0-1/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20101","description":"Explore wound chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPC0","description":"ICD-KAPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE23C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGED1","description":"ICD-FGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIE0","description":"ICD-FEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53502","description":"Repair of urethra injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHC1","description":"ICD-JHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHPD1","description":"ICD-KHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0581U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","description":"CPT-0581U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAIA1","description":"ICD-AAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB1","description":"ICD-IGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYB0","description":"ICD-LBYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair clitoris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56805","description":"Repair clitoris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE225","description":"Reduced Physical Function _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIE0","description":"ICD-KDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB217","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQE1","description":"ICD-GCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBB0","description":"ICD-MKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaginectomy w/nodes compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57112","description":"Vaginectomy w/nodes compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCF1","description":"ICD-KCCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA0","description":"ICD-BCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special casting material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4590","description":"Special casting material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHF0","description":"ICD-JFHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCME0","description":"ICD-OCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBF0","description":"ICD-KHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC1","description":"ICD-NLLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCF0","description":"ICD-OCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF1","description":"ICD-MAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasminogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85421","description":"Fibrinolytic plasminogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTA0","description":"ICD-ADTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX31","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADF1","description":"ICD-CADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5116","description":"Injection_ trastuzumab-qyyp_ biosimilar_ (trazimera)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0696T","description":"Body Surface-Activation Mapping Of Pacemaker Or Pacing Cardioverter-Defibrillator Lead(S) To Optimize Electrical Synchrony_ Cardiac Resynchronization Therapy Device_ Including","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18G","description":"Special Care Low _ ADL Index 15-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC1","description":"ICD-BBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADA1","description":"ICD-NADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KABF0","description":"ICD-KABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRF0","description":"ICD-DGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Per pm reeval est pat 65+ yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99397","description":"Per pm reeval est pat 65+ yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD1","description":"ICD-BILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPA0","description":"ICD-CHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thorax stereo rad targetw/tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32701","description":"Thorax stereo rad targetw/tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infant safety class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9447","description":"Infant safety class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp w/specimen collection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43260","description":"Ercp w/specimen collection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe clubfoot wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3380","description":"Shoe clubfoot wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB44","description":"High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4271","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholinesterase assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82013","description":"Acetylcholinesterase assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laps rmvl vgl arry&pls gen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0314T","description":"Laps rmvl vgl arry&pls gen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDF0","description":"ICD-GCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilation of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57400","description":"Dilation of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA1","description":"ICD-OJEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9048","description":"Dexamethasone_ lacrimal opthalamic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including MR guidance; first lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10011","description":"Fine needle aspiration biopsy_ including MR guidance; first lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAD1","description":"ICD-OIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt ureteral stent prq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50695","description":"Plmt ureteral stent prq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12B","description":"Special Care High _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE0","description":"ICD-OHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9096","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63283","description":"Bx/exc idrl spine lesn scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55500","description":"Removal of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEYC0","description":"ICD-HEYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2040","description":"Tisagenlecleucel_ up to 250 million CAR-positive viable T cells_ including leukapheresis and dose preparation procedures_ per i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9323","description":"Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg_CT studies performed for radiation treatment)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCE1","description":"ICD-OHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPA1","description":"ICD-FFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1487","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","description":"HCPCS-M1487","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTE0","description":"ICD-OBTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBE1","description":"ICD-CIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE0","description":"ICD-OBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient lift electric","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0635","description":"Patient lift electric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNE0","description":"ICD-OGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Central dexa ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3096F","description":"Central dexa ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAE0","description":"ICD-JCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ noble metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2722","description":"Crown resin w/ noble metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWC1","description":"ICD-DEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIAF1","description":"ICD-OIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGB1","description":"ICD-FEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAD0","description":"ICD-GAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft head/neck 2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11308","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANE1","description":"ICD-FANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIB0","description":"ICD-JDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2215","description":"Pneumatic caster tire tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJF1","description":"ICD-OCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB1","description":"ICD-FFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 5999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4726","description":"Dialys sol fld vol > 5999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01250","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","description":"CPT-01250","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQF1","description":"ICD-CGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLA1","description":"ICD-AFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q0521","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","description":"HCPCS-Q0521","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43622","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0917T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","description":"CPT-0917T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD0","description":"ICD-JBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAB0","description":"ICD-MCAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8F","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTF0","description":"ICD-KFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv/hib vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90698","description":"Dtap-ipv/hib vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser surgery eye strands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67031","description":"Laser surgery eye strands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mitomycin pyelocalyceal instillation_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9281","description":"Mitomycin pyelocalyceal instillation_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0092A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS\u0002CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace prox & dist upright","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4070","description":"Replace prox & dist upright","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPF0","description":"ICD-JEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLNC1","description":"ICD-OLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBA0","description":"ICD-EHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAB1","description":"ICD-OAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wedge resect of lung diag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32507","description":"Wedge resect of lung diag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQF1","description":"ICD-PKQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJB1","description":"ICD-BCJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHME0","description":"ICD-GHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore and drain kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50125","description":"Explore and drain kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTD0","description":"ICD-KBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7518","description":"Catheter placement in coronary artery(ies) for coronary angiography_ including intraprocedural injection(s) for coronary angiography_ imaging supervision and interpretation_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Oncology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4031","description":"Radiation Oncology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stainless steel crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2933","description":"Prefab stainless steel crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOA0","description":"ICD-LDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEJC0","description":"ICD-BEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open bowel to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44300","description":"Open bowel to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTD0","description":"ICD-EBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXC0","description":"ICD-CBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26500","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"D5w infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7070","description":"D5w infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB141","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCDA1","description":"ICD-MCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tail bone ulcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15922","description":"Removal of tail bone ulcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair upper jaw fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30580","description":"Repair upper jaw fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDE1","description":"ICD-EHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA211","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND C","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ascending aortic graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33864","description":"Ascending aortic graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB1","description":"ICD-IGMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27498","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteopath manj 3-4 regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98926","description":"Osteopath manj 3-4 regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC0","description":"ICD-JHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEDB1","description":"ICD-MEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE1","description":"ICD-KEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD0","description":"ICD-PJRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAOE0","description":"ICD-PAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKE1","description":"ICD-CAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0025","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot_ adductus positioning device_ adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3161","description":"Foot_ adductus positioning device_ adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME1","description":"ICD-KDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33275","description":"Transcatheter removal of permanent leadless pacemaker_ right ventricular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQE1","description":"ICD-KIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemostatic agent_ gastrointestinal_ topical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1052","description":"Hemostatic agent_ gastrointestinal_ topical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sitz bath chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0162","description":"Sitz bath chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Npo (nothing-mouth) ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6020F","description":"Npo (nothing-mouth) ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLTD0","description":"ICD-OLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD1","description":"ICD-DBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRF0","description":"ICD-PHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEC0","description":"ICD-NEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0376U","description":"Oncology (prostate cancer)_ image analysis of at least 128 histologic features and clinical factors_ prognostic algorithm determining the risk of distant metastases_ and prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUE1","description":"ICD-BDUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF0","description":"ICD-JDTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA0","description":"ICD-NJIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4296","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","description":"HCPCS-A4296","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVF1","description":"ICD-NGVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft arm/leg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64898","description":"Nerve graft arm/leg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHF0","description":"ICD-CDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonprim loc anat bx site tum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3250F","description":"Nonprim loc anat bx site tum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB0","description":"ICD-BECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD0","description":"ICD-PDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald_ tv caption decoder","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5271","description":"Ald_ tv caption decoder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABE0","description":"ICD-JABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDNC0","description":"ICD-GDNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7197","description":"Antithrombin iii injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Monitor cable elec vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0485","description":"Monitor cable elec vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert idrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63305","description":"Remove vert idrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56637","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Matrl for vocal cord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1878","description":"Matrl for vocal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMD0","description":"ICD-CEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITE0","description":"ICD-FITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbital replacement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5928","description":"Orbital replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRB0","description":"ICD-HIRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAD0","description":"ICD-FAAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXA0","description":"ICD-CIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEA1","description":"ICD-JCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA1","description":"ICD-PGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF1","description":"ICD-LBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bladder-vagina lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57320","description":"Repair bladder-vagina lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKC0","description":"ICD-NIKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHE0","description":"ICD-CAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOD0","description":"ICD-GDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPA1","description":"ICD-NDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD15B","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHE0","description":"ICD-BBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBC0","description":"ICD-MEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Free skin flap microvasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15757","description":"Free skin flap microvasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPF1","description":"ICD-FGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87468","description":"Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICD1","description":"ICD-IICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTA0","description":"ICD-GCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLB1","description":"ICD-FBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC1","description":"ICD-DAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE0","description":"ICD-KDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUC0","description":"ICD-MLUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nhl stg unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9138","description":"Onc dx nhl stg unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDA1","description":"ICD-KFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD1","description":"ICD-MFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLD1","description":"ICD-NLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biphos thxpy vein ord/recvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4100F","description":"Biphos thxpy vein ord/recvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVE1","description":"ICD-CCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGA0","description":"ICD-BFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue suspension","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41512","description":"Tongue suspension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6598","description":"Gradient compression bandage roll_ elastic medium stretch_ per linear yard_ any width_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC31","description":"ICD-3CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81191","description":"Ntrk1 (Neurotrophic Receptor Tyrosine Kinase 1) (Eg_ Solid Tumors) Translocation Analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12004","description":"Rpr s/n/ax/gen/trk7.6-12.5cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCKF0","description":"ICD-KCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX45","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIB1","description":"ICD-OGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAAF0","description":"ICD-MAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61760","description":"Implant brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD22C","description":"Clinically Complex _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE0","description":"ICD-MJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/bx pleura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32609","description":"Thoracoscopy w/bx pleura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE1","description":"ICD-NLLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0360U","description":"Oncology (lung)_ enzyme-linked immunosorbent assay (ELISA) of 7 autoantibodies (p53_ NY-ESO-1_ CAGE_ GBU4-5_ SOX2_ MAGE A4_ and HuD)_ plasma_ algorithm reported as a categoric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnioamp-mp_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4250","description":"Amnioamp-mp_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRD0","description":"ICD-PDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIBE0","description":"ICD-JIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEGE1","description":"ICD-OEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUA0","description":"ICD-CDUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36012","description":"Place catheter in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA0","description":"ICD-IAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1801","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1801","description":"HCPCS-B1801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96146","description":"Psychological or neuropsychological test administration_ with single automated_ standardized instrument via electronic platform_ with automated result only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art pressure waveform analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93050","description":"Art pressure waveform analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCNE0","description":"ICD-BCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFF1","description":"ICD-NEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair w/allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64910","description":"Nerve repair w/allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33975","description":"Implant ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bordetella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86615","description":"Bordetella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCCE1","description":"ICD-OCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens_ hydrophilic_ dual focus_ per lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2525","description":"Contact lens_ hydrophilic_ dual focus_ per lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHE1","description":"ICD-KDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJC0","description":"ICD-JGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJA1","description":"ICD-BHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"New episode for condition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1127F","description":"New episode for condition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUB0","description":"ICD-GIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endodontic procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3999","description":"Endodontic procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANE1","description":"ICD-OANE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp lt 130 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3074F","description":"Syst bp lt 130 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQC0","description":"ICD-GEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASF0","description":"ICD-LASF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9598","description":"Positron emission tomography radiopharmaceutical_ diagnostic_ for non-tumor identification_ not otherwise classified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAB0","description":"ICD-GBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27881","description":"Amputation of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0516","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 30-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB42","description":"Very High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPE1","description":"ICD-GEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD1","description":"ICD-NLKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd accessory_ mounting sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2512","description":"Sgd accessory_ mounting sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF0","description":"ICD-OJMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excess skin arm/hand","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15837","description":"Excise excess skin arm/hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJB1","description":"ICD-KAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXF0","description":"ICD-JHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA0","description":"ICD-MKDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUC1","description":"ICD-JDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA1","description":"ICD-JDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4D","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36500","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of diaphragm hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39541","description":"Repair of diaphragm hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE141","description":"Special Care High _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLD1","description":"ICD-JBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDB0","description":"ICD-JCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGME1","description":"ICD-IGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytp fna eval ea addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88177","description":"Cytp fna eval ea addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iodine i-125 sodium iodide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9527","description":"Iodine i-125 sodium iodide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMD0","description":"ICD-JEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTF1","description":"ICD-MGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-ophthalmic fva","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9733","description":"Non-ophthalmic fva","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenotype dna hiv w/clt add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87904","description":"Phenotype dna hiv w/clt add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDD0","description":"ICD-GEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forensic cytopathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88125","description":"Forensic cytopathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXC1","description":"ICD-BHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1B","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscop ultrasound exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43231","description":"Esophagoscop ultrasound exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audit/dast 15-30 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99408","description":"Audit/dast 15-30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gerd symps assessed 12 month","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1118F","description":"Gerd symps assessed 12 month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98981","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0416U","description":"Infectious agent detection by nucleic acid (DNA)_ genitourinary pathogens_ identification of 20 bacterial and fungal organisms_ including identification of 20 associated antib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1467","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","description":"HCPCS-M1467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone (rykindo)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2801","description":"Injection_ risperidone (rykindo)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1195","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry_ msi by dna-based testing status_ or bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/t/o & vag repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58263","description":"Vag hyst w/t/o & vag repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXC0","description":"ICD-NIXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2181","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCB0","description":"ICD-CCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33755","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOD1","description":"ICD-KIOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dispensing fee binaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5160","description":"Dispensing fee binaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9800","description":"Patients who are identified as having an intolerance or allergy to beta-blocker therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1503","description":"HCPCS-C1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9376","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEF1","description":"ICD-BAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23D","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQE1","description":"ICD-DDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ncntc r-t fluor wnd img 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0598T","description":"Ncntc r-t fluor wnd img 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95722","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADD0","description":"ICD-BADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB06","description":"Very High Rehab _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBA1","description":"ICD-BEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAAF1","description":"ICD-EAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBE1","description":"ICD-FIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam ribs uni 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71100","description":"X-ray exam ribs uni 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9044","description":"Injection_ cemiplimab-rwlc_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKA1","description":"ICD-GBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKA0","description":"ICD-JAKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9455","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCGB0","description":"ICD-JCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens pmma spherical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2500","description":"Contact lens pmma spherical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo without joints pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3924","description":"Hfo without joints pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rad exp time w/o fluor doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9501","description":"Rad exp time w/o fluor doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMD0","description":"ICD-BAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4185","description":"Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUB0","description":"ICD-GHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth stone removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91851","description":"Anesth stone removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hg a1c level lt 7.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3044F","description":"Hg a1c level lt 7.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NENA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NENA0","description":"ICD-NENA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3B","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain bl w/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51102","description":"Drain bl w/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80081","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAYC1","description":"ICD-OAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA0","description":"ICD-KBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSF0","description":"ICD-KHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood_ l/r_ cmv-neg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9051","description":"Blood_ l/r_ cmv-neg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0659","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","description":"HCPCS-E0659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTB0","description":"ICD-OGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath report nongyn spcmn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0550F","description":"Cytopath report nongyn spcmn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43333","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHSF0","description":"ICD-DHSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE1","description":"ICD-GDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGMC0","description":"ICD-AGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFF0","description":"ICD-BAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bld typing serologic rh phnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86906","description":"Bld typing serologic rh phnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88377","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA0","description":"ICD-GGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA21C","description":"Clinically Complex _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2102","description":"HCPCS-A2102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of eye fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67005","description":"Partial removal of eye fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6251","description":"Absorpt drg <=16 sq in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBD0","description":"ICD-ICBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNE1","description":"ICD-OKNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHE1","description":"ICD-BEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77407","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD1","description":"ICD-BEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYD1","description":"ICD-CCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDC0","description":"ICD-NCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear localization/abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78807","description":"Nuclear localization/abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0938T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","description":"CPT-0938T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECF0","description":"ICD-GECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFB1","description":"ICD-JBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF0","description":"ICD-KIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA0","description":"ICD-GITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triflupromazine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3400","description":"Triflupromazine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWF1","description":"ICD-HDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD0","description":"ICD-NGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0382U","description":"Hyperphenylalaninemia monitoring by patient-collected blood card sample_ quantitative measurement of phenylalanine and tyrosine_ liquid chromatography with tandem mass spectro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipoprotein bld by nmr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83704","description":"Lipoprotein bld by nmr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCA1","description":"ICD-OJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC0","description":"ICD-OAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDA0","description":"ICD-KHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ischm stroke symp ge3 hrsb/4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1066F","description":"Ischm stroke symp ge3 hrsb/4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl exchange/transfuse non-nb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36455","description":"Bl exchange/transfuse non-nb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42107","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQC1","description":"ICD-HEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDA1","description":"ICD-ACDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDC0","description":"ICD-NIDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0530","description":"Electronic positional obstructive sleep apnea treatment_ with sensor_ includes all components and accessories_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB10","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34706","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection_ all nonselec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0030","description":"Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention On The Date Of The Encounter Or Within The Previous 12 Months (Counseling_ Pharmacotherapy_ Or Bot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23150","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB1","description":"ICD-OGSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral med adm direct observe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0033","description":"Oral med adm direct observe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 vhd 451-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0802","description":"Pov group 1 vhd 451-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert body dcmprn crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63081","description":"Remove vert body dcmprn crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0841T","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block_ with frozen section(s)_ single specimen (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8G","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery transpose/endovas taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33889","description":"Artery transpose/endovas taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF0","description":"ICD-IEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse gallbladder & bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47720","description":"Fuse gallbladder & bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEE1","description":"ICD-FGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBC0","description":"ICD-ADBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE0","description":"ICD-OGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diab manage trn ind/group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0109","description":"Diab manage trn ind/group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTC1","description":"ICD-OFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB35","description":"Ultra High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLC1","description":"ICD-KHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVC1","description":"ICD-JIVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB33","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPC1","description":"ICD-CDPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA0","description":"ICD-FFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mattress foam rubber","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0272","description":"Mattress foam rubber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA31","description":"ICD-2IA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66988","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1 Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSE0","description":"ICD-CHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDB1","description":"ICD-MLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOE0","description":"ICD-LAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK6","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFC1","description":"ICD-ODFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap removal of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45395","description":"Lap removal of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54050","description":"Destruction penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUD0","description":"ICD-JDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive_ liquid or equal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4364","description":"Adhesive_ liquid or equal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYE0","description":"ICD-HDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES124","description":"Extensive Services _ ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHCC1","description":"ICD-JHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB31","description":"ICD-2HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB0","description":"ICD-EALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tiss exam molecular study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88387","description":"Tiss exam molecular study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd low limb pros vacuum pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5782","description":"Hd low limb pros vacuum pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHC1","description":"ICD-IIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB1","description":"ICD-FIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE0","description":"ICD-CCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1703","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1703","description":"CDT-D1703","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF1","description":"ICD-KAQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHD1","description":"ICD-BAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55712","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","description":"CPT-55712","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHF0","description":"ICD-OAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECA1","description":"ICD-AECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23073","description":"Exc shoulder tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig les complicat","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7415","description":"Excision malig les complicat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0060U","description":"Twin zygosity_ genomic targeted sequence analysis of chromosome 2_ using circulating cell-free fetal DNA in maternal blood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct orbit/forehead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21175","description":"Reconstruct orbit/forehead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKC1","description":"ICD-KEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCLE1","description":"ICD-GCLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abrasion lesions add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15787","description":"Abrasion lesions add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVD0","description":"ICD-KGVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEQF1","description":"ICD-HEQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0514","description":"Disp fee inhal drugs/90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26121","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD0","description":"ICD-LHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLMF1","description":"ICD-OLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGMA0","description":"ICD-EGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81471","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-16375","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16375","description":"CPT-16375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth repair of hernia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75251","description":"Anesth repair of hernia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin peel therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17360","description":"Skin peel therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCD0","description":"ICD-GCCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aor ane >=6.0 cm max diam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9599","description":"Aor ane >=6.0 cm max diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper facial prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8043","description":"Upper facial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB0","description":"ICD-GBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE0","description":"ICD-KAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTF1","description":"ICD-JHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKA1","description":"ICD-CAKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIA0","description":"ICD-EIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJB0","description":"ICD-BDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADD0","description":"ICD-CADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAA1","description":"ICD-JAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Standard size footplate each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0042","description":"Standard size footplate each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDGD0","description":"ICD-JDGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPA1","description":"ICD-KFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB0","description":"ICD-FEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRF0","description":"ICD-HFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPF1","description":"ICD-NIPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1137","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74470","description":"X-ray exam of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIGA1","description":"ICD-GIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSD0","description":"ICD-CBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCJF1","description":"ICD-BCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag ctr rigi pos pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0643","description":"Lso sag ctr rigi pos pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVD1","description":"ICD-OKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFE1","description":"ICD-BFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC141","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDE0","description":"ICD-OEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEE1","description":"ICD-IEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens trifocal seg width > 28","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2319","description":"Lens trifocal seg width > 28","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA1","description":"ICD-BCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFEC1","description":"ICD-BFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA0","description":"ICD-IGDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbit surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67599","description":"Orbit surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF1","description":"ICD-EEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pierce earlobes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69090","description":"Pierce earlobes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOD1","description":"ICD-OLOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE0","description":"ICD-NDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDD0","description":"ICD-MKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebase hybrid prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5725","description":"Rebase hybrid prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKC0","description":"ICD-JCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021A","description":"Imm admin by intramusc injection of (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimp adenovirus Oxford 1 preserv free_ 0.5 ml dose_ 1st dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFB1","description":"ICD-FHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26433","description":"Repair finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Talymed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4127","description":"Talymed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of ovary(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58900","description":"Biopsy of ovary(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24940","description":"Revision of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGLD1","description":"ICD-NGLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOF0","description":"ICD-CBOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAC0","description":"ICD-CDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFF0","description":"ICD-GHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFB0","description":"ICD-GIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pland chemo docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0519F","description":"Pland chemo docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFA0","description":"ICD-BGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysat sol fld vol > 999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4721","description":"Dialysat sol fld vol > 999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impl/redo electrd antrum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43881","description":"Impl/redo electrd antrum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMB1","description":"ICD-GIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB0","description":"ICD-ABMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABF0","description":"ICD-CABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6600","description":"Gradient compression bandaging supply_ high density foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMC1","description":"ICD-GDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0525U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","description":"CPT-0525U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMF1","description":"ICD-CGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33940","description":"Removal of donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1944","description":"Injection_ aripiprazole lauroxil_ (aristada)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLXB1","description":"ICD-NLXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRA1","description":"ICD-OGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin sub grft t/arm/lg child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15273","description":"Skin sub grft t/arm/lg child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF0","description":"ICD-LHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOB1","description":"ICD-GDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFF0","description":"ICD-OBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF0","description":"ICD-OJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alveolus clsd reduc stblz te","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7771","description":"Alveolus clsd reduc stblz te","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA1","description":"ICD-NJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of catheter vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36510","description":"Insertion of catheter vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1166","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of oxalate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83945","description":"Assay of oxalate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15854","description":"Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCID0","description":"ICD-CCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymph choriomeningitis ab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86727","description":"Lymph choriomeningitis ab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE1","description":"ICD-BFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion ther other than che","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0081","description":"Infusion ther other than che","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRF1","description":"ICD-LGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAC1","description":"ICD-OHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD0","description":"ICD-CDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTB0","description":"ICD-JCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF0","description":"ICD-DDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWE1","description":"ICD-CIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD1","description":"ICD-AIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC1","description":"ICD-NICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qty act mcc mg perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9670","description":"Qty act mcc mg perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSA0","description":"ICD-DDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWE0","description":"ICD-PDWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHF0","description":"ICD-AIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLC1","description":"ICD-MJLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj tst 3-4 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95908","description":"Nrv cndj tst 3-4 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUB0","description":"ICD-KDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp ilioiliac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35663","description":"Art byp ilioiliac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB31","description":"ICD-4BB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62360","description":"Insert spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB0","description":"ICD-OIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99214","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHE0","description":"ICD-MBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5154","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","description":"HCPCS-Q5154","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us nuchal meas 1 gest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76813","description":"Ob us nuchal meas 1 gest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES14D","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt hx act drain prev 90 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8560","description":"Pt hx act drain prev 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFE0","description":"ICD-OCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJE0","description":"ICD-NGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHGE0","description":"ICD-BHGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose polyp(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30115","description":"Removal of nose polyp(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBA0","description":"ICD-MIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove nasal foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30320","description":"Remove nasal foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKB0","description":"ICD-KBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain external ear lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69000","description":"Drain external ear lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18B","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93015","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vitamin d 25 hydroxy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82306","description":"Vitamin d 25 hydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJA1","description":"ICD-GHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray adrenal gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75840","description":"Vein x-ray adrenal gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBC1","description":"ICD-NFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB0","description":"ICD-JGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal flow sheet","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0501F","description":"Prenatal flow sheet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALD1","description":"ICD-IALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF0","description":"ICD-FHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERC0","description":"ICD-PERC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX07","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27030","description":"Drainage of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRE1","description":"ICD-HIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vena cava filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1880","description":"Vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA31","description":"ICD-3GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIB1","description":"ICD-NCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYD1","description":"ICD-PIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGID1","description":"ICD-JGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35321","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9076","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","description":"HCPCS-J9076","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00948","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","description":"CPT-00948","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36589","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert bladder cath complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51703","description":"Insert bladder cath complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57000","description":"Exploration of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21248","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAOB1","description":"ICD-OAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0202U","description":"NFCT DS BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ furosemide (furoscix)_ 20 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1941","description":"Injection_ furosemide (furoscix)_ 20 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect hip/pelv tum < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27049","description":"Resect hip/pelv tum < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIF0","description":"ICD-CHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBFD1","description":"ICD-FBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMC0","description":"ICD-OGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise urine flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50830","description":"Revise urine flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse esophagus & intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43341","description":"Fuse esophagus & intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion pump refill kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4220","description":"Infusion pump refill kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antinuclear antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86038","description":"Antinuclear antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTA0","description":"ICD-FBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE0","description":"ICD-NATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Pasireotide Long Acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9454","description":"Injection_ Pasireotide Long Acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOF1","description":"ICD-DDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMA1","description":"ICD-FFMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF0","description":"ICD-NFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCE1","description":"ICD-GGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB0","description":"ICD-BEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA1","description":"ICD-CASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sps ankle device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1816","description":"Sps ankle device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Odontics transosteal implnt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6050","description":"Odontics transosteal implnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKC1","description":"ICD-FAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVC0","description":"ICD-FDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUB0","description":"ICD-BDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9592","description":"Copper cu-64_ dotatate_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKD1","description":"ICD-FHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analyze pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93724","description":"Analyze pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10D","description":"Special Care High _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ballistocardiogram","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3902","description":"Ballistocardiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDE0","description":"ICD-CCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens lenticular bifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2115","description":"Lens lenticular bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1371","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","description":"HCPCS-M1371","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUB0","description":"ICD-CFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX56","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNF1","description":"ICD-NHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBLC1","description":"ICD-GBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERC1","description":"ICD-OERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAD1","description":"ICD-OFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDF0","description":"ICD-JCDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft hand tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26358","description":"Repair/graft hand tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NALE0","description":"ICD-NALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCF0","description":"ICD-JCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0891T","description":"Accelerated_ repetitive high-dose functional connectivity MRI-guided theta-burst stimulation_ including neuronavigation_ delivery and management_ subsequent treatment day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFN5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aprotonin_ 10_000 kiu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0365","description":"Aprotonin_ 10_000 kiu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED0","description":"ICD-OJED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr f/e/e/n/l/m 2.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12011","description":"Rpr f/e/e/n/l/m 2.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBB0","description":"ICD-NBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDB1","description":"ICD-ACDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96158","description":"Health Behavior Intervention_ Individual_ Face-To-Face; Initial 30 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28193","description":"Removal of foot foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA1","description":"ICD-CFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB215","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB224","description":"Clinically Complex _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX46","description":"Very High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE254","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJA0","description":"ICD-FCJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE1","description":"ICD-GCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSE1","description":"ICD-GFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSC1","description":"ICD-DFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSC0","description":"ICD-PGSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKB0","description":"ICD-BBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-3/> piece w/o graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21143","description":"Lefort i-3/> piece w/o graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pituitary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61546","description":"Removal of pituitary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF1","description":"ICD-PBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIB1","description":"ICD-MCIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29877","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconst lwr jaw w/o fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21195","description":"Reconst lwr jaw w/o fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE13C","description":"Special Care Low _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIF1","description":"ICD-IDIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0748T","description":"Injections of stem cell product into perianal perifistular soft tissue_ including fistula preparation (eg_ removal of setons_ fistula curettage_ closure of internal openings)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOC1","description":"ICD-DAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUD1","description":"ICD-ADUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_phys coor-care ovrsght","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9008","description":"Mccd_phys coor-care ovrsght","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMB0","description":"ICD-FDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bartonella dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87470","description":"Bartonella dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCRA0","description":"ICD-KCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLND0","description":"ICD-NLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXF1","description":"ICD-BIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo spiral prefabricated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1951","description":"Afo spiral prefabricated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFHA0","description":"ICD-KFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJA0","description":"ICD-BDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXF1","description":"ICD-FBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNA1","description":"ICD-OBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54300","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"repair cast partial framework_ maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5622","description":"repair cast partial framework_ maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stress mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9454","description":"Stress mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureter endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50980","description":"Ureter endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anal tags","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46230","description":"Removal of anal tags","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXC0","description":"ICD-JAXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKC0","description":"ICD-NLKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYC1","description":"ICD-DFYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-stranded_i-125","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2639","description":"Brachytx_ non-stranded_i-125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAOB1","description":"ICD-LAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUF0","description":"ICD-AGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE210","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHLV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDD0","description":"ICD-ADDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC1","description":"ICD-PJYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTD1","description":"ICD-FDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp ext fixate strut change","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20697","description":"Comp ext fixate strut change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTC1","description":"ICD-MHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB1","description":"ICD-FAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC0","description":"ICD-CATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8X","description":"High Rehab _ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTD1","description":"ICD-JBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAA0","description":"ICD-ECAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES311","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTF1","description":"ICD-IHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lubricant per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4402","description":"Lubricant per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDF0","description":"ICD-BEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOE0","description":"ICD-GAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWB1","description":"ICD-OIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMD1","description":"ICD-EDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24A","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBC1","description":"ICD-NBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJD0","description":"ICD-CAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoscopy flex biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43202","description":"Esophagoscopy flex biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA0","description":"ICD-KIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB10C","description":"Special Care High _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME1","description":"ICD-BBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIE1","description":"ICD-GAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIF0","description":"ICD-EBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVC1","description":"ICD-BFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special childcare waiver/d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2026","description":"Special childcare waiver/d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQF0","description":"ICD-GHQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD1","description":"ICD-BBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIFE0","description":"ICD-OIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dx laryngoscopy newborn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31520","description":"Dx laryngoscopy newborn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPE0","description":"ICD-BAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97171","description":"Athletic training evaluation_ high complexity_ requiring these components: A medical history and physical activity profile_ with 3 or more comorbidities that affect physical a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMD1","description":"ICD-IBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD1","description":"ICD-MBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERF1","description":"ICD-GERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEA0","description":"ICD-GBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9303","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9303","description":"HCPCS-C9303","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEC1","description":"ICD-AFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWF0","description":"ICD-CCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test def 8-14 classes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0481","description":"Drug test def 8-14 classes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBD0","description":"ICD-ADBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB0","description":"ICD-BEKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDE0","description":"ICD-MFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVA1","description":"ICD-NGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOC0","description":"ICD-DCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF0","description":"ICD-DCSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBD1","description":"ICD-FIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD0","description":"ICD-JDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC1","description":"ICD-PESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0359U","description":"Oncology (prostate cancer)_ analysis of all prostate-specific antigen (PSA) structural isoforms by phase separation and immunoassay_ plasma_ algorithm reports risk of cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAA0","description":"ICD-ADAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44238","description":"Laparoscope proc intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCND0","description":"ICD-FCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKD0","description":"ICD-BAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00802","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","description":"CPT-00802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVB1","description":"ICD-NLVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLF0","description":"ICD-MGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFB0","description":"ICD-KGFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPC0","description":"ICD-KBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMB1","description":"ICD-BFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD236","description":"Reduced Physical Function _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFE1","description":"ICD-NHFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAE1","description":"ICD-KAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFE0","description":"ICD-KIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHD1","description":"ICD-EBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71046","description":"Radiologic examination_ chest; 2 views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEC1","description":"ICD-GCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt brain chemotx add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61517","description":"Implt brain chemotx add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHGC1","description":"ICD-GHGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88154","description":"Cytopath c/v select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0577T","description":"Electrophysiological Evaluation Of Implantable Cardioverter-Defibrillator System With Substernal Electrode (Includes Defibrillation Threshold Evaluation_ Induction Of Arrhythm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOA0","description":"ICD-PGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alloskin ac_ 1 cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4141","description":"Alloskin ac_ 1 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18C","description":"Special Care High _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection intraop add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48400","description":"Injection intraop add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLD0","description":"ICD-FGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of finger abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26010","description":"Drainage of finger abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEB1","description":"ICD-ABEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSA0","description":"ICD-GDSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28291","description":"Hallux rigidus correction with cheilectomy_ debridement and capsular release of the first metatarsophalangeal joint; with implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOA0","description":"ICD-PJOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQD1","description":"ICD-PKQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSE1","description":"ICD-LCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGF1","description":"ICD-JHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77262","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transferase (ast) (sgot)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84450","description":"Transferase (ast) (sgot)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5157","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","description":"HCPCS-Q5157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prednisolone oral per 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7510","description":"Prednisolone oral per 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening methadone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80358","description":"Drug screening methadone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin graft f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15155","description":"Cult skin graft f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22B","description":"Special Care High _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOB0","description":"ICD-OFOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB0","description":"ICD-GHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHB1","description":"ICD-BEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl alkaline battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8622","description":"Repl alkaline battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert cath pleura w/ image","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32557","description":"Insert cath pleura w/ image","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-EGFR monoclonal antibody therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9839","description":"Anti-EGFR monoclonal antibody therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Restrata minimatrix_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2026","description":"Restrata minimatrix_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8D","description":"High Rehab _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEB0","description":"ICD-NBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGA0","description":"ICD-NGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSD1","description":"ICD-GBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel implant sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7306","description":"Levonorgestrel implant sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC234","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDA0","description":"ICD-EBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAB1","description":"ICD-GGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA0","description":"ICD-CCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE0","description":"ICD-GDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGD1","description":"ICD-FIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum & vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57250","description":"Repair rectum & vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFOF0","description":"ICD-OFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLF1","description":"ICD-BBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIC1","description":"ICD-AHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPF0","description":"ICD-JFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHID1","description":"ICD-EHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF0","description":"ICD-GHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAIC1","description":"ICD-MAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50690","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0047","description":"Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Are Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQC0","description":"ICD-LIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove fix space maintainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1555","description":"Remove fix space maintainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of nail fold toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11765","description":"Excision of nail fold toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Control unit bowel system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0350","description":"Control unit bowel system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish brain cavity shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62220","description":"Establish brain cavity shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBE0","description":"ICD-MGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface material","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1820","description":"Soft interface material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARD0","description":"ICD-GARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISA1","description":"ICD-PISA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVF0","description":"ICD-KFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Atomic absorption","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82190","description":"Atomic absorption","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc chronic 1vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92943","description":"Prq card revasc chronic 1vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVC1","description":"ICD-BEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration multiple fi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6905","description":"Hand restoration multiple fi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHF1","description":"ICD-BCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00528","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","description":"CPT-00528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KC31","description":"ICD-1KC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastoid surgery revision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69603","description":"Mastoid surgery revision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0955T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","description":"CPT-0955T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast diep or siea flap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2068","description":"Breast diep or siea flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5943","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5943","description":"CDT-D5943","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe metatarsal bar between","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3410","description":"Shoe metatarsal bar between","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE1","description":"ICD-FCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBB0","description":"ICD-GHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg scan w/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0297T","description":"Ext ecg scan w/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX42","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPB1","description":"ICD-GGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYE0","description":"ICD-HFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUE0","description":"ICD-OKUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change nephroureteral cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50387","description":"Change nephroureteral cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD0","description":"ICD-FCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBF0","description":"ICD-JBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sterile gauze > 48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6404","description":"Sterile gauze > 48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB0","description":"ICD-FIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLB1","description":"ICD-MBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBID1","description":"ICD-NBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASE0","description":"ICD-LASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFA0","description":"ICD-GEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDC0","description":"ICD-OGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0300U","description":"Oncology (Pan Tumor)_ Whole Genome Sequencing And Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Tissue_ Blood_ Or Bone Marrow_ Comparative Sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHPB1","description":"ICD-BHPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84252","description":"Assay of vitamin b-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKC0","description":"ICD-BDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE1","description":"ICD-KFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB1","description":"ICD-NGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth face/skull bone surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19051","description":"Anesth face/skull bone surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABID1","description":"ICD-ABID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture tiss condtin mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5851","description":"Denture tiss condtin mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAD0","description":"ICD-FEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLD0","description":"ICD-IFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystatin c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82610","description":"Cystatin c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5D","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLPF1","description":"ICD-NLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXF1","description":"ICD-NDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB0","description":"ICD-NHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNE0","description":"ICD-CHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28F","description":"Clinically Complex _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQF0","description":"ICD-CBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Belt/harness extremity","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0945","description":"Belt/harness extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lingual frenectomy (frenulectomy)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7962","description":"Lingual frenectomy (frenulectomy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1035","description":"Molecular diagnostic test reader_ nonprescription self-administered and self-collected use_ fda approved_ authorized or cleared","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of porphobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84110","description":"Assay of porphobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEEE0","description":"ICD-KEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csit perf sx or high chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8966","description":"Csit perf sx or high chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros sock multi ply upper lm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8435","description":"Pros sock multi ply upper lm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML46","description":"Medium Rehab plus Extensive_ ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLB1","description":"ICD-JGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEE1","description":"ICD-CIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bivalirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0583","description":"Bivalirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVD1","description":"ICD-KHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA1","description":"ICD-BAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETC0","description":"ICD-KETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect shoulder tumor 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23078","description":"Resect shoulder tumor 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYE1","description":"ICD-KCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25119","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBF1","description":"ICD-ODBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB235","description":"Special Care Low _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc back tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21933","description":"Exc back tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0458T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; subcutaneous electrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject suprvlv aortography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93567","description":"Inject suprvlv aortography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC PAN-TUM DNA&RNA GNRJ SEQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0211U","description":"ONC PAN-TUM DNA&RNA GNRJ SEQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB125","description":"Clinically Complex _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise vag graft open abd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57296","description":"Revise vag graft open abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMB1","description":"ICD-CBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Forearm or wrist surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25999","description":"Forearm or wrist surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD0","description":"ICD-FILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEB0","description":"ICD-ADEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHCA1","description":"ICD-MHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD1","description":"ICD-GGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB220","description":"Reduced Physical Function _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24110","description":"Remove humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHC0","description":"ICD-FAHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF1","description":"ICD-BALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBD1","description":"ICD-BHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BC11","description":"ICD-3BC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHE1","description":"ICD-FCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet imaging initial dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0252","description":"Pet imaging initial dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33894","description":"Endovascular Stent Repair Of Coarctation Of The Ascending_ Transverse_ Or Descending Thoracic Or Abdominal Aorta_ Involving Stent Placement; Across Major Side Branches","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSB1","description":"ICD-OJSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMA1","description":"ICD-ACMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRD1","description":"ICD-GDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0652U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0652U","description":"CPT-0652U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1019","description":"Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at 12 months as demonstrated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAD1","description":"ICD-NKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOB1","description":"ICD-LHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol ipratrop non-comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7620","description":"Albuterol ipratrop non-comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50785","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled carbon dioxide test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94770","description":"Exhaled carbon dioxide test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair humerus with graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24435","description":"Repair humerus with graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESA0","description":"ICD-HESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD0","description":"ICD-CEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate crtd sns dev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0272T","description":"Interrogate crtd sns dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47505","description":"Injection procedure for cholangiography through an existing catheter(eg_ percutaneous transhepatic or t-tube)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEA1","description":"ICD-MFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85999","description":"Hematology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel pad removable for","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3485","description":"Shoe heel pad removable for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUF1","description":"ICD-GHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVA0","description":"ICD-BBVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD0","description":"ICD-JHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSB1","description":"ICD-DBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOC1","description":"ICD-HDOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIB0","description":"ICD-GGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rsa upper extr exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349T","description":"Rsa upper extr exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXC1","description":"ICD-NDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPA0","description":"ICD-GCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGB0","description":"ICD-BCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKF1","description":"ICD-FDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of midfoot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28304","description":"Incision of midfoot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVB0","description":"ICD-NAVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC0","description":"ICD-GFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE23A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin barrier liquid per oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4369","description":"Skin barrier liquid per oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF0","description":"ICD-KBYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC0","description":"ICD-IABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX02","description":"Low Rehab plus Extensive _ ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6753","description":"Retainer Crown - Porcelain Fused To Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1028","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGD0","description":"ICD-OCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEMB0","description":"ICD-CEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECA1","description":"ICD-KECA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBC0","description":"ICD-OJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDF0","description":"ICD-GDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE1","description":"ICD-FDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA42","description":"Default_ /60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had more than one emergency department visit in the last 30 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9850","description":"Patient had more than one emergency department visit in the last 30 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilat macular exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2021F","description":"Dilat macular exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9162","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0241T","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion during 3-dimensn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD1","description":"ICD-EFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracranial uni/ltd study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93882","description":"Extracranial uni/ltd study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"User adjustable heel height","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5990","description":"User adjustable heel height","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUB0","description":"ICD-JAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRA1","description":"ICD-LDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"NEURO ALZHEIMER CELL AGGREGJ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0206U","description":"NEURO ALZHEIMER CELL AGGREGJ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA06","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare sho","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visc & infraren abd 3 prosth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34847","description":"Visc & infraren abd 3 prosth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mediastinoscpy w/lmph nod bx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39402","description":"Mediastinoscpy w/lmph nod bx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reprogram cochlear implt 7/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92604","description":"Reprogram cochlear implt 7/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEA0","description":"ICD-GGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFAA1","description":"ICD-CFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF1","description":"ICD-EABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF0","description":"ICD-NCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMA0","description":"ICD-OJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBGD0","description":"ICD-JBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENA1","description":"ICD-KENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56631","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKA0","description":"ICD-JFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMD1","description":"ICD-EIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAC0","description":"ICD-AFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cltx post ankle fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27767","description":"Cltx post ankle fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEA0","description":"ICD-MEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5945","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5945","description":"CDT-D5945","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ctr mount pwr elev leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1012","description":"Ctr mount pwr elev leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHD1","description":"ICD-FIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWC1","description":"ICD-PLWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1352","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0334U","description":"Oncology (solid organ)_ targeted genomic sequence analysis_ formalin-fixed paraffin-embedded (FFPE) tumor tissue_ DNA analysis_ 84 or more genes_ interrogation for sequence va","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA1","description":"ICD-FABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0655T","description":"Transperineal focal laser ablation of malignant prostate tissue_ including transrectal imaging guidance_ with MR-fused images or other enhanced ultrasound imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9813","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9813","description":"HCPCS-C9813","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIGD0","description":"ICD-NIGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIEC0","description":"ICD-NIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUC1","description":"ICD-IEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27552","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt neurostim radiofq rec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8682","description":"Implt neurostim radiofq rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEC0","description":"ICD-MGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0603","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","description":"HCPCS-J0603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroscop rotator cuff repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29827","description":"Arthroscop rotator cuff repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF1","description":"ICD-OBXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE0","description":"ICD-PFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCA1","description":"ICD-AFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKC0","description":"ICD-OCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAE0","description":"ICD-ECAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERF1","description":"ICD-DERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01999","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","description":"CPT-01999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE1","description":"ICD-PBSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOC0","description":"ICD-CEOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD0","description":"ICD-FDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81163","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTC0","description":"ICD-FDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1117","description":"Documentation Stating Patient Has A Diagnosis Of A Degenerative Neurological Condition Such As Als_ Ms_ Or Parkinson_S Diagnosed At Any Time Before Or During The Episode Of Ca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36474","description":"Endovenous ablation therapy of incompetent vein_ extremity_ inclusive of all imaging guidance and monitoring_ percutaneous_ mechanochemical; subsequent vein(s) treated in a si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABD1","description":"ICD-BABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us guidance fetal reduct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8055","description":"Us guidance fetal reduct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVB1","description":"ICD-NIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18D","description":"Clinically Complex _ ADL Index 11-14/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAEC0","description":"ICD-JAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"R&l hrt art/ventricle angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93461","description":"R&l hrt art/ventricle angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAA0","description":"ICD-KHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61516","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQC1","description":"ICD-PCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22315","description":"Closed tx vert fx w/manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVE1","description":"ICD-GDVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCID0","description":"ICD-JCID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAMA1","description":"ICD-EAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive remover per ounce","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4455","description":"Adhesive remover per ounce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0968T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","description":"CPT-0968T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat shoulder dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23650","description":"Treat shoulder dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ trans atherectomy_ dir","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1714","description":"Cath_ trans atherectomy_ dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ cool-tip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2630","description":"Cath_ ep_ cool-tip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50405","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBF1","description":"ICD-EGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD14A","description":"Clinically Complex _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Image std nomenclature","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9318","description":"Image std nomenclature","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nelarabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9261","description":"Nelarabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB236","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMC1","description":"ICD-CGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB17","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43360","description":"Gastrointestinal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAA0","description":"ICD-GBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8E","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGE1","description":"ICD-JEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCRD0","description":"ICD-HCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDB0","description":"ICD-GDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQC1","description":"ICD-OKQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE144","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC11","description":"ICD-3FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIVF0","description":"ICD-NIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Brolucizumab-Dbll_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0179","description":"Injection_ Brolucizumab-Dbll_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo transesophageal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93316","description":"Echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiotherapy dose plan imrt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77301","description":"Radiotherapy dose plan imrt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"The Start Of An Episode Of Care Documented In The Medical Record","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1106","description":"The Start Of An Episode Of Care Documented In The Medical Record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epiandrosterone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6049","description":"Epiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWB0","description":"ICD-PHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB0","description":"ICD-CHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDE0","description":"ICD-MGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEKA0","description":"ICD-KEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36578","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPF1","description":"ICD-BEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC1","description":"ICD-EDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophgl motil w/stim/perfus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91013","description":"Esophgl motil w/stim/perfus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTF0","description":"ICD-EFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBF1","description":"ICD-NIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of nucleotidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83915","description":"Assay of nucleotidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUF0","description":"ICD-EFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Daptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0878","description":"Daptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repeat drainage of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33011","description":"Repeat drainage of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAHA1","description":"ICD-AAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sodium thiosulfate_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0208","description":"Injection_ sodium thiosulfate_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosphenytoin sodi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0078","description":"Injection_ fosphenytoin sodi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper limb orthosis nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3999","description":"Upper limb orthosis nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apically positioned flap","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4245","description":"Apically positioned flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB256","description":"Special Care Low _ ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splint elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8452","description":"Splint elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES255","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete occlusal adjustment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9952","description":"Complete occlusal adjustment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38H","description":"Extensive Services _ ADL Index 2-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip disartic sach thermopls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5595","description":"Hip disartic sach thermopls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSB1","description":"ICD-GDSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound filler gel/paste /oz","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6261","description":"Wound filler gel/paste /oz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRB0","description":"ICD-GCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB44","description":"Medium Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compres burn garment_ noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6512","description":"Compres burn garment_ noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1274","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrnd unhlthy oh use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3016F","description":"Pt scrnd unhlthy oh use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHE0","description":"ICD-OLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pow mobil dev no dmepdac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0899","description":"Pow mobil dev no dmepdac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair carpal bone shorten","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25394","description":"Repair carpal bone shorten","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIDD0","description":"ICD-AIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE256","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49591","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADD0","description":"ICD-JADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27050","description":"Biopsy of sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFD0","description":"ICD-GFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Optokinetic nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92544","description":"Optokinetic nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA230","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable male external cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4349","description":"Disposable male external cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWC0","description":"ICD-PAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSF1","description":"ICD-OFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFC1","description":"ICD-OLFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay bld/serum cholesterol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82465","description":"Assay bld/serum cholesterol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAXD0","description":"ICD-CAXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10A","description":"Special Care Low _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder over 12.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2114","description":"Spherocylinder over 12.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quant tiagabine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80199","description":"Drug screen quant tiagabine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVF0","description":"ICD-BHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alveoplasty w/ extraction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7310","description":"Alveoplasty w/ extraction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystouretero w/excise tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52355","description":"Cystouretero w/excise tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair standard w/ leg r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1150","description":"Wheelchair standard w/ leg r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath stent cca w/o eps","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37216","description":"Transcath stent cca w/o eps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPD0","description":"ICD-FDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate leg veins radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37760","description":"Ligate leg veins radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vis 20/40/> w/in 90 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4175F","description":"Vis 20/40/> w/in 90 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE14D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKMB0","description":"ICD-MKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81259","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJA1","description":"ICD-FIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPA0","description":"ICD-BEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXA0","description":"ICD-BCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NANC0","description":"ICD-NANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACA0","description":"ICD-FACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJC0","description":"ICD-NJJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFF0","description":"ICD-OHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB36","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown 3/4 cast base metal","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2781","description":"Crown 3/4 cast base metal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF0","description":"ICD-FBLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMC1","description":"ICD-GEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0088","description":"Professional services_ initial visit_ for the administration of anti-infective_ pain management_ chelation_ pulmonary hypertension_ inotropic_ or other intravenous infusion dr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVC0","description":"ICD-OBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITA1","description":"ICD-GITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient recorded spirometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94014","description":"Patient recorded spirometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2143","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At One Year (9 To 15 Months) Postoperatively Was Greater Than 22 And Functional Status Measured","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dehydroepiandrosterone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82627","description":"Dehydroepiandrosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Photodynamic tx addl 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96571","description":"Photodynamic tx addl 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB0","description":"ICD-KBOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFE1","description":"ICD-NKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain flow imaging only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78610","description":"Brain flow imaging only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1B","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth skull repair/fract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21551","description":"Anesth skull repair/fract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phototherapy light w/ photom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0202","description":"Phototherapy light w/ photom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine eltrd plate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63664","description":"Revise spine eltrd plate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWA0","description":"ICD-HHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVD1","description":"ICD-BBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35226","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ during operative procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73530","description":"Radiologic examination_ hip_ during operative procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Betadine/iodine swabs/wipes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4247","description":"Betadine/iodine swabs/wipes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLC0","description":"ICD-NLLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC116","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55708","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","description":"CPT-55708","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHF1","description":"ICD-IFHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRD0","description":"ICD-CFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX15","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc mel cnr stg 0 - iic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8944","description":"Ajcc mel cnr stg 0 - iic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9457","description":"Injection Sulfur Hexafouride Lipid Microsphere Per Ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd varices ligation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43244","description":"Egd varices ligation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heel bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28300","description":"Incision of heel bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC236","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJE0","description":"ICD-NDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFED1","description":"ICD-GFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB31","description":"Medium Rehab _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ROTAVIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87425","description":"IAAD IA ROTAVIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD226","description":"Clinically Complex _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIEE1","description":"ICD-JIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92651","description":"Auditory Evoked Potentials; For Hearing Status Determination_ Broadband Stimuli_ With Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUA1","description":"ICD-OCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of lower leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27715","description":"Revision of lower leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1028","description":"Take-Home Supply Of Nasal Naloxone; 2-Pack Of 8Mg Per 0.1 Ml Nasal Spray (Provision Of The Services By A Medicare-Enrolled Opioid Treatment Program); List Separately In Additi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECCE1","description":"ICD-ECCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXE1","description":"ICD-FEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE1","description":"ICD-FFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA21","description":"ICD-2GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ foot_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6587","description":"Gradient pressure wrap with adjustable straps_ foot_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88367","description":"Insitu hybridization auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rubeola antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86765","description":"Rubeola antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1237","description":"Patient reason for not screening for food insecurity_ housing instability_ transportation needs_ utility difficulties_ and interpersonal safety (e.g._ patient declined or othe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXD0","description":"ICD-BFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19357","description":"Breast reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11642","description":"Exc f/e/e/n/l mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVB0","description":"ICD-OIVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of heart chamber","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33735","description":"Revision of heart chamber","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFB0","description":"ICD-GDFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ctlso infant immobilizer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1001","description":"Ctlso infant immobilizer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul trial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0282T","description":"Periph field stimul trial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker seat attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0156","description":"Walker seat attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37220","description":"Iliac revasc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46999","description":"Anus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vag hyst w/uro repair compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58293","description":"Vag hyst w/uro repair compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYE1","description":"ICD-OCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD1","description":"ICD-HGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care after delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59430","description":"Care after delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rsv mab im 50mg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90378","description":"Rsv mab im 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2067","description":"Medication Assisted Treatment_ Methadone; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxicology Test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIE1","description":"ICD-CDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQA0","description":"ICD-LAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQA0","description":"ICD-ODQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv musc migraine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64615","description":"Chemodenerv musc migraine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBF0","description":"ICD-NKBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEOF0","description":"ICD-KEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump cap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4283","description":"Replacement breastpump cap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF1","description":"ICD-LGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRD0","description":"ICD-KFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFE1","description":"ICD-BGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD0","description":"ICD-CCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulm funct tst plethysmograp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94726","description":"Pulm funct tst plethysmograp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKD0","description":"ICD-GCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lipid profile not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8728","description":"Lipid profile not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB1","description":"ICD-PJOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Segmentectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32484","description":"Segmentectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTA0","description":"ICD-CBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Participant-Directed Community Supports","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1900","description":"Participant-Directed Community Supports","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5108","description":"Injection_ pegfilgrastim-jmdb_ biosimilar_ (Fulphila)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4420","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","description":"HCPCS-Q4420","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/o fol w/cont_ breast_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8908","description":"MRI w/o fol w/cont_ breast_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ankle bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28130","description":"Removal of ankle bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC31","description":"ICD-1DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft kneecap tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27381","description":"Repair/graft kneecap tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81279","description":"Jak2 (Janus Kinase 2) (Eg_ Myeloproliferative Disorder) Targeted Sequence Analysis (Eg_ Exons 12 And 13)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99328","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7176","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7176","description":"HCPCS-J7176","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYB0","description":"ICD-DDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA1","description":"ICD-AEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYD1","description":"ICD-OHYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUF0","description":"ICD-ADUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA1","description":"ICD-KIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cephalothin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1890","description":"Cephalothin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFID0","description":"ICD-GFID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9743","description":"Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGPA0","description":"ICD-OGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit blood products diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9538","description":"Hit blood products diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMA0","description":"ICD-OGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrde addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61864","description":"Implant neuroelectrde addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt trnsfrd from anesth to cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0581F","description":"Pt trnsfrd from anesth to cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0584T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHB1","description":"ICD-GEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKF1","description":"ICD-GEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1602","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1602","description":"CDT-D1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTC0","description":"ICD-CGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPF0","description":"ICD-JDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYB0","description":"ICD-DGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve lobectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32486","description":"Sleeve lobectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD0","description":"ICD-OHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBB1","description":"ICD-OJBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAME1","description":"ICD-EAME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX2C","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOB0","description":"ICD-HIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHE1","description":"ICD-MEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing solid stirrup calf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1980","description":"Afo sing solid stirrup calf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJB0","description":"ICD-FDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQB0","description":"ICD-KEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB215","description":"Special Care Low _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE1","description":"ICD-OIVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB21","description":"ICD-2FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCB0","description":"ICD-NDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNF1","description":"ICD-JFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-rays bone survey complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77075","description":"X-rays bone survey complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thorax spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22327","description":"Treat thorax spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGUE0","description":"ICD-MGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEB0","description":"ICD-EFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE205","description":"Reduced Physical Function _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPA0","description":"ICD-KEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA5C","description":"Very High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFF0","description":"ICD-OKFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair bearings","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2210","description":"Wheelchair bearings","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVA0","description":"ICD-JEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95148","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058U","description":"Oncology (Merkel cell carcinoma)_ detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen)_ serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70300","description":"X-ray exam of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNB1","description":"ICD-KFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AFKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB1","description":"ICD-KIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMB0","description":"ICD-CCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30999","description":"Nasal surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complex body section x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76101","description":"Complex body section x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCC1","description":"ICD-EBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB1","description":"ICD-EHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDA1","description":"ICD-IIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBD0","description":"ICD-NEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC10B","description":"Special Care High _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVE0","description":"ICD-CIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg splnt ped p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4043","description":"Cast sup lng leg splnt ped p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADD1","description":"ICD-IADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing id_ digit_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5254","description":"Hearing id_ digit_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1022","description":"Addition to lower extremity prosthesis_ endoskeletal_ kneedisarticulation_ above knee_ hip disarticulation_ positional rotation unit_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVF0","description":"ICD-OAVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral appliance therapy (OAT) titration visit","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9955","description":"Oral appliance therapy (OAT) titration visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotaxis assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86155","description":"Chemotaxis assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB25D","description":"Clinically Complex _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSB1","description":"ICD-KCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palliative Care Services Given To Patient Any Time During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0031","description":"Palliative Care Services Given To Patient Any Time During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBE0","description":"ICD-OHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCGA1","description":"ICD-CCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFD0","description":"ICD-CFFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1958","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1958","description":"HCPCS-J1958","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmprsburngrmnt glove-axilla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6506","description":"Cmprsburngrmnt glove-axilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc pt assistant ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0157","description":"Hhc pt assistant ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt education noc individ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9445","description":"Pt education noc individ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEB0","description":"ICD-NKEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSB0","description":"ICD-CDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast 1st strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19283","description":"Perq dev breast 1st strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVA0","description":"ICD-BGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj manipulation under anest","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7830","description":"Tmj manipulation under anest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAD1","description":"ICD-CIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tb intradermal test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86580","description":"Tb intradermal test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain arm/elbow bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23935","description":"Drain arm/elbow bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Renin stimulation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80417","description":"Renin stimulation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODMF0","description":"ICD-ODMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sisi hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92564","description":"Sisi hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF0","description":"ICD-NCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admin hepatitis b vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0010","description":"Admin hepatitis b vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35331","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA11","description":"ICD-4LA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35001","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCPD1","description":"ICD-KCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE1","description":"ICD-OGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Physical therapy treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97039","description":"Physical therapy treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL52","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGD1","description":"ICD-KFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology/Hematology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4019","description":"Oncology/Hematology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIE0","description":"ICD-IDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPF0","description":"ICD-KDPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture tiss conditn maxill","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5850","description":"Denture tiss conditn maxill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histoplasmosis skin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86510","description":"Histoplasmosis skin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90587","description":"Dengue vaccine_ quadrivalent_ live_ 3 dose schedule_ for subcutaneous use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLE0","description":"ICD-BBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0559U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","description":"CPT-0559U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHF1","description":"ICD-NJHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDXF0","description":"ICD-JDXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMA1","description":"ICD-GGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC0","description":"ICD-IFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC0","description":"ICD-OHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA0","description":"ICD-JCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEAD0","description":"ICD-MEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKB1","description":"ICD-OGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB21","description":"Medium Rehab _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occ orthotic device adjust","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7881","description":"Occ orthotic device adjust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental other tmj films","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0321","description":"Dental other tmj films","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIE1","description":"ICD-OAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impr med time edarr pain med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9426","description":"Impr med time edarr pain med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0406","description":"HCPCS-C0406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ conivaptan hydrochloride_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9488","description":"Injection_ conivaptan hydrochloride_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPD0","description":"ICD-OJPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKD1","description":"ICD-NGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00750","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","description":"CPT-00750","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9913","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9913","description":"CDT-D9913","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA150","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0340U","description":"Oncology (pan-cancer)_ analysis of minimal residual disease (MRD) from plasma_ with assays personalized to each patient based on prior next-generation sequencing of the patien","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAE1","description":"ICD-AEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1454","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","description":"HCPCS-M1454","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGE1","description":"ICD-CFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI ct scan ord rvwd rqstd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3324F","description":"MRI ct scan ord rvwd rqstd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFVD0","description":"ICD-CFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hymenotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56442","description":"Hymenotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYE1","description":"ICD-LIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC1","description":"ICD-JGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF1","description":"ICD-OAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay myeloperoxidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83876","description":"Assay myeloperoxidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oseltamivir phosphate 75mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9019","description":"Oseltamivir phosphate 75mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA115","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peginesatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0890","description":"Peginesatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD1","description":"ICD-KDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFA1","description":"ICD-ODFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE0","description":"ICD-FBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1902","description":"HCPCS-A1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBD0","description":"ICD-MJBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/enzymes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86971","description":"Rbc pretx incubatj w/enzymes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bekesy audiometry screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92560","description":"Bekesy audiometry screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDE0","description":"ICD-GFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc mechanical fragility","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85547","description":"Rbc mechanical fragility","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rotation wrst w/ cable lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6625","description":"Rotation wrst w/ cable lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0302","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0302","description":"CDT-D0302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE1","description":"ICD-PKRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPD1","description":"ICD-KEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27446","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOE0","description":"ICD-KAOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphere bifocal 7.12-20.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2202","description":"Lens sphere bifocal 7.12-20.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drive wheel excludes tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2394","description":"Drive wheel excludes tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Full mouth x-ray of teeth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70320","description":"Full mouth x-ray of teeth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/balloon dilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45386","description":"Colonoscopy w/balloon dilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suture small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44602","description":"Suture small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUB0","description":"ICD-GAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVC0","description":"ICD-JBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECAF1","description":"ICD-ECAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp ge 130 - 139mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3075F","description":"Syst bp ge 130 - 139mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteoarthritis assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1006F","description":"Osteoarthritis assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"After cataract laser surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66821","description":"After cataract laser surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUF1","description":"ICD-JAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx compl front sinus fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21344","description":"Open tx compl front sinus fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0259U","description":"Nephrology (chronic kidney disease)_ nuclear magnetic resonance spectroscopy measurement of myo-inositol_ valine_ and creatinine_ algorithmically combined with cystatin C (by","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qual card diag prior 12 mons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1460F","description":"Qual card diag prior 12 mons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD210","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEB1","description":"ICD-MKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQD1","description":"ICD-ODQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUC1","description":"ICD-BEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIE0","description":"ICD-NJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXD0","description":"ICD-OJXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plas shoe insert w ank joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2180","description":"Plas shoe insert w ank joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDEA1","description":"ICD-MDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLA0","description":"ICD-MFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sagit rigid panel prefab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0635","description":"Lso sagit rigid panel prefab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFSF0","description":"ICD-GFSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD1","description":"ICD-JEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF0","description":"ICD-BECF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sympt sten-tia/strk<120days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9006F","description":"Sympt sten-tia/strk<120days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF1","description":"ICD-IDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lockingelbow forearm cntrbal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6693","description":"Lockingelbow forearm cntrbal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBSA1","description":"ICD-GBSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Weight mgmt class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9449","description":"Weight mgmt class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF1","description":"ICD-FFVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEA1","description":"ICD-KBEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0549U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","description":"CPT-0549U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB241","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXB1","description":"ICD-OFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECF1","description":"ICD-FECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKE0","description":"ICD-FAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB1","description":"ICD-KAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antidepres rxthxpy not rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4063F","description":"Antidepres rxthxpy not rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0850","description":"Pwc gp 3 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATD0","description":"ICD-BATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE236","description":"Clinically Complex _ ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICB1","description":"ICD-IICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPB0","description":"ICD-FCPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35182","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAB1","description":"ICD-OLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8X","description":"High Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corticoster sparng thrpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4142F","description":"Corticoster sparng thrpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHC1","description":"ICD-EFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KASC0","description":"ICD-KASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko adj jnt pos r sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1833","description":"Ko adj jnt pos r sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUE0","description":"ICD-KGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICD0","description":"ICD-FICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRF1","description":"ICD-PGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC43","description":"Ultra High Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral mr contrast_ 100 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9954","description":"Oral mr contrast_ 100 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0544U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544U","description":"CPT-0544U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Robt lin-radsurg fractx 2-5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0340","description":"Robt lin-radsurg fractx 2-5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise lower leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27691","description":"Revise lower leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA56","description":"Very High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92653","description":"Anesth removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJB0","description":"ICD-NFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUC1","description":"ICD-NEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin symp vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1004F","description":"Clin symp vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILD1","description":"ICD-FILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ga67 gallium","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9556","description":"Ga67 gallium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUC0","description":"ICD-BFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRD0","description":"ICD-CCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC0","description":"ICD-EEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No f/u eval q3mo opiod tx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9563","description":"No f/u eval q3mo opiod tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDD1","description":"ICD-KEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/signal-averaged","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93278","description":"Ecg/signal-averaged","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLA0","description":"ICD-NCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTC1","description":"ICD-OCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0026U","description":"Oncology (thyroid)_ DNA and mRNA of 112 genes_ next-generation sequencing_ fine needle aspirate of thyroid nodule_ algorithmic analysis reported as a categorical result (Posi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKE0","description":"ICD-GEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close mult vsd w/resection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33676","description":"Close mult vsd w/resection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1201","description":"HCPCS-A1201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELF0","description":"ICD-AELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18D","description":"Special Care Low _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Furosemide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1940","description":"Furosemide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLC0","description":"ICD-KFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo sprng wir drsflx calf bd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1900","description":"Afo sprng wir drsflx calf bd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA31","description":"ICD-2HA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KB31","description":"ICD-2KB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQC1","description":"ICD-PJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF0","description":"ICD-IBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als1-emergency","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0427","description":"Als1-emergency","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF1","description":"ICD-EAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00811","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","description":"CPT-00811","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23700","description":"Fixation of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81180","description":"ATXN3 (ataxin 3) (eg_ spinocerebellar ataxia_ Machado-Joseph disease) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALE0","description":"ICD-FALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENC1","description":"ICD-JENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB1","description":"ICD-FBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGE0","description":"ICD-CIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26775","description":"Treat finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVA1","description":"ICD-OGVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC1","description":"ICD-OLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD0","description":"ICD-KBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATB1","description":"ICD-KATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fracture frame dual w cross","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0946","description":"Fracture frame dual w cross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUA1","description":"ICD-KDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDC0","description":"ICD-IEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIA1","description":"ICD-FHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC1","description":"ICD-OLIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42950","description":"Reconstruction of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGB0","description":"ICD-GAGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor inhibitor test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85335","description":"Factor inhibitor test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCC1","description":"ICD-ODCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33995","description":"Insertion Of Ventricular Assist Device_ Percutaneous_ Including Radiological Supervision And Interpretation; Right Heart_ Venous Access Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC22D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTF1","description":"ICD-MLTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWF0","description":"ICD-PFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC1","description":"ICD-FFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc renal art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0234T","description":"Trluml perip athrc renal art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA0","description":"ICD-NEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETB0","description":"ICD-JETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation cervical mucus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89330","description":"Evaluation cervical mucus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB1","description":"ICD-ABDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFB1","description":"ICD-CCFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRD0","description":"ICD-HIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE20D","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC1","description":"ICD-CCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJF0","description":"ICD-GGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7670","description":"Metaproterenol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIF0","description":"ICD-NEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB44","description":"Ultra High Rehab _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB240","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVE1","description":"ICD-ODVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01680","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","description":"CPT-01680","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEME1","description":"ICD-OEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAA0","description":"ICD-GCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx head/neck t1-t2no prg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9109","description":"Onc dx head/neck t1-t2no prg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEVF1","description":"ICD-JEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea 1 ses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0435T","description":"Prgrmg eval npgs apnea 1 ses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLD0","description":"ICD-GGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hysteroscopy resect septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58560","description":"Hysteroscopy resect septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE0","description":"ICD-BCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIC1","description":"ICD-CCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dressing <=16 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6021","description":"Collagen dressing <=16 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL03","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short sta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUD1","description":"ICD-OHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHB1","description":"ICD-IHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEB0","description":"ICD-FGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF0","description":"ICD-JAKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYA0","description":"ICD-OCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67107","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation caregiver is trained and certified in dementia care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2185","description":"Documentation caregiver is trained and certified in dementia care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc visc aorta 2 graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34842","description":"Endovasc visc aorta 2 graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUD0","description":"ICD-OAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25275","description":"Repair forearm tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYC1","description":"ICD-LGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIFC0","description":"ICD-BIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKF0","description":"ICD-GBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"American amnion_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4307","description":"American amnion_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18G","description":"Special Care High _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe caliper plate new","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3610","description":"Trans shoe caliper plate new","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of aluminum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82108","description":"Assay of aluminum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTB0","description":"ICD-BCTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66987","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31755","description":"Repair of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No wet-dry drssings rx recmd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4266F","description":"No wet-dry drssings rx recmd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29901","description":"Mcp joint arthroscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE0","description":"ICD-BDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE0","description":"ICD-KDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGNB1","description":"ICD-CGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0604","description":"Inpatient Respite Care - A flat per diem rate before area wage adjustment paid for each day on which the patient is in an inpatient facility and is receiving respite care.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHB1","description":"ICD-NJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEF0","description":"ICD-MCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB5D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMF0","description":"ICD-BBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clear outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69205","description":"Clear outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMF1","description":"ICD-BIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tendon lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26476","description":"Tendon lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath w/drainage 2-way latex","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4314","description":"Cath w/drainage 2-way latex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay cst base mtl >=3 surfa","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6613","description":"Onlay cst base mtl >=3 surfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINA0","description":"ICD-CINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCB0","description":"ICD-OLCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14040","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFDC1","description":"ICD-JFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTA0","description":"ICD-IFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEB1","description":"ICD-NCEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC231","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insrt heart pm atrial & vent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33208","description":"Insrt heart pm atrial & vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRC0","description":"ICD-OLRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSF1","description":"ICD-LFSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUA1","description":"ICD-NDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91313","description":"SARSCOV2 VACCINE BIVALENT 50 MCG/0.5 ML IM USE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/drug screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0049","description":"Alcohol/drug screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHF1","description":"ICD-NAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMB0","description":"ICD-AHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0898T","description":"Noninvasive prostate cancer estimation map_ derived from augmentative analysis of image-guided fusion biopsy and pathology_ including visualization of margin volume and locati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLEB1","description":"ICD-NLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25C","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGB1","description":"ICD-GFGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J1553","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","description":"HCPCS-J1553","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB0","description":"ICD-KGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARE0","description":"ICD-HARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRA1","description":"ICD-DDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngeal function studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92520","description":"Laryngeal function studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQB1","description":"ICD-PHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTE0","description":"ICD-OJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIF0","description":"ICD-EAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETD1","description":"ICD-CETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFF0","description":"ICD-FGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ hla-m_ l/r_ unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9052","description":"Platelets_ hla-m_ l/r_ unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDD0","description":"ICD-AEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB14C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tretinoin topical 5 g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0117","description":"Tretinoin topical 5 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLC0","description":"ICD-FHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE0","description":"ICD-NECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGA1","description":"ICD-ODGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTF1","description":"ICD-OHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPD1","description":"ICD-GIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOB0","description":"ICD-CEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPE0","description":"ICD-NGPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRF1","description":"ICD-PLRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE1","description":"ICD-KBQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28666","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBF0","description":"ICD-JGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj facial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64402","description":"N block inj facial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye photography","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92285","description":"Eye photography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUF0","description":"ICD-EHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGE1","description":"ICD-BEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj hi_ initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9003","description":"Mccd_ risk adj hi_ initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHD1","description":"ICD-OHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAB0","description":"ICD-ADAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB32","description":"Low Rehab_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEJD0","description":"ICD-OEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prehensile actuator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7040","description":"Prehensile actuator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQA0","description":"ICD-DAQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIF1","description":"ICD-ADIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMF0","description":"ICD-JHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laiv vacc pandemic intranasl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90664","description":"Laiv vacc pandemic intranasl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch home day #2 cea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8834","description":"Pt disch home day #2 cea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJAD0","description":"ICD-OJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCAA1","description":"ICD-CCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTD1","description":"ICD-OBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neonate crit care initial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99468","description":"Neonate crit care initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADA1","description":"ICD-MADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHNC1","description":"ICD-NHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18D","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Noble Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6122","description":"Implant Supported Retainer For Metal Fpd - Noble Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive testis surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54535","description":"Extensive testis surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLF0","description":"ICD-OFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 45 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90834","description":"Psytx pt&/family 45 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco-use counsel>10min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0437","description":"Tobacco-use counsel>10min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVA1","description":"ICD-FHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF0","description":"ICD-GEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIHA1","description":"ICD-IIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Feeding aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5951","description":"Feeding aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWF1","description":"ICD-KAWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetone assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82010","description":"Acetone assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWC1","description":"ICD-KBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt in the home per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9131","description":"Pt in the home per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCA0","description":"ICD-NKCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFD1","description":"ICD-NDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSB0","description":"ICD-OGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2A","description":"Default_ /PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/control bleed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45382","description":"Colonoscopy w/control bleed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA1","description":"ICD-JFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA1","description":"ICD-JBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emr hd pmp elec/combo_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0494","description":"Emr hd pmp elec/combo_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA3C","description":"Very High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPA0","description":"ICD-CCPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advancing rheumatology patient care mips value pathways","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0053","description":"Advancing rheumatology patient care mips value pathways","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debridement of a periimplant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6101","description":"Debridement of a periimplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELD0","description":"ICD-KELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB1","description":"ICD-KBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB16","description":"Very High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD116","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28307","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAE1","description":"ICD-IDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBD0","description":"ICD-BIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMB0","description":"ICD-CIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GICF0","description":"ICD-GICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGDB1","description":"ICD-GGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX14","description":"High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIB0","description":"ICD-IGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBAC1","description":"ICD-GBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES144","description":"Extensive Services _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE210","description":"Special Care High _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx ovarian unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9117","description":"Onc dx ovarian unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX22","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA1","description":"ICD-GDRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Static or dynami afo pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4396","description":"Static or dynami afo pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92137","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","description":"CPT-92137","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl trifocal 4.00/>6","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2306","description":"Lens sphcyl trifocal 4.00/>6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMC1","description":"ICD-JIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUD1","description":"ICD-EHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tint_ any color/solid/grad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2745","description":"Tint_ any color/solid/grad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stationary liquid 02","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0439","description":"Stationary liquid 02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHF1","description":"ICD-GAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9046","description":"Cocaine hydrochloride nasal solution for topical administration_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE130","description":"Special Care High _ ADL Index 15-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC255","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gardner vag dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87511","description":"Gardner vag dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODCA0","description":"ICD-ODCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB0","description":"ICD-MBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF1","description":"ICD-FGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAD1","description":"ICD-BFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLA0","description":"ICD-OKLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATC1","description":"ICD-CATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4035F","description":"Influenza imm rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQF1","description":"ICD-CIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroidectomy_ total or complete with parathyroid autotransplantation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7555","description":"Thyroidectomy_ total or complete with parathyroid autotransplantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ bal dil_ non-vascular","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1726","description":"Cath_ bal dil_ non-vascular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Naltrexone_ depot form","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2315","description":"Naltrexone_ depot form","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML20","description":"Medium Rehab plus Extensive_ ADL Index 2-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBYD0","description":"ICD-PBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRF0","description":"ICD-PBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUE0","description":"ICD-KDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEC1","description":"ICD-CFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMB0","description":"ICD-KCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA154","description":"Reduced Physical Function _ ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE0","description":"ICD-KGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA1","description":"ICD-GBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFE1","description":"ICD-KBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB145","description":"Clinically Complex _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9483","description":"Remote in-home visit for the e&m of a new patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires these 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE205","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITE0","description":"ICD-NITE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC31","description":"ICD-4DC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKE1","description":"ICD-CEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Derma-fat-fascia graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15770","description":"Derma-fat-fascia graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBF1","description":"ICD-ECBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEME0","description":"ICD-CEME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF0","description":"ICD-ODKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCC1","description":"ICD-CHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCE0","description":"ICD-BGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEF1","description":"ICD-FAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28A","description":"Special Care Low _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore/treat hand joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26070","description":"Explore/treat hand joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB206","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQC0","description":"ICD-HHQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRF0","description":"ICD-HGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0905T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","description":"CPT-0905T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of kidney wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50500","description":"Repair of kidney wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELF1","description":"ICD-FELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 1 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0801","description":"Pov group 1 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion >2.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11313","description":"Shave skin lesion >2.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No brst cncr dx min invasive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8877","description":"No brst cncr dx min invasive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22612","description":"Lumbar spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of prolactin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84146","description":"Assay of prolactin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSD1","description":"ICD-OJSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTA1","description":"ICD-KGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Systemic corticosteroids rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4135F","description":"Systemic corticosteroids rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye exam with photos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92230","description":"Eye exam with photos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD136","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHC1","description":"ICD-GDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJF0","description":"ICD-NJJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGED0","description":"ICD-JGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motor function mapping ntms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0310T","description":"Motor function mapping ntms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9277","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","description":"HCPCS-J9277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB0","description":"ICD-HDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop colon lavage add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44701","description":"Intraop colon lavage add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOA0","description":"ICD-GHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non coring needle or stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4212","description":"Non coring needle or stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm device eval in person","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93288","description":"Pm device eval in person","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUD0","description":"ICD-OCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC1","description":"ICD-NBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8G","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oligoclonal bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83916","description":"Oligoclonal bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINA0","description":"ICD-BINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEB0","description":"ICD-FBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWB0","description":"ICD-OEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGF0","description":"ICD-OIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1050","description":"Functional status was measured by the Oswestry Disability Index (ODI version 2.1a) patient reported outcome tool within three m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0670","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0670","description":"HCPCS-G0670","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPC0","description":"ICD-JHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJD0","description":"ICD-BBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXA1","description":"ICD-FIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC1","description":"ICD-CCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay secretory type ii pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0423T","description":"Assay secretory type ii pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNB0","description":"ICD-FCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJE0","description":"ICD-KHJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EECC1","description":"ICD-EECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB144","description":"Special Care Low _ ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3CC21","description":"ICD-3CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGIE0","description":"ICD-GGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81308","description":"Palb2 (Partner And Localizer Of Brca2) (Eg_ Breast And Pancreatic Cancer) Gene Analysis; Known Familial Variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTE1","description":"ICD-FDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of chest artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37616","description":"Ligation of chest artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFB1","description":"ICD-GEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nvr cndj tst 1-2 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95907","description":"Nvr cndj tst 1-2 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self care current status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8987","description":"Self care current status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA0","description":"ICD-NCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JA11","description":"ICD-3JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pouch drain high output","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4412","description":"Ost pouch drain high output","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place perm pacing cardiovert","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0448","description":"Place perm pacing cardiovert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL2D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMA1","description":"ICD-EIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96932","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19328","description":"Removal of breast implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0C","description":"High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aud osseo dev_ int/ext comp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8690","description":"Aud osseo dev_ int/ext comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJA0","description":"ICD-BAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44145","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD1","description":"ICD-KBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DERA0","description":"ICD-DERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2055","description":"Idecabtagene Vicleucel_ Up To 460 Million Autologous B-Cell Maturation Antigen (Bcma) Directed Car-Positive T Cells_ Including Leukapheresis And Dose Preparation Procedures_ P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIMC1","description":"ICD-OIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBA0","description":"ICD-ADBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJC1","description":"ICD-GGJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYE0","description":"ICD-PDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve teasing preparations","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88362","description":"Nerve teasing preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX10","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem/popl revas w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37224","description":"Fem/popl revas w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITF0","description":"ICD-CITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24A","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOC1","description":"ICD-GAOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogen m array copy no&snp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81229","description":"Cytogen m array copy no&snp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat pleurodesis w/agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32560","description":"Treat pleurodesis w/agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29874","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1704","description":"HCPCS-B1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Induced abortion 32 or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2267","description":"Induced abortion 32 or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0751T","description":"Digitization of glass microscope slides for level II_ surgical pathology_ gross and microscopic examination (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0692U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692U","description":"CPT-0692U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4438","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","description":"HCPCS-Q4438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 3 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3378F","description":"Ajcc brstcncr stage 3 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID1","description":"ICD-MAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1015T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","description":"CPT-1015T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDC1","description":"ICD-FFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Select picture audiometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92583","description":"Select picture audiometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy vagus nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43651","description":"Laparoscopy vagus nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKA0","description":"ICD-BFKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQF0","description":"ICD-OGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCA1","description":"ICD-ACCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTD1","description":"ICD-OJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF1","description":"ICD-NKKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excursion amplifier pulley t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6641","description":"Excursion amplifier pulley t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTF0","description":"ICD-MJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 100","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88249","description":"Chromosome analysis 100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVC0","description":"ICD-GAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUE1","description":"ICD-EHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0365U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pjp proph ordered low cd4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9222","description":"Pjp proph ordered low cd4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap vent/abd hern proc comp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49653","description":"Lap vent/abd hern proc comp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect recur gyn mal w/lym","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58958","description":"Resect recur gyn mal w/lym","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHD0","description":"ICD-JDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Order for ceph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9197","description":"Order for ceph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYB1","description":"ICD-LIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29830","description":"Elbow arthroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPC1","description":"ICD-NCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thawing cryopresrved sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89353","description":"Thawing cryopresrved sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47780","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1701","description":"HCPCS-B1701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYB1","description":"ICD-PGYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDC1","description":"ICD-GBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nicotine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6055","description":"Nicotine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMD0","description":"ICD-NLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28G","description":"Special Care High _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of salivary stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42335","description":"Removal of salivary stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTB1","description":"ICD-FBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of nail bed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11762","description":"Reconstruction of nail bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0871T","description":"Replacement of a subcutaneous peritoneal ascites pump_ including reconnection between pump and indwelling bladder and peritoneal catheters_ including initial programming and i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","description":"CPT-15017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCC1","description":"ICD-CCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD1","description":"ICD-NHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microprocessor control uplmb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6882","description":"Microprocessor control uplmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUD0","description":"ICD-CHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tendon sheath lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26160","description":"Remove tendon sheath lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBE0","description":"ICD-OIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERF0","description":"ICD-PERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKB0","description":"ICD-BFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGF0","description":"ICD-FIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODOD0","description":"ICD-ODOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31300","description":"Laryngotomy (thyrotomy_ laryngofissure)_ with removal of tumor or laryngocele_ cordectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAE0","description":"ICD-FHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA15","description":"Default_ /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE1","description":"ICD-OIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0509U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509U","description":"CPT-0509U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME0","description":"ICD-FCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJD0","description":"ICD-CIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DISB0","description":"ICD-DISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD21C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFUE0","description":"ICD-JFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77785","description":"Remote Afterloading High Dose Rate Radionuclide Brachytherapy; 1 Channel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1972","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1972","description":"HCPCS-L1972","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTD0","description":"ICD-KHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUB0","description":"ICD-IDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBB0","description":"ICD-CHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88307","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELC0","description":"ICD-OELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc tempory vessel occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61623","description":"Endovasc tempory vessel occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOF1","description":"ICD-HFOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA4A","description":"Medium Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9735","description":"Patient unable to complete the FOTO shoulder intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibility and an a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHHE1","description":"ICD-EHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0619","description":"Hospital Special Treatment Room Support Component (Hstrsc) Breast Diagnostic Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sperm evaluation test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89329","description":"Sperm evaluation test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0104U","description":"Hereditary pan cancer (eg_ hereditary breast and ovarian cancer_ hereditary endometrial cancer_ hereditary colorectal cancer)_ genomic sequence analysis panel utilizing a comb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening pap smear by phys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P3001","description":"Screening pap smear by phys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Er- or pr- breast cancer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3316F","description":"Er- or pr- breast cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMC0","description":"ICD-CCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCJE1","description":"ICD-KCJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBD0","description":"ICD-EGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOD0","description":"ICD-LBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0647T","description":"Insertion of gastrostomy tube_ percutaneous_ with magnetic gastropexy_ under ultrasound guidance_ image documentation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGA1","description":"ICD-NFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMF1","description":"ICD-KBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQD1","description":"ICD-LIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oth resp proc_ indiv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0238","description":"Oth resp proc_ indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRE0","description":"ICD-KBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFE0","description":"ICD-FIFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1304","description":"HCPCS-A1304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCE1","description":"ICD-ICCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBKF1","description":"ICD-BBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric emptying imag study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78264","description":"Gastric emptying imag study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast cancer dx min invsive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8875","description":"Breast cancer dx min invsive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gdh enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82965","description":"Assay of gdh enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33234","description":"Removal of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE141","description":"Special Care Low _ ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF0","description":"ICD-OFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive hand surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26250","description":"Extensive hand surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQF0","description":"ICD-DIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAE0","description":"ICD-KGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA14","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ag detect nos ia single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87450","description":"Ag detect nos ia single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDE1","description":"ICD-GDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOF1","description":"ICD-LDOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0292U","description":"Psychiatry (Stress Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 72 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69915","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2023F","description":"Adjacent tissue transfer or rearrangement_ scalp_ arms and/or legs; defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILA0","description":"ICD-CILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQB1","description":"ICD-CDQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Outrigger bil w/ vert extens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1085","description":"Outrigger bil w/ vert extens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place stereo cath brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0169T","description":"Place stereo cath brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGE1","description":"ICD-NKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31511","description":"Remove foreign body larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXF0","description":"ICD-KGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBND1","description":"ICD-KBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCE0","description":"ICD-FCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Establish access to artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36100","description":"Establish access to artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF1","description":"ICD-GFEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myelography neck spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72240","description":"Myelography neck spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOF1","description":"ICD-DGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCC0","description":"ICD-ACCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ intraspinal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1755","description":"Catheter_ intraspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJD1","description":"ICD-JIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental onlay resin 3 surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2663","description":"Dental onlay resin 3 surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPD0","description":"ICD-OHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pseudoaneurysm injection trt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36002","description":"Pseudoaneurysm injection trt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1456","description":"Injection_ fosaprepitant (teva)_ not therapeutically equivalent to j1453_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYD1","description":"ICD-LEYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vis inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9628","description":"Vis inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHD1","description":"ICD-EEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs cranial lesion complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61798","description":"Srs cranial lesion complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA36","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIF0","description":"ICD-AFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELA1","description":"ICD-JELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMF1","description":"ICD-JEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold sock suspension t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6110","description":"Elbow mold sock suspension t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYD0","description":"ICD-GCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8D","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIA1","description":"ICD-CCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-META0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"META0","description":"ICD-META0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKC1","description":"ICD-CEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess hlth/behave subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96151","description":"Assess hlth/behave subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIQF1","description":"ICD-OIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC121","description":"Special Care High _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIF1","description":"ICD-OJIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABE0","description":"ICD-GABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQD1","description":"ICD-GGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57700","description":"Revision of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL21","description":"High Rehab plus Extensive _ ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUB0","description":"ICD-AGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81518","description":"Oncology (breast)_ mRNA_ gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping)_ utilizing formalin-fixed paraffin-embedded tissue_ algorithm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUB1","description":"ICD-ACUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILB0","description":"ICD-FILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYC1","description":"ICD-LDYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA0","description":"ICD-NEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF0","description":"ICD-OEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFYA0","description":"ICD-OFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFAB1","description":"ICD-AFAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAHA0","description":"ICD-OAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abdomen surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49999","description":"Abdomen surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of galactose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82760","description":"Assay of galactose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5162","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","description":"HCPCS-Q5162","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo dbl solid stirrup w/o j","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2030","description":"Kafo dbl solid stirrup w/o j","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPF1","description":"ICD-FDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHB1","description":"ICD-MFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADDE0","description":"ICD-ADDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD1","description":"ICD-GEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWD0","description":"ICD-KCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEXD0","description":"ICD-JEXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGRB0","description":"ICD-KGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2472","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","description":"HCPCS-J2472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59136","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIF1","description":"ICD-AHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect scapula tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23210","description":"Resect scapula tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36576","description":"Repair tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","description":"CPT-01756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFPC0","description":"ICD-FFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML4A","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00530","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","description":"CPT-00530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDUF0","description":"ICD-BDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dvt prophylx recvd day 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4070F","description":"Dvt prophylx recvd day 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2311","description":"Injection_ naloxone hydrochloride (zimhi)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vacuum drain bottle/tube kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7048","description":"Vacuum drain bottle/tube kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Door to punc time <2hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9580","description":"Door to punc time <2hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPC0","description":"ICD-BIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGND0","description":"ICD-KGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF0","description":"ICD-BIJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID0","description":"ICD-NKID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ear mold/insert_ disp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5265","description":"Ear mold/insert_ disp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC THYR MRNA XPRSN ALYS 593","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0204U","description":"ONC THYR MRNA XPRSN ALYS 593","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5299","description":"Hearing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54316","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No pharm ther osteo rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8635","description":"No pharm ther osteo rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBB1","description":"ICD-KDBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTC1","description":"ICD-IBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Attendance at delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99464","description":"Attendance at delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ra disease activity mod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3471F","description":"Ra disease activity mod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMB0","description":"ICD-OBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESB1","description":"ICD-OESB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC20B","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMF1","description":"ICD-OJMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of cervix radical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57531","description":"Removal of cervix radical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHD1","description":"ICD-AGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC0","description":"ICD-KIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65210","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPE0","description":"ICD-JEPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVE1","description":"ICD-CAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0604","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0604","description":"HCPCS-B0604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc pt dischg >2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9254","description":"Doc pt dischg >2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family Medicine Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4005","description":"Family Medicine Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF0","description":"ICD-NGNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB140","description":"Special Care High _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHD0","description":"ICD-FBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA145","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVD0","description":"ICD-GDVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86316","description":"Immunoassay tumor other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD134","description":"Clinically Complex _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services utilized by patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9694","description":"Hospice services utilized by patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFD0","description":"ICD-NCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of anal fissure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46200","description":"Removal of anal fissure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB26","description":"Low Rehab_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHAA0","description":"ICD-AHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo assess inc xray docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3340F","description":"Mammo assess inc xray docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEE0","description":"ICD-KHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No rx ace/arb therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8937","description":"No rx ace/arb therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2004","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2004","description":"CDT-D2004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB0","description":"ICD-OASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAC1","description":"ICD-MHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEEC0","description":"ICD-CEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postop dsg cast chg shlder/t","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6384","description":"Postop dsg cast chg shlder/t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDB0","description":"ICD-NCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYF1","description":"ICD-HGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYD1","description":"ICD-GGYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apicoect/perirad surg anter","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3410","description":"Apicoect/perirad surg anter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPA1","description":"ICD-FAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest wall repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47251","description":"Anesth chest wall repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMA1","description":"ICD-JAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF0","description":"ICD-ODFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reteplase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2993","description":"Reteplase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suture complicate wnd > 5 cm","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7912","description":"Suture complicate wnd > 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial proctectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45113","description":"Partial proctectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES316","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Particle agglut antbdy scrn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86403","description":"Particle agglut antbdy scrn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA0","description":"ICD-FCFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKA1","description":"ICD-CDKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77412","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28D","description":"Special Care High _ ADL Index 2-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBA0","description":"ICD-GGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Root surgery bicuspid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3421","description":"Root surgery bicuspid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo new ureter/bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50947","description":"Laparo new ureter/bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open tx nose & septal fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21335","description":"Open tx nose & septal fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0072A","description":"ADM SARSCV2 10MCG TRS-SUCR 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A9294","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","description":"HCPCS-A9294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUD1","description":"ICD-CGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA231","description":"Clinically Complex _ ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBB1","description":"ICD-IHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJF0","description":"ICD-FFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKA1","description":"ICD-OJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAD1","description":"ICD-MLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abdom w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74175","description":"Ct angio abdom w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC44","description":"High Rehab _ ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFA1","description":"ICD-FCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEC0","description":"ICD-IDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap with adjustable straps_ bra_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6589","description":"Gradient pressure wrap with adjustable straps_ bra_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sagittal rigid panel cus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0636","description":"Lso sagittal rigid panel cus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHA0","description":"ICD-OJHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUE0","description":"ICD-MIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUF1","description":"ICD-MLUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80307","description":"Drug test(s)_ presumptive_ any number of drug classes_ any number of devices or procedures; by instrument chemistry analyzers (eg_ utilizing immunoassay [eg_ EIA_ ELISA_ EMIT_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","description":"HCPCS-J3404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHD1","description":"ICD-KGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL0B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder prosthesis removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23334","description":"Shoulder prosthesis removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD14C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aminolevulinic acid hcl top","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7308","description":"Aminolevulinic acid hcl top","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMD1","description":"ICD-JHMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c manual swingaway","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1028","description":"W/c manual swingaway","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clear eyelid gland w/heat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0207T","description":"Clear eyelid gland w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD0","description":"ICD-GCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIYF0","description":"ICD-DIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA23","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQA0","description":"ICD-DDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMD1","description":"ICD-JIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67299","description":"Eye surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQF0","description":"ICD-PDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB234","description":"Clinically Complex _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJD0","description":"ICD-FBJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect phalanx of toe tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28175","description":"Resect phalanx of toe tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cath vertebral art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36226","description":"Place cath vertebral art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAHA0","description":"ICD-JAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINB0","description":"ICD-OINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC1","description":"ICD-BEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBD0","description":"ICD-FEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGID1","description":"ICD-CGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurovascular pedicle flap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15750","description":"Neurovascular pedicle flap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8009","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8009","description":"HCPCS-C8009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQE0","description":"ICD-LAQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILD1","description":"ICD-MILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTC1","description":"ICD-MDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLD1","description":"ICD-MHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAD1","description":"ICD-EBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD0","description":"ICD-OGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIE0","description":"ICD-ACIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYA0","description":"ICD-ODYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC0","description":"ICD-FGNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fem urinary collect pouch","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4328","description":"Fem urinary collect pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENF1","description":"ICD-JENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCD0","description":"ICD-ICCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFA1","description":"ICD-NAFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKF0","description":"ICD-JDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWF0","description":"ICD-LEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mastectomy bra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8000","description":"Mastectomy bra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGIF1","description":"ICD-IGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF0","description":"ICD-ABAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resin two surfaces-anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2331","description":"Resin two surfaces-anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLC1","description":"ICD-KBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD260","description":"Special Care High _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove uterus after cesarean","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59525","description":"Remove uterus after cesarean","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1705","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1705","description":"HCPCS-B1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDB1","description":"ICD-EHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA1","description":"ICD-KIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQA0","description":"ICD-KCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF0","description":"ICD-EBEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJD0","description":"ICD-GFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKFD0","description":"ICD-NKFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In-hospital on call service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99026","description":"In-hospital on call service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITF0","description":"ICD-GITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJF1","description":"ICD-GEJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVD1","description":"ICD-BHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMB0","description":"ICD-FFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csi any other than pci 2 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8964","description":"Csi any other than pci 2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","description":"HCPCS-A4543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKB1","description":"ICD-JGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIF1","description":"ICD-GHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERB0","description":"ICD-PERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE1","description":"ICD-HBWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYA1","description":"ICD-OHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJF0","description":"ICD-JCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBTA0","description":"ICD-NBTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAC1","description":"ICD-NBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures repair resin base","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5610","description":"Dentures repair resin base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND0","description":"ICD-BBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNA1","description":"ICD-NFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4D","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0505","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0505","description":"HCPCS-C0505","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0A","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLRA0","description":"ICD-PLRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsals","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28309","description":"Incision of metatarsals","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE1","description":"ICD-GDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0611U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","description":"CPT-0611U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEOB0","description":"ICD-DEOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBA0","description":"ICD-IIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD23D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chimerism anal w/cell select","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81268","description":"Chimerism anal w/cell select","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ovine_ 1000 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3472","description":"Ovine_ 1000 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI w/cont_ breast_ bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8906","description":"MRI w/cont_ breast_ bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAID1","description":"ICD-BAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0571T","description":"Insertion Or Replacement Of Implantable Cardioverter-Defibrillator System With Substernal Electrode(S)_ Including All Imaging Guidance And Electrophysiological Evaluation (Inc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAYD1","description":"ICD-HAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap replace gastr adj device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43773","description":"Lap replace gastr adj device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of forearm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25031","description":"Drainage of forearm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKC0","description":"ICD-JDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFA0","description":"ICD-GHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKB0","description":"ICD-NHKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBC1","description":"ICD-OCBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair & adjust spectacles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92370","description":"Repair & adjust spectacles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNF0","description":"ICD-ODNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx septal&nose fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21337","description":"Closed tx septal&nose fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Secondary urethral surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54340","description":"Secondary urethral surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE112","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81336","description":"SMN1 (survival of motor neuron 1_ telomeric) (eg_ spinal muscular atrophy) gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate atria lmtd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33254","description":"Ablate atria lmtd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB28E","description":"Special Care High _ ADL Index 2-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5221","description":"Hearing aid_ contralateral routing system_ binaural_ BTE/BTE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOC1","description":"ICD-GEOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0674","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0674","description":"HCPCS-G0674","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chlamydia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86631","description":"Chlamydia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAB0","description":"ICD-MKAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVD1","description":"ICD-NAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYC0","description":"ICD-LAYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Agglutinins febrile antigen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86000","description":"Agglutinins febrile antigen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0326U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free circulating DNA analysis of 83 or more genes_ interrogation for sequence variants_ gene copy number a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGM5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC5B","description":"Very High Rehab _ ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHB1","description":"ICD-NGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEA0","description":"ICD-NDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreatectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48154","description":"Pancreatectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIID1","description":"ICD-FIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBC1","description":"ICD-BEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKE0","description":"ICD-CDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIUF1","description":"ICD-CIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9486","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX51","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUC1","description":"ICD-EFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGA0","description":"ICD-JHGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAC1","description":"ICD-EGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9771","description":"Nasal/sinus endoscopy_ cryoablation nasal tissue(s) and/or nerve(s)_ unilateral or bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDSD1","description":"ICD-LDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC214","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDC0","description":"ICD-OCDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAE1","description":"ICD-BIAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27509","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTE1","description":"ICD-BBTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42305","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2251","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a qualified health care professional who cannot report evaluation and management services_ provided to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLB0","description":"ICD-OBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pentastarch 10% solution","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2513","description":"Pentastarch 10% solution","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01780","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","description":"CPT-01780","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF0","description":"ICD-JHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVA1","description":"ICD-NDVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBF1","description":"ICD-OJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0686U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686U","description":"CPT-0686U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDC1","description":"ICD-MHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDD0","description":"ICD-FGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYB1","description":"ICD-OCYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1004","description":"Documentation of medical reason for not screening for TB or interpreting results (i.e._ patient positive for TB and documentati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genome re-evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81427","description":"Genome re-evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Under Hospice Care In The Current Reporting Month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0051","description":"Patients Under Hospice Care In The Current Reporting Month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUC0","description":"ICD-FAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATC1","description":"ICD-BATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lepirudin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1945","description":"Lepirudin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJC1","description":"ICD-CEJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So hard plas stabili pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3678","description":"So hard plas stabili pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOB0","description":"ICD-PKOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx orbit fx combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21387","description":"Opn tx orbit fx combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB1","description":"ICD-LBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogate subq defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93261","description":"Interrogate subq defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBE1","description":"ICD-EDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFKB1","description":"ICD-JFKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65850","description":"Incision of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 11-12 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95912","description":"Nrv cndj test 11-12 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone sodium phos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1100","description":"Dexamethasone sodium phos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUF0","description":"ICD-IDUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc abdl tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22900","description":"Exc abdl tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90968","description":"Esrd home pt srv p day 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Card tamp w/in 30d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9408","description":"Card tamp w/in 30d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGDB0","description":"ICD-FGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASF1","description":"ICD-OASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHBF0","description":"ICD-CHBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAA1","description":"ICD-EIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEA0","description":"ICD-BIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKE1","description":"ICD-GFKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0852T","description":"Digitization of glass microscope slides for morphometric analysis_ in situ hybridization (quantitative or semiquantitative)_ manual_ per specimen; each additional single probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAF1","description":"ICD-GDAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50040","description":"Drainage of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pov group 2 hd 301-450 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0807","description":"Pov group 2 hd 301-450 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE0","description":"ICD-NJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OELF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OELF0","description":"ICD-OELF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAF0","description":"ICD-JAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24C","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUA0","description":"ICD-NBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0515T","description":"Insertion of wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming_ and imaging supervision and interpretation_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEE1","description":"ICD-ODEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXC0","description":"ICD-OHXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDC1","description":"ICD-KFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery rupture thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35142","description":"Repair artery rupture thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9781","description":"Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g._ patient with adverse effect_ alle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGE0","description":"ICD-BGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIF0","description":"ICD-JAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEID1","description":"ICD-MEID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coch implant microphone repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8616","description":"Coch implant microphone repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81277","description":"Cytogenomic Neoplasia (Genome-Wide) Microarray Analysis_ Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants For Chromosomal Abnormalities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA1","description":"ICD-FGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIB0","description":"ICD-GAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Dalbavancin_ 10 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9443","description":"Injection_ Dalbavancin_ 10 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDD1","description":"ICD-ODDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28I","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJF1","description":"ICD-CCJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1404","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1404","description":"CDT-D1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Floxuridine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9200","description":"Floxuridine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAD1","description":"ICD-NIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9083","description":"Injection_ amivantamab-vmjw_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ref to outpt card rehab prog","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4500F","description":"Ref to outpt card rehab prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQA1","description":"ICD-PLQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIYE1","description":"ICD-KIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME1","description":"ICD-IFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27810","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procenta_ per 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4310","description":"Procenta_ per 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES112","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPE1","description":"ICD-BFPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove aortic assist device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33968","description":"Remove aortic assist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL03","description":"Very High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHE1","description":"ICD-GHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB1","description":"ICD-KBEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABF1","description":"ICD-FABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBE1","description":"ICD-ICBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9056","description":"Injection_ bendamustine hydrochloride (vivimusta)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRE0","description":"ICD-OIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD0","description":"ICD-KIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ca screen;pelvic/breast exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0101","description":"Ca screen;pelvic/breast exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMB0","description":"ICD-EBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release wrist/forearm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25295","description":"Release wrist/forearm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRE0","description":"ICD-PKRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reposition venous catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36597","description":"Reposition venous catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vascular endoscopy procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37501","description":"Vascular endoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL12","description":"Very High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37294","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","description":"CPT-37294","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25530","description":"Treat fracture of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi not calculated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8421","description":"Bmi not calculated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EA31","description":"ICD-1EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9819","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ lyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9319","description":"Injection_ romidepsin_ lyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt education noc group","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9446","description":"Pt education noc group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCD0","description":"ICD-GFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLE0","description":"ICD-NBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE0","description":"ICD-NBIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable pack w/bowel syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0352","description":"Disposable pack w/bowel syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB0","description":"ICD-FANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED1","description":"ICD-IGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMB0","description":"ICD-OGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIYC0","description":"ICD-PIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCID1","description":"ICD-BCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAE1","description":"ICD-OCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abscess imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78806","description":"Abscess imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81312","description":"PABPN1 (poly[A] binding protein nuclear 1) (eg_ oculopharyngeal muscular dystrophy) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI neck spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72156","description":"MRI neck spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31294","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metaproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7669","description":"Metaproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYC0","description":"ICD-GIYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJD1","description":"ICD-NKJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25230","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88304","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESE1","description":"ICD-LESE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDD1","description":"ICD-JEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHA1","description":"ICD-ECHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IA11","description":"ICD-1IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVB0","description":"ICD-NBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opn tx nasomax fx w/fixj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21346","description":"Opn tx nasomax fx w/fixj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIA0","description":"ICD-GCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special eye evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92060","description":"Special eye evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKD1","description":"ICD-BIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELB0","description":"ICD-KELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2102","description":"Dilated Retinal Eye Exam With Interpretation By An Ophthalmologist Or Optometrist Documented And Reviewed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No qual card diag prior12mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1461F","description":"No qual card diag prior12mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFIA1","description":"ICD-CFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC0C","description":"Ultra High Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93284","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repos nstim apnea sensing ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0433T","description":"Repos nstim apnea sensing ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAWE0","description":"ICD-OAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE0","description":"ICD-EEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISE1","description":"ICD-CISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUB1","description":"ICD-KGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infect control supplies nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8301","description":"Infect control supplies nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB0","description":"ICD-MHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHD0","description":"ICD-CIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFF0","description":"ICD-NAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB31","description":"ICD-2AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMB0","description":"ICD-MDMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"U/s trtmt_ not leiomyomata","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9734","description":"U/s trtmt_ not leiomyomata","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51720","description":"Treatment of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB0","description":"ICD-NAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4148","description":"Enteral feeding supply kit; elastomeric control fed_ per day_ includes but not limited to feeding/flushing syringe_ administration set tubing_ dressings_ tape","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hmes or trach valve housing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7505","description":"Hmes or trach valve housing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy vent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4366","description":"Ostomy vent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thrombolytic venous therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37212","description":"Thrombolytic venous therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC20C","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBF1","description":"ICD-KIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDCC1","description":"ICD-NDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAED0","description":"ICD-IAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2050","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2050","description":"HCPCS-A2050","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust knee ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1810","description":"Adjust knee ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVC0","description":"ICD-OFVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHF0","description":"ICD-JHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEB0","description":"ICD-EEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKA0","description":"ICD-CGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD0","description":"ICD-GGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA01","description":"Default_ /Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Front caster assem complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0077","description":"Front caster assem complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem exostosis any site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7471","description":"Rem exostosis any site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LERF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LERF1","description":"ICD-LERF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHE1","description":"ICD-ECHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0109","description":"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5_comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJD1","description":"ICD-OHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAE0","description":"ICD-JDAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE1","description":"ICD-DGWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYB0","description":"ICD-PLYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISA0","description":"ICD-OISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPA0","description":"ICD-KAPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJF1","description":"ICD-BAJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID1","description":"ICD-KIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat odontoid fx w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22319","description":"Treat odontoid fx w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAD1","description":"ICD-KGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63088","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tibial length sock fx or equ","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2840","description":"Tibial length sock fx or equ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB1","description":"ICD-KAXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/tla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37228","description":"Tib/per revasc w/tla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB1","description":"ICD-GFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD206","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dschrg med/current med merge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1111F","description":"Dschrg med/current med merge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD204","description":"Special Care Low _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat sternum fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21820","description":"Treat sternum fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHE1","description":"ICD-CCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBOE0","description":"ICD-HBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA1","description":"ICD-CAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQB0","description":"ICD-KHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFED0","description":"ICD-IFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB4A","description":"Very High Rehab _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"T cell absolute count/ratio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86360","description":"T cell absolute count/ratio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27235","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKF1","description":"ICD-BFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of osteocalcin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83937","description":"Assay of osteocalcin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUB0","description":"ICD-NCUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urtr inj at surg/1mos post","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9631","description":"Urtr inj at surg/1mos post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD13D","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLA1","description":"ICD-GGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1404","description":"HCPCS-C1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENB0","description":"ICD-CENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBND1","description":"ICD-JBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA136","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29884","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKEF1","description":"ICD-MKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJED1","description":"ICD-OJED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWC0","description":"ICD-DFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opps/php;activity therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0176","description":"Opps/php;activity therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXA1","description":"ICD-JGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC2B","description":"High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9304","description":"HCPCS-C9304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVE1","description":"ICD-NHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4174","description":"PalinGen or ProMatrX_ 0.36 mg per 0.25 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1059T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1059T","description":"CPT-1059T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86850","description":"Rbc antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0467T","description":"Revision or replacement of chest wall respiratory sensor electrode or electrode array_ including connection to existing pulse generator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWD0","description":"ICD-CAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES11A","description":"Extensive Services _ ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCKF1","description":"ICD-OCKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hand les sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26111","description":"Exc hand les sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEF1","description":"ICD-NEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METB1","description":"ICD-METB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHF0","description":"ICD-MKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLE1","description":"ICD-MDLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF1","description":"ICD-BHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB0","description":"ICD-OJDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath fl nongyn smears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88104","description":"Cytopath fl nongyn smears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDC1","description":"ICD-NJDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA13A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr n-hf/genit >30.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12047","description":"Intmd rpr n-hf/genit >30.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0B","description":"Low Rehab_ ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWC0","description":"ICD-LHWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNA1","description":"ICD-KGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB50","description":"High Rehab _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDE1","description":"ICD-BEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroglobulin antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86800","description":"Thyroglobulin antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stem cells total count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86367","description":"Stem cells total count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kyphosis pad floating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1025","description":"Kyphosis pad floating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ subcutaneous cardiac rhythm monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33286","description":"Removal_ subcutaneous cardiac rhythm monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL07","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace picc cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36584","description":"Replace picc cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo radical nephrectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50545","description":"Laparo radical nephrectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIA1","description":"ICD-ACIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIOC0","description":"ICD-LIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pralatrexate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9307","description":"Pralatrexate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9591","description":"Fluoroestradiol f 18_ diagnostic_ 1 millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOD1","description":"ICD-PFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAF0","description":"ICD-NKAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dimenhydrinate injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1240","description":"Dimenhydrinate injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX8E","description":"High Rehab plus Extensive _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF0","description":"ICD-PIWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVB0","description":"ICD-OEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5132","description":"Injection_ adalimumab-afzb (abrilada)_ biosimilar_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUD0","description":"ICD-BIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHF1","description":"ICD-FIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thromboplastin time partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85730","description":"Thromboplastin time partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXA0","description":"ICD-JCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTF1","description":"ICD-GDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection pantroprazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0164","description":"Injection pantroprazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDA0","description":"ICD-KEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIC0","description":"ICD-OLIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2B","description":"Default_ /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arthroereisis_ subtalar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2117","description":"Arthroereisis_ subtalar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLD1","description":"ICD-MBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYB0","description":"ICD-PDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCND0","description":"ICD-BCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGB1","description":"ICD-OGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUB1","description":"ICD-MJUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSA0","description":"ICD-PHSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Split blood or products","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86985","description":"Split blood or products","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFE0","description":"ICD-FHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEE1","description":"ICD-KGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx breast add lesion us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19084","description":"Bx breast add lesion us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCF1","description":"ICD-MDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAC0","description":"ICD-BIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair amputee heavy dut","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1195","description":"Wheelchair amputee heavy dut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDA1","description":"ICD-NCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA1","description":"ICD-NJXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNE0","description":"ICD-FGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95718","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of palm bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26025","description":"Drainage of palm bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise anal ext tag/papilla","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46220","description":"Excise anal ext tag/papilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB0","description":"ICD-HCWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62141","description":"Repair of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colistimethate sodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0770","description":"Colistimethate sodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA21","description":"Very High Rehab _ ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEE1","description":"ICD-AFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKF0","description":"ICD-FEKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-METC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"METC0","description":"ICD-METC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB0","description":"ICD-EFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXD1","description":"ICD-NJXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJE0","description":"ICD-NEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contraceptive pills for bc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4993","description":"Contraceptive pills for bc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILB1","description":"ICD-MILB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID1","description":"ICD-KHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPE1","description":"ICD-BIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCA1","description":"ICD-BDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj chem pres ajcc iii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8927","description":"Adj chem pres ajcc iii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQC0","description":"ICD-LBQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0758T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ histochemical stain on frozen tissue block (List separately in addition to code","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLB0","description":"ICD-FHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 2 or 3 stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0341","description":"Lifestyle mod 2 or 3 stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF0","description":"ICD-FBHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB0","description":"ICD-CFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHF1","description":"ICD-JBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIB0","description":"ICD-OAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMB0","description":"ICD-CHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33236","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB146","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIMC0","description":"ICD-IIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHA1","description":"ICD-KEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX20","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44715","description":"Prepare donor intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCB1","description":"ICD-AHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gjb2 gene known fam variants","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81253","description":"Gjb2 gene known fam variants","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25B","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us follow-up per fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76816","description":"Ob us follow-up per fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA1","description":"ICD-FEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAF1","description":"ICD-KBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC2D","description":"Medium Rehab _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVB1","description":"ICD-BDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAPB1","description":"ICD-BAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCD1","description":"ICD-JFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB0","description":"ICD-OHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFD1","description":"ICD-OGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-53866","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","description":"CPT-53866","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A6518","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","description":"HCPCS-A6518","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1148","description":"Ongoing care not possible because the patient self-discharged early (e.g._ financial or insurance reasons_ transportation problems_ or reason unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ oritavancin (Kimyrsa)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2406","description":"Injection_ oritavancin (Kimyrsa)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVF0","description":"ICD-NHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93356","description":"Myocardial Strain Imaging Using Speckle Tracking-Derived Assessment Of Myocardial Mechanics (List Separately In Addition To Codes For Echocardiography Imaging)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cetirizine hydrochloride_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1201","description":"Injection_ cetirizine hydrochloride_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46700","description":"Repair of anal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB0","description":"ICD-FEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens/es other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2599","description":"Contact lens/es other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB151","description":"Special Care Low _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0562T","description":"Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATC0","description":"ICD-AATC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test socket below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5620","description":"Test socket below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluate swallowing function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92610","description":"Evaluate swallowing function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGC1","description":"ICD-BBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILD1","description":"ICD-JILD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ulnar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24675","description":"Treat ulnar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of artery/vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35761","description":"Exploration of artery/vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEC0","description":"ICD-JHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4043F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBC0","description":"ICD-CCBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67141","description":"Treatment of retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73070","description":"X-ray exam of elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKB0","description":"ICD-NJKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perphenazine 4mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0175","description":"Perphenazine 4mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA40","description":"High Rehab _ ADL Index 0-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXA1","description":"ICD-OEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E2513","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","description":"HCPCS-E2513","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAA1","description":"ICD-OCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOD0","description":"ICD-GEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE1","description":"ICD-IIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHB1","description":"ICD-FEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVB1","description":"ICD-GIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJKC0","description":"ICD-OJKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA15","description":"Very High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"End of life counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0257","description":"End of life counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALB1","description":"ICD-EALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair detached retina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67101","description":"Repair detached retina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC0","description":"ICD-EHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise hand/foot nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64704","description":"Revise hand/foot nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD1","description":"ICD-EIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0082","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s hom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psy evaluation of records","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90885","description":"Psy evaluation of records","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAKE1","description":"ICD-BAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conization of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57520","description":"Conization of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobile arm supports reclinin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2628","description":"Mobile arm supports reclinin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD212","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert cervical dilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59200","description":"Insert cervical dilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pd catheter anchor belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4653","description":"Pd catheter anchor belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBF0","description":"ICD-GEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18B","description":"Special Care High _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWD1","description":"ICD-KAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUB1","description":"ICD-OEUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGA1","description":"ICD-JFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD12D","description":"Special Care High _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEIE1","description":"ICD-MEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDPF1","description":"ICD-BDPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA0","description":"ICD-CHJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBNF1","description":"ICD-BBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dress/debrid p-thick burn m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16025","description":"Dress/debrid p-thick burn m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75860","description":"Vein x-ray neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFLC0","description":"ICD-FFLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vent mgmt inpat subq day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94003","description":"Vent mgmt inpat subq day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFED1","description":"ICD-KFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGA1","description":"ICD-GAGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Middle ear surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69799","description":"Middle ear surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6590","description":"External urinary catheters; disposable_ with wicking material_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIND0","description":"ICD-JIND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin dispos pen 1.5 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5570","description":"Insulin dispos pen 1.5 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA01","description":"Low Rehab_ ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5211","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1000F","description":"Tobacco use assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung volume reduction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32491","description":"Lung volume reduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSB0","description":"ICD-PGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9906","description":"Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso flex trnk sj-ss pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0456","description":"Tlso flex trnk sj-ss pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA32","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behav hlth day treat_ per hr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2012","description":"Behav hlth day treat_ per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec seat depth/w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1298","description":"Wheelchair spec seat depth/w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx intracav admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79200","description":"Nuclear rx intracav admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEB0","description":"ICD-AEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYC1","description":"ICD-KBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHGD0","description":"ICD-FHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise breast duct fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19112","description":"Excise breast duct fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECD1","description":"ICD-OECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF1","description":"ICD-EDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRA0","description":"ICD-HDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIF0","description":"ICD-BBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise excessive skin leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15833","description":"Excise excessive skin leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75962","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID1","description":"ICD-ICID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA24","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX40","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDD1","description":"ICD-AHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC1","description":"ICD-MKBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27566","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHE1","description":"ICD-OGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0538","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","description":"HCPCS-G0538","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0021U","description":"Oncology (prostate)_ detection of 8 autoantibodies (ARF 6_ NKX3-1_ 5_-UTR-BMI1_ CEP 164_ 3_-UTR-Ropporin_ Desmocollin_ AURKAIP-1_ CSNK2A2)_ multiplexed immunoassay and flow cy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tube_ pneumatic caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2385","description":"Tube_ pneumatic caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGA0","description":"ICD-CFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96137","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; each additional 30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFF0","description":"ICD-CDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF0","description":"ICD-ECEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31582","description":"Revision of larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIDF1","description":"ICD-NIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBB0","description":"ICD-NJBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX33","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMD1","description":"ICD-OEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla i & ii typing lr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81370","description":"Hla i & ii typing lr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9313","description":"Injection_ moxetumomab pasudotox-tdfk_ 0.01 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB5A","description":"Very High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171U","description":"Targeted genomic sequence analysis panel_ acute myeloid leukemia_ myelodysplastic syndrome_ and myeloproliferative neoplasms_ DNA analysis_ 23 genes_ interrogation for sequenc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDB0","description":"ICD-EGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE1","description":"ICD-FCAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITA0","description":"ICD-NITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGA0","description":"ICD-NBGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy vulva lesions sim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56501","description":"Destroy vulva lesions sim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and radiotracer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52250","description":"Cystoscopy and radiotracer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVD0","description":"ICD-GIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Somatosensory testing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95938","description":"Somatosensory testing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FUT2 GNOTYP FUT2 EXON 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0186U","description":"FUT2 GNOTYP FUT2 EXON 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroelectrode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64585","description":"Revise/remove neuroelectrode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD1","description":"ICD-FCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FB11","description":"ICD-2FB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9753","description":"Destruction of intraosseous basivertebral nerve_ each additional vertebral body_ including imaging guidance (e.g._ fluoroscopy)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8F","description":"Medium Rehab _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43760","description":"Change of gastrostomy tube_ percutaneous_ without imaging or endoscopic guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic seq analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81455","description":"Targeted genomic seq analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRA1","description":"ICD-OFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPC0","description":"ICD-CCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQD0","description":"ICD-HCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CA31","description":"ICD-2CA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gr27 sealed leadacid battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2371","description":"Gr27 sealed leadacid battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGTA0","description":"ICD-CGTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant connecting bar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6055","description":"Implant connecting bar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME1","description":"ICD-MLME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLC0","description":"ICD-ECLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELC1","description":"ICD-CELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cocoon membrane_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4264","description":"Cocoon membrane_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB245","description":"Reduced Physical Function _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB0","description":"ICD-OKHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSE0","description":"ICD-PHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBEB0","description":"ICD-BBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay lipoprotein pla2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83698","description":"Assay lipoprotein pla2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBSB1","description":"ICD-CBSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiology hrt trnspl mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81595","description":"Cardiology hrt trnspl mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIA0","description":"ICD-JFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug scrn quant oxcarbazepin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80183","description":"Drug scrn quant oxcarbazepin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB14B","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC145","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic exenteration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45126","description":"Pelvic exenteration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGEF1","description":"ICD-CGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL33","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23330","description":"Remove shoulder foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVA0","description":"ICD-FGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHP1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX54","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCME1","description":"ICD-NCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subsequent hospital care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99233","description":"Subsequent hospital care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Molded inner boot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2280","description":"Molded inner boot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55180","description":"Revision of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40652","description":"Repair lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagomyotomy thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43331","description":"Esophagomyotomy thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parvovirus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86747","description":"Parvovirus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADD1","description":"ICD-KADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannula declotting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36861","description":"Cannula declotting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD1","description":"ICD-OKGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation cone locator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5985","description":"Radiation cone locator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1741","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1741","description":"HCPCS-C1741","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXB1","description":"ICD-OGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD0","description":"ICD-FGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA0A","description":"Low Rehab_ ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plast socket jts/thgh lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5105","description":"Plast socket jts/thgh lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCGA1","description":"ICD-NCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD0","description":"ICD-HGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTF0","description":"ICD-OJTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDA1","description":"ICD-FDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo fem fx cast thermoplas","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2126","description":"Kafo fem fx cast thermoplas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excavation of a tooth resulting in the determination of non-restorability","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2989","description":"Excavation of a tooth resulting in the determination of non-restorability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0986T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","description":"CPT-0986T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIC0","description":"ICD-BEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conn tiss_ human(inc fascia)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1762","description":"Conn tiss_ human(inc fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB0","description":"ICD-CBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occlusal guard - hard appliance_ partial arch","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9946","description":"Occlusal guard - hard appliance_ partial arch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHD1","description":"ICD-CDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles bifocal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92341","description":"Fit spectacles bifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXE0","description":"ICD-OBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENA1","description":"ICD-BENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC4C","description":"Very High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81309","description":"Pik3Ca (Phosphatidylinositol-4_ 5-Biphosphate 3-Kinase_ Catalytic Subunit Alpha) (Eg_ Colorectal And Breast Cancer) Gene Analysis_ Targeted Sequence Analysis (Eg_ Exons 7_ 9_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSF0","description":"ICD-PBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical placement of craniofacial implant - extra oral","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7993","description":"Surgical placement of craniofacial implant - extra oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB1","description":"ICD-NICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17282","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29850","description":"Knee arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUE1","description":"ICD-EIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9459","description":"Flutemetamol F18_ diagnostic_ per study dose_ up to 5 millicuries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD0","description":"ICD-OICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90621","description":"Meningococcal recombinant lipoprotein vaccine_ serogroup B (MenB-FHbp)_ 2 or 3 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0110","description":"Stroke with Motor <22.35 & Age <84.5_ comorbidity in tier 3 (HIPPS rate code)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90626","description":"Tick-borne encephalitis virus vaccine_ inactivated; 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXB0","description":"ICD-JGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAB0","description":"ICD-EGAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enema tube_ with or without adapter_ any type_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4457","description":"Enema tube_ with or without adapter_ any type_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFC0","description":"ICD-OHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTD1","description":"ICD-ADTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOC1","description":"ICD-LGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKA1","description":"ICD-OKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRC0","description":"ICD-KHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLC1","description":"ICD-MHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWD0","description":"ICD-PIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA0","description":"ICD-EHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICE0","description":"ICD-EICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7207","description":"Injection_ factor VIII_ (antihemophilic factor_ recombinant)_ PEGylated_ 1 IU","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BABF0","description":"ICD-BABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGMC0","description":"ICD-KGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEB1","description":"ICD-OIEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEB0","description":"ICD-ACEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1100","description":"Radiation Therapy For Prostate Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pasrr level ii","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2011","description":"Pasrr level ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBLC0","description":"ICD-JBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemorrhoidopexy by stapling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46947","description":"Hemorrhoidopexy by stapling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paclitaxel protein bound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9264","description":"Paclitaxel protein bound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATD0","description":"ICD-FATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFF1","description":"ICD-CHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHXD0","description":"ICD-KHXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA1","description":"ICD-NHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33955","description":"Ecmo/ecls insj ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHHF0","description":"ICD-KHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rev/remvl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0269T","description":"Rev/remvl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sprvsd xrcz back pn >12 wks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4242F","description":"Sprvsd xrcz back pn >12 wks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEHE1","description":"ICD-OEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC1","description":"ICD-FEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAD1","description":"ICD-IDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intestine transplnt cadaver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44135","description":"Intestine transplnt cadaver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen supplies regulator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1353","description":"Oxygen supplies regulator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOD1","description":"ICD-PDOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISF0","description":"ICD-GISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGC0","description":"ICD-OFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQE0","description":"ICD-PDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHE0","description":"ICD-KBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNA0","description":"ICD-NBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCJA1","description":"ICD-JCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92202","description":"Ophthalmoscopy_ Extended; With Drawing Of Optic Nerve Or Macula (Eg_ For Glaucoma_ Macular Pathology_ Tumor) With Interpretation And Report_ Unilateral Or Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIF1","description":"ICD-GIIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood platelet aggregation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85576","description":"Blood platelet aggregation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc share dec prior proc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9297","description":"No doc share dec prior proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special anesthesia procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99135","description":"Special anesthesia procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDE0","description":"ICD-KHDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA0","description":"ICD-JIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capt maxilla","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0382","description":"Cone beam ct capt maxilla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUF1","description":"ICD-NEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHBA1","description":"ICD-BHBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDBE0","description":"ICD-MDBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ank symes mold sckt sach ft","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5050","description":"Ank symes mold sckt sach ft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC15A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCD1","description":"ICD-NFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arch supp att to shoe long/m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3090","description":"Arch supp att to shoe long/m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD1","description":"ICD-BIDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEE0","description":"ICD-OCEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76000","description":"Fluoroscopy (separate procedure)_ up to 1 hour physician or other qualified health care professional time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA1","description":"ICD-GHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc extend prosth init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34825","description":"Endovasc extend prosth init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB0","description":"ICD-ICCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cogenex Amniotic Membrane_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4229","description":"Cogenex Amniotic Membrane_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD23C","description":"Special Care High _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom mold shoe remov prost","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3250","description":"Custom mold shoe remov prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fc receptor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86243","description":"Fc receptor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disease progn ra poor docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3475F","description":"Disease progn ra poor docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retreat root canal anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3346","description":"Retreat root canal anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81410","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE1","description":"ICD-NBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ulnar nerve at elbow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64718","description":"Revise ulnar nerve at elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB0","description":"ICD-FHHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDA0","description":"ICD-IEDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWC1","description":"ICD-DCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids synthetic 4-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80351","description":"Cannabinoids synthetic 4-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED1","description":"ICD-EFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osa mg qual act perform","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8759","description":"Osa mg qual act perform","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hd hosp bed_ 350-600 lbs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0301","description":"Hd hosp bed_ 350-600 lbs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replc tth&acrlc on mtl frmwk","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5670","description":"Replc tth&acrlc on mtl frmwk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIED0","description":"ICD-IIED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB23D","description":"Special Care High _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJA1","description":"ICD-NEJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEOD1","description":"ICD-CEOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extraoral first film","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0250","description":"Extraoral first film","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHC0","description":"ICD-OIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXF1","description":"ICD-GGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAA0","description":"ICD-JCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB0C","description":"Medium Rehab _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fr frz plasma donor retested","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9060","description":"Fr frz plasma donor retested","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1221","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of urethra defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53520","description":"Repair of urethra defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meg evoked single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95966","description":"Meg evoked single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE10A","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0902","description":"HCPCS-A0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAF0","description":"ICD-CDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKE1","description":"ICD-BHKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2427","description":"Injection_ paliperidone palmitate extended release (invega hafyera_ or invega trinza)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA0","description":"ICD-JAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGF0","description":"ICD-KHGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of elbow or wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29260","description":"Strapping of elbow or wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dentures adjust part mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5422","description":"Dentures adjust part mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVA0","description":"ICD-BIVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray&fluoro 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71034","description":"Chest x-ray&fluoro 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pmkr_ single_ non rate-resp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2620","description":"Pmkr_ single_ non rate-resp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correct skn color 6.1-20.0cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11921","description":"Correct skn color 6.1-20.0cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTF0","description":"ICD-KHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBA0","description":"ICD-GFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA0","description":"ICD-GFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"alloPLY_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4323","description":"alloPLY_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Close mastoid fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69700","description":"Close mastoid fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHEF1","description":"ICD-JHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDJB1","description":"ICD-CDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBRB0","description":"ICD-PBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray liver w/hemodynam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75885","description":"Vein x-ray liver w/hemodynam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00872","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","description":"CPT-00872","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gen use back cush wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2612","description":"Gen use back cush wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTE0","description":"ICD-NCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRB0","description":"ICD-DGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13A","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBF0","description":"ICD-IIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAC1","description":"ICD-FBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of urine phosphorus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84105","description":"Assay of urine phosphorus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINE0","description":"ICD-FINE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove epididymis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54830","description":"Remove epididymis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93270","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2092","description":"Angiotensin Converting Enzyme (Ace) Inhibitor Or Angiotensin Receptor Blocker (Arb) Or Angiotensin Receptor-Neprilysin Inhibitor (Arni) Therapy Prescribed Or Currently Being T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCE0","description":"ICD-ADCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1330","description":"Documentation of patient reason(s) for not having a follow up exam (e.g._ inadequate time for follow up)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proton trmt intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77523","description":"Proton trmt intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5100","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","description":"HCPCS-Q5100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDE1","description":"ICD-IBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVD0","description":"ICD-OEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27040","description":"Biopsy of soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0633T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Unilateral; Without Contrast Material","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC1","description":"ICD-OAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGE0","description":"ICD-OFGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JB11","description":"ICD-4JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD114","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal aneuploidy trisom risk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81507","description":"Fetal aneuploidy trisom risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay tumor ca 19-9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86301","description":"Immunoassay tumor ca 19-9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supply/accessory/service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9900","description":"Supply/accessory/service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWF0","description":"ICD-OJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFPA0","description":"ICD-CFPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBD1","description":"ICD-MKBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB160","description":"Reduced Physical Function _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disconnect locking wrist uni","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6615","description":"Disconnect locking wrist uni","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCTA0","description":"ICD-OCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6030","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","description":"HCPCS-L6030","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRB0","description":"ICD-DCRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81249","description":"G6PD (glucose-6-phosphate dehydrogenase) (eg_ hemolytic anemia_ jaundice)_ gene analysis; full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQF0","description":"ICD-KGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluorodopa f-18_ diagnostic_ per mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9602","description":"Fluorodopa f-18_ diagnostic_ per mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC0","description":"ICD-FEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABF1","description":"ICD-NABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whole blood for transfusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9010","description":"Whole blood for transfusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFED0","description":"ICD-MFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Init day hosp neonate care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99477","description":"Init day hosp neonate care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWE0","description":"ICD-GFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC0","description":"ICD-BEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWE0","description":"ICD-KFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHBF1","description":"ICD-FHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GESF1","description":"ICD-GESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLF0","description":"ICD-KHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69100","description":"Biopsy of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUD1","description":"ICD-FGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0455T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device_ vascular hemostatic seal_ mechano-electr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGED0","description":"ICD-IGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC1","description":"ICD-CGYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTB0","description":"ICD-NFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND1","description":"ICD-OGND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOC0","description":"ICD-OCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonvascular shunt x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75809","description":"Nonvascular shunt x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXA0","description":"ICD-GCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIB1","description":"ICD-AGIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temozolomide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9328","description":"Temozolomide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLB1","description":"ICD-NCLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC1","description":"ICD-GDEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J8522","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","description":"HCPCS-J8522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHE1","description":"ICD-MJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cochlear device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8614","description":"Cochlear device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBF1","description":"ICD-NEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVD1","description":"ICD-JBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q24h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9500","description":"Hit antibiotic q24h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE0","description":"ICD-IFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCF0","description":"ICD-OGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLA0","description":"ICD-MDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIF0","description":"ICD-JFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio lwr extr w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73706","description":"Ct angio lwr extr w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA236","description":"Reduced Physical Function _ ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE0","description":"ICD-NGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAD1","description":"ICD-FFAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES25B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB0","description":"ICD-HGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKUF0","description":"ICD-MKUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGF1","description":"ICD-NBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHA0","description":"ICD-IAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUB1","description":"ICD-IIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy filter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4368","description":"Ostomy filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9680","description":"Onsite Ac C Tx Nsg Fac Res W/Chf Billd Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78831","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWD1","description":"ICD-OJWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAKD1","description":"ICD-CAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVA0","description":"ICD-NCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNF0","description":"ICD-BHNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADF0","description":"ICD-IADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAF0","description":"ICD-BCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD0","description":"ICD-HGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRF0","description":"ICD-HBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCNE1","description":"ICD-NCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX56","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKBC0","description":"ICD-MKBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are counseled on connection with a csp and explicitly opt out","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1317","description":"Patients who are counseled on connection with a csp and explicitly opt out","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8G","description":"Very High Rehab _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semen anal strict criteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89322","description":"Semen anal strict criteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISF0","description":"ICD-CISF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0697U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697U","description":"CPT-0697U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ace/arb therapy rxd/taken","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4010F","description":"Ace/arb therapy rxd/taken","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin or another antiplatelet therapy not used_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1057","description":"Aspirin or another antiplatelet therapy not used_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0570","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","description":"HCPCS-G0570","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDD0","description":"ICD-CBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB1","description":"ICD-BFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKB0","description":"ICD-FDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5251","description":"Hearing aid_ prog_ bin_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Male condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4267","description":"Male condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA1","description":"ICD-CCRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJXA0","description":"ICD-NJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIE1","description":"ICD-IFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGF1","description":"ICD-FDGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEF0","description":"ICD-GIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPC0","description":"ICD-NGPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite skin graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15760","description":"Composite skin graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIB1","description":"ICD-IDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Residential Habilitation 1-3 Supp 1:1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0101","description":"Residential Habilitation 1-3 Supp 1:1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8D","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0787","description":"External Ambulatory Infusion Pump_ Insulin_ Dosage Rate Adjustment Using Therapeutic Continuous Glucose Sensing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp tibial-tib/peroneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35570","description":"Art byp tibial-tib/peroneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41016","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services for patient provided any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9718","description":"Hospice services for patient provided any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABB1","description":"ICD-CABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOD0","description":"ICD-GBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","description":"CPT-01714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOC0","description":"ICD-HHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUD0","description":"ICD-AGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bebtelovimab_ 175 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0222","description":"Injection_ bebtelovimab_ 175 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDPB0","description":"ICD-FDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOA1","description":"ICD-KBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl of subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33272","description":"Rmvl of subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transposition of vein valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34510","description":"Transposition of vein valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQE1","description":"ICD-ODQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUD0","description":"ICD-NHUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TOTAL_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4330","description":"TOTAL_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF1","description":"ICD-KAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHA1","description":"ICD-EDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISD0","description":"ICD-GISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIUE1","description":"ICD-BIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-52597","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","description":"CPT-52597","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFTA0","description":"ICD-NFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAC0","description":"ICD-MBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF0","description":"ICD-OEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIRD0","description":"ICD-DIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epoetin beta esrd use","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0887","description":"Epoetin beta esrd use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELA0","description":"ICD-IELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFD1","description":"ICD-GBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amalgam three surfaces perma","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2160","description":"Amalgam three surfaces perma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1019","description":"Clinical decision support mechanism LogicNets_ as defined by the Medicare appropriate use criteria program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Platelet Function Disorder Panel)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0277U","description":"Hematology (genetic platelet function disorder)_ genomic sequence analysis of 31 genes_ blood_ buccal swab_ or amniotic fluid (Versitiâ„¢ Platelet Function Disorder Panel)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"P-mastectomy w/ln removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19302","description":"P-mastectomy w/ln removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECD0","description":"ICD-FECD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Csit perf on low chd rsk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8965","description":"Csit perf on low chd rsk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFB0","description":"ICD-KIFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAMD0","description":"ICD-CAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit simple cath care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5498","description":"Hit simple cath care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy w/exc of tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31540","description":"Laryngoscopy w/exc of tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hook/hand_ hvy dty_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6722","description":"Hook/hand_ hvy dty_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTF1","description":"ICD-IGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPD1","description":"ICD-CCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Frozen cell preparation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88241","description":"Frozen cell preparation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFD1","description":"ICD-GCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CoreText or ProText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4246","description":"CoreText or ProText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXF1","description":"ICD-KIXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0426U","description":"Genome (eg_ unexplained constitutional or heritable disorder or syndrome)_ ultra-rapid sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGC0","description":"ICD-GEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lodging per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9976","description":"Lodging per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RARE DS XOM DNA ALYS PROBAND","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0214U","description":"RARE DS XOM DNA ALYS PROBAND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTE1","description":"ICD-OHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB12B","description":"Special Care Low _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAC1","description":"ICD-OCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDA1","description":"ICD-BIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCD0","description":"ICD-CFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF0","description":"ICD-BCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD160","description":"Clinically Complex _ ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIF1","description":"ICD-CAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVD1","description":"ICD-OCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALD1","description":"ICD-AALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26645","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACD0","description":"ICD-OACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOB1","description":"ICD-DAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVF1","description":"ICD-JDVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKF0","description":"ICD-FHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15014","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","description":"CPT-15014","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLB1","description":"ICD-GDLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Betamethasone acet&sod phosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0702","description":"Betamethasone acet&sod phosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hightop w/ supp/pronator chi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3206","description":"Hightop w/ supp/pronator chi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC126","description":"Reduced Physical Function _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBHD0","description":"ICD-BBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDD0","description":"ICD-AGDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQD1","description":"ICD-HIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gauze>16<=48 sq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6217","description":"Non-sterile gauze>16<=48 sq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kafo femoral fx cast rigid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2136","description":"Kafo femoral fx cast rigid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTC1","description":"ICD-EBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECA0","description":"ICD-FECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKID1","description":"ICD-NKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0494T","description":"Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system_ including decannulation_ separation from the perfusion sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB254","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc repair abdom aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75952","description":"Endovasc repair abdom aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVC0","description":"ICD-JDVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXA1","description":"ICD-FHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spinal cord thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63064","description":"Decompress spinal cord thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0348U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 25 gene report_ with variant analysis and reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF0","description":"ICD-GAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2116","description":"Patients 66 Years Of Age And Older With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Adv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC1","description":"ICD-LDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35621","description":"Art byp axillary-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBA0","description":"ICD-NHBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICB0","description":"ICD-OICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64582","description":"Open Implantation Of Hypoglossal Nerve Neurostimulator Array_ Pulse Generator_ And Distal Respiratory Sensor Electrode Or Electrode Array","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81234","description":"DMPK (DM1 protein kinase) (eg_ myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYA0","description":"ICD-HDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA0","description":"ICD-GEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDA1","description":"ICD-MKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destroy premal lesions 15/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17004","description":"Destroy premal lesions 15/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDFF1","description":"ICD-FDFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cervical laminoplsty 2/> seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63050","description":"Cervical laminoplsty 2/> seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w/o doppler complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93307","description":"Tte w/o doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB0","description":"ICD-NAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire_ integrate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2392","description":"Solid caster tire_ integrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXC1","description":"ICD-JHXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMC0","description":"ICD-BHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter w/bag 3-way","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4313","description":"Catheter w/bag 3-way","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1902","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1902","description":"CDT-D1902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBC0","description":"ICD-GGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA24","description":"Default_ /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB0","description":"ICD-GFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3B","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drill skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61108","description":"Drill skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBRA0","description":"ICD-LBRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reas not incl histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9419","description":"Med reas not incl histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBD0","description":"ICD-CBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFL3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00124","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","description":"CPT-00124","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTD0","description":"ICD-BGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAE0","description":"ICD-OGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0518U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","description":"CPT-0518U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity prosthes nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7499","description":"Upper extremity prosthes nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duodenal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91022","description":"Duodenal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin; other source_ quantitative_ each specimen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82042","description":"Albumin; other source_ quantitative_ each specimen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB225","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKB0","description":"ICD-OBKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Friction dampening arm supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2629","description":"Friction dampening arm supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stent_ non-coa/non-cov w/del","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1876","description":"Stent_ non-coa/non-cov w/del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC1","description":"ICD-EHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2BC31","description":"ICD-2BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test socket symes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5618","description":"Test socket symes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJC0","description":"ICD-NHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exoskeletal bk ultralt mater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5785","description":"Exoskeletal bk ultralt mater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPC1","description":"ICD-OFPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress spine cord add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63066","description":"Decompress spine cord add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSA0","description":"ICD-DFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMD0","description":"ICD-BCMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C0506","description":"Non-traumatic spinal cord injury with Motor <23.75._comorbidity in tier 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHE1","description":"ICD-BIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Homecare train pt session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5109","description":"Homecare train pt session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunfix e-phorsis/urine/csf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86335","description":"Immunfix e-phorsis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0563T","description":"Evacuation Of Meibomian Glands_ Using Heat Delivered Through Wearable_ Open-Eye Eyelid Treatment Devices And Manual Gland Expression_ Bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA1","description":"ICD-EFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAA1","description":"ICD-NGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8003","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8003","description":"HCPCS-C8003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPD1","description":"ICD-NFPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGED1","description":"ICD-OGED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rabies ig im/sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90375","description":"Rabies ig im/sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of oral tissue hard","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7285","description":"Biopsy of oral tissue hard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCUC1","description":"ICD-NCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC0","description":"ICD-ODNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKA0","description":"ICD-FEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subs visit for episode","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0526F","description":"Subs visit for episode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wbc alkaline phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85540","description":"Wbc alkaline phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC1","description":"ICD-CDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARE1","description":"ICD-OARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE0","description":"ICD-OFVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSC1","description":"ICD-HFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEE1","description":"ICD-FEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFA1","description":"ICD-JBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC30","description":"Medium Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLF0","description":"ICD-ODLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBF1","description":"ICD-FCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFBA0","description":"ICD-OFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4LA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4LA31","description":"ICD-4LA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPB0","description":"ICD-FAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJSC0","description":"ICD-PJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply bone fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20692","description":"Apply bone fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHE0","description":"ICD-FDHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB145","description":"Special Care High _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQE0","description":"ICD-PLQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWA0","description":"ICD-DBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28B","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFE0","description":"ICD-NCFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA0","description":"ICD-EELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCID1","description":"ICD-OCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64913","description":"Nerve repair; with nerve allograft_ each additional strand (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supported employment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6106","description":"Supported employment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko derot ant cruciate custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1840","description":"Ko derot ant cruciate custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental tomographic survey","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0322","description":"Dental tomographic survey","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEE1","description":"ICD-OJEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB52","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEA1","description":"ICD-EEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHD1","description":"ICD-GDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWC1","description":"ICD-CBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of amputation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24935","description":"Revision of amputation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FA21","description":"ICD-2FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMB1","description":"ICD-MAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmprs burngarment foot-thigh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6508","description":"Cmprs burngarment foot-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRB1","description":"ICD-GBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRC1","description":"ICD-GDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply r&l pulm art bands","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33620","description":"Apply r&l pulm art bands","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB24","description":"High Rehab _ ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRD1","description":"ICD-HGRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23105","description":"Remove shoulder joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX53","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA46","description":"Ultra High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMF0","description":"ICD-MCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYC1","description":"ICD-LIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTB1","description":"ICD-FDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0013","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","description":"HCPCS-J0013","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo cholangiopancreatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43262","description":"Endo cholangiopancreatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant spinal canal cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62351","description":"Implant spinal canal cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC0","description":"ICD-CCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assistive technology assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97755","description":"Assistive technology assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTF0","description":"ICD-ABTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFED1","description":"ICD-BFED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRE0","description":"ICD-CDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVD0","description":"ICD-KEVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYD0","description":"ICD-OKYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sign lang/oral interpreter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1013","description":"Sign lang/oral interpreter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUC1","description":"ICD-IFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUA1","description":"ICD-IBUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKDF0","description":"ICD-OKDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHB1","description":"ICD-FHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMB0","description":"ICD-FAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe dennis browne splint bo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3640","description":"Shoe dennis browne splint bo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","description":"CPT-00212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUE1","description":"ICD-GHUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE0","description":"ICD-LHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCEA1","description":"ICD-NCEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Test for chlorohydrocarbons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82441","description":"Test for chlorohydrocarbons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0101","description":"HCPCS-B0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam unilat ribs/chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71101","description":"X-ray exam unilat ribs/chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUB0","description":"ICD-GEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fo pip dip no jt spr pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3927","description":"Fo pip dip no jt spr pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKTD0","description":"ICD-OKTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disp wound suct_ drsg/access","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9272","description":"Disp wound suct_ drsg/access","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21081","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIAC0","description":"ICD-KIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor wght kininogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85293","description":"Clot factor wght kininogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLME0","description":"ICD-MLME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHUC0","description":"ICD-MHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 hd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0870","description":"Pwc gp 4 hd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilate urethra stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53601","description":"Dilate urethra stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLC1","description":"ICD-NHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUF1","description":"ICD-IIUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ apadamtase alfa_ 10 units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9167","description":"Injection_ apadamtase alfa_ 10 units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGEA1","description":"ICD-JGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXD1","description":"ICD-FDXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0618U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","description":"CPT-0618U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUE1","description":"ICD-JBUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy extraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57282","description":"Colpopexy extraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHC0","description":"ICD-JEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrin test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82938","description":"Gastrin test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE201","description":"Clinically Complex _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD104","description":"Reduced Physical Function _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESA1","description":"ICD-KESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vasopressin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84588","description":"Assay of vasopressin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB1","description":"ICD-GCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECD1","description":"ICD-JECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDC1","description":"ICD-FCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain lining lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61512","description":"Remove brain lining lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla x-match noncytotoxc addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86826","description":"Hla x-match noncytotoxc addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2133","description":"Patients 66-80 Years Of Age With At Least One Claim/Encounter For Frailty During The Measurement Period And Either One Acute Inpatient Encounter With A Diagnosis Of Advanced I","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-77438","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","description":"CPT-77438","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4542","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KA31","description":"ICD-1KA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHME0","description":"ICD-IHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal motility study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78258","description":"Esophageal motility study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped crit care transport","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99466","description":"Ped crit care transport","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MLG-Complete_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4256","description":"MLG-Complete_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0105","description":"HCPCS-C0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crown resin w/ high noble me","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2720","description":"Crown resin w/ high noble me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSC0","description":"ICD-PDSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE1","description":"ICD-ECTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXF0","description":"ICD-NFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAC0","description":"ICD-GCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGED0","description":"ICD-EGED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0461U","description":"Oncology_ pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes_ whole blood or buccal swab_ with variant analysis_ includin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24538","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQB1","description":"ICD-DAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB1","description":"ICD-HAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDA1","description":"ICD-OHDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCF1","description":"ICD-GHCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34703","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection_ all nonsele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq lamot/lam lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0275T","description":"Perq lamot/lam lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBA0","description":"ICD-NCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JELF1","description":"ICD-JELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB15","description":"Low Rehab_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Deliver placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59414","description":"Deliver placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVC1","description":"ICD-NBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1705","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1705","description":"CDT-D1705","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx nsclc stg3b-4 metasta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9066","description":"Onc dx nsclc stg3b-4 metasta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41018","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVC0","description":"ICD-OIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Proctosigmoidoscopy removal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45309","description":"Proctosigmoidoscopy removal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOF0","description":"ICD-PFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiolipin antibody ea ig","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86147","description":"Cardiolipin antibody ea ig","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Systemic antimicrobials prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9961","description":"Systemic antimicrobials prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair semi-recl detach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1110","description":"Wheelchair semi-recl detach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft head/neck >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64886","description":"Nerve graft head/neck >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunotherapy administration with electroporation_ intramuscular","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0732T","description":"Immunotherapy administration with electroporation_ intramuscular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMA0","description":"ICD-BFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFSC1","description":"ICD-LFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBEE1","description":"ICD-OBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylindr 7.25d/4.25-6d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2113","description":"Spherocylindr 7.25d/4.25-6d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ventricular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33978","description":"Remove ventricular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIB1","description":"ICD-BBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0587U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","description":"CPT-0587U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKLE0","description":"ICD-NKLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJF0","description":"ICD-FDJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTA1","description":"ICD-FGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHE1","description":"ICD-GDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXB1","description":"ICD-JFXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76017","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","description":"CPT-76017","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA33","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTB0","description":"ICD-EBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB240","description":"Clinically Complex _ ADL Index 2-5/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGMS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd us transmural injxn/mark","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43253","description":"Egd us transmural injxn/mark","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oprelvekin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2355","description":"Oprelvekin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97168","description":"Re-evaluation of occupational therapy established plan of care_ requiring these components: An assessment of changes in patient functional or medical status with revised plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15952","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Completion pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32488","description":"Completion pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rufinamide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80210","description":"Rufinamide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9066","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9066","description":"HCPCS-J9066","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPE1","description":"ICD-NIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No tpa init w/in 3 hrs","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8602","description":"No tpa init w/in 3 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB0","description":"ICD-GAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIB0","description":"ICD-OJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vancomycin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3370","description":"Vancomycin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply long leg cast brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29358","description":"Apply long leg cast brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF1","description":"ICD-NJDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEOD0","description":"ICD-LEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE1","description":"ICD-CEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAD0","description":"ICD-MGAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDDE1","description":"ICD-KDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69801","description":"Incise inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMB0","description":"ICD-CGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB104","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIA1","description":"ICD-JEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC1","description":"ICD-HGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8G","description":"Medium Rehab _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXF1","description":"ICD-OJXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAND0","description":"ICD-OAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0231","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0231","description":"HCPCS-M0231","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF0","description":"ICD-BGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAA1","description":"ICD-MIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0372T","description":"Adaptive behavior treatment social skills group_ administered by physician or other qualified health care professional face-to-face with multiple patients","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYC1","description":"ICD-OIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFL4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWB1","description":"ICD-GHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDRB0","description":"ICD-DDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQB0","description":"ICD-LIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cultr oocyte/embryo <4 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89251","description":"Cultr oocyte/embryo <4 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCC0","description":"ICD-KDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODVD1","description":"ICD-ODVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGB0","description":"ICD-BDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIUE1","description":"ICD-NIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISE1","description":"ICD-HISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD23B","description":"Clinically Complex _ ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJIA1","description":"ICD-NJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEF1","description":"ICD-NAEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDQA1","description":"ICD-PDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDOA1","description":"ICD-HDOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCB0","description":"ICD-ACCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAXE1","description":"ICD-JAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYD1","description":"ICD-HIYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDE0","description":"ICD-EBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGID1","description":"ICD-MGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJD1","description":"ICD-OAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51520","description":"Removal of bladder lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJMC1","description":"ICD-MJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mrcp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8037","description":"Mrcp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20975","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOE1","description":"ICD-GFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQC1","description":"ICD-KFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2169","description":"Services performed by a occupational therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program_ each 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 or more neuropsych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8947","description":"1 or more neuropsych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHK6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIB1","description":"ICD-BDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen radius & ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25393","description":"Lengthen radius & ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDF1","description":"ICD-EGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy speaking valve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8501","description":"Tracheostomy speaking valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB23A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBID0","description":"ICD-IBID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWB1","description":"ICD-LGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card angio/athrect addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92925","description":"Prq card angio/athrect addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFF1","description":"ICD-NIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEC1","description":"ICD-EHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBNF1","description":"ICD-OBNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood fungus culture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87103","description":"Blood fungus culture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caloric vstblr test w/rec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92537","description":"Caloric vstblr test w/rec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEE0","description":"ICD-EGEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWD0","description":"ICD-GGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKD0","description":"ICD-GIKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2075","description":"Medication Assisted Treatment_ Medication Not Otherwise Specified; Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-adher band w>=3in <5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6454","description":"Self-adher band w>=3in <5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPA1","description":"ICD-BFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84446","description":"Assay of vitamin e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL30","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCC0","description":"ICD-EGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIF0","description":"ICD-BDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of digoxin free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80163","description":"Assay of digoxin free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGF1","description":"ICD-KEGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF0","description":"ICD-BDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3DB31","description":"ICD-3DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for elbow x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24220","description":"Injection for elbow x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Goserelin acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9202","description":"Goserelin acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC1","description":"ICD-MBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434U","description":"Drug metabolism (adverse drug reactions and drug response)_ genomic analysis panel_ variant analysis of 25 genes with reported phenotypes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50080","description":"Removal of kidney stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27511","description":"Treatment of thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRF1","description":"ICD-OFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0960T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","description":"CPT-0960T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBC1","description":"ICD-OBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01160","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","description":"CPT-01160","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSD0","description":"ICD-CFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOD1","description":"ICD-HGOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of fecal fat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82715","description":"Assay of fecal fat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE18F","description":"Clinically Complex _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JECC0","description":"ICD-JECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise major vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33824","description":"Revise major vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYF0","description":"ICD-OIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval npgs apnea study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0436T","description":"Prgrmg eval npgs apnea study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LC31","description":"ICD-1LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLID0","description":"ICD-NLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYD0","description":"ICD-GBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUB0","description":"ICD-MLUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1110T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1110T","description":"CPT-1110T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ankle x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27648","description":"Injection for ankle x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEE1","description":"ICD-IIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ neurostim test kit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1897","description":"Lead_ neurostim test kit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD0","description":"ICD-JIUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGVC1","description":"ICD-NGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNC0","description":"ICD-GCNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Str markers spec anal addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81266","description":"Str markers spec anal addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ diag/abl_ 3d/vect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1732","description":"Cath_ ep_ diag/abl_ 3d/vect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB0","description":"ICD-OECB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj heparin sodium per 1000u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1644","description":"Inj heparin sodium per 1000u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB0","description":"ICD-EFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA1","description":"ICD-OGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27556","description":"Treat knee dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:1)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1728","description":"Employment - Employment Skills Development (1:1)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB21","description":"ICD-1KB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1488","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","description":"HCPCS-M1488","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density/peripheral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77081","description":"Dxa bone density/peripheral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIFC0","description":"ICD-NIFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain cerebro spinal fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62272","description":"Drain cerebro spinal fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXF1","description":"ICD-FCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2428","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","description":"HCPCS-J2428","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB5A","description":"High Rehab _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPF1","description":"ICD-CEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEC0","description":"ICD-NGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBA1","description":"ICD-CFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply intrcav radiat interm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77762","description":"Apply intrcav radiat interm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIF1","description":"ICD-NBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp carotid-subclavian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35606","description":"Art byp carotid-subclavian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF1","description":"ICD-OGRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCQC1","description":"ICD-GCQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJE0","description":"ICD-JBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPB1","description":"ICD-OAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJB1","description":"ICD-JBJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEKA1","description":"ICD-GEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFCE1","description":"ICD-MFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJB1","description":"ICD-OFJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKAA1","description":"ICD-OKAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brain image w/flow 4 + views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78606","description":"Brain image w/flow 4 + views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQF1","description":"ICD-PFQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABD0","description":"ICD-MABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strapping of hand or finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29280","description":"Strapping of hand or finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37260","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","description":"CPT-37260","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0336U","description":"Rare diseases (constitutional/heritable disorders)_ whole genome sequence analysis_ including small sequence changes_ copy number variants_ deletions_ duplications_ mobile e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNF0","description":"ICD-BFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEF0","description":"ICD-NJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBF1","description":"ICD-MBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control band & belt b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2640","description":"Pelvic control band & belt b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYD0","description":"ICD-KCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWB0","description":"ICD-CIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOF1","description":"ICD-PIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crisis intervention per hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9484","description":"Crisis intervention per hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUD0","description":"ICD-EFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETA0","description":"ICD-CETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIB1","description":"ICD-AHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg1-2 noprogres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9072","description":"Onc dx brst stg1-2 noprogres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB0","description":"ICD-NBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFQE0","description":"ICD-GFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat/back cus no dmepdac ver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0669","description":"Seat/back cus no dmepdac ver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AELE1","description":"ICD-AELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFA1","description":"ICD-GDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct orbit/ear/fossa w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70482","description":"Ct orbit/ear/fossa w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWD0","description":"ICD-HBWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1374","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","description":"HCPCS-M1374","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1303","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB52","description":"High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBD1","description":"ICD-IEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKGA0","description":"ICD-NKGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIB0","description":"ICD-ECIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBA1","description":"ICD-BBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of gum lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41826","description":"Excision of gum lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB210","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg filler paste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6240","description":"Hydrocolld drg filler paste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDC0","description":"ICD-OLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC201","description":"Special Care Low _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB214","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHE0","description":"ICD-EFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-49188","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","description":"CPT-49188","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of rectal marker","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46030","description":"Removal of rectal marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54530","description":"Removal of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWE0","description":"ICD-DGWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0901T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","description":"CPT-0901T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB221","description":"Clinically Complex _ ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAB1","description":"ICD-CBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-pop-tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35623","description":"Art byp axillary-pop-tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE0","description":"ICD-JFCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGD0","description":"ICD-OKGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB0","description":"ICD-CFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insitu hybridization (fish)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88365","description":"Insitu hybridization (fish)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKED1","description":"ICD-OKED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB234","description":"Special Care Low _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cell marker study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88182","description":"Cell marker study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGPC1","description":"ICD-KGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gene test retinoblastoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3841","description":"Gene test retinoblastoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD0","description":"ICD-LBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBB1","description":"ICD-NLBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1 quant&revrse trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87536","description":"Hiv-1 quant&revrse trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34812","description":"Open femoral artery exposure for delivery of endovascular prosthesis_ by groin incision_ unilateral (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA0","description":"ICD-JCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5103","description":"Injection_ infliximab-dyyb_ biosimilar_ (Inflectra)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA4C","description":"Very High Rehab _ ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMC0","description":"ICD-FDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAME0","description":"ICD-NAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ ippe or awv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0468","description":"Fqhc visit_ ippe or awv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB1","description":"ICD-NDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB36","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noc retail items andsupplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1999","description":"Noc retail items andsupplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTD0","description":"ICD-NDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0562","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","description":"HCPCS-G0562","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTB1","description":"ICD-KHTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hast w/oxygen titrate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94453","description":"Hast w/oxygen titrate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDWA0","description":"ICD-HDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNE1","description":"ICD-FDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKF1","description":"ICD-ODKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72157","description":"MRI chest spine w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64610","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Miscellaneous component_ supply or accessory for use with total artificial heart system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8698","description":"Miscellaneous component_ supply or accessory for use with total artificial heart system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mucopolysaccharides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83864","description":"Mucopolysaccharides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0380U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis_ 20 gene variants and CYP2D6 deletion or duplication analysis with reported genotype and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clearance of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68530","description":"Clearance of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRF1","description":"ICD-DHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDUB0","description":"ICD-NDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHB0","description":"ICD-KEHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSF1","description":"ICD-KBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cntct lens hydrophil bifocl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2522","description":"Cntct lens hydrophil bifocl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHA1","description":"ICD-IFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA0","description":"ICD-OASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFA0","description":"ICD-OHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFE0","description":"ICD-OFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chd risk imt study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0126T","description":"Chd risk imt study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB11C","description":"Clinically Complex _ ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGPA1","description":"ICD-GGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMD0","description":"ICD-MGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHA0","description":"ICD-GBHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digital sub 2 or more images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0394","description":"Digital sub 2 or more images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMA1","description":"ICD-AIMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXA0","description":"ICD-CFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0713T","description":"Noninvasive Arterial Plaque Analysis Using Software Processing Of Data From Non-Coronary Computerized Tomography Angiography; Data Review_ Interpretation And Report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX24","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73510","description":"Radiologic examination_ hip_ unilateral; complete_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYD1","description":"ICD-KBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACE1","description":"ICD-AACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9712","description":"Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g._ intestinal infection_ pertussis_ bacterial infection_ lyme disease_ otitis media_ acute sinu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPF0","description":"ICD-JHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWB1","description":"ICD-HCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78430","description":"Myocardial Imaging_ Positron Emission Tomography (Pet)_ Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S]_ When Performed); Single Study_ At Re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA113","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHNC1","description":"ICD-CHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Persistent asthma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1038F","description":"Persistent asthma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB0","description":"ICD-EHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0908T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","description":"CPT-0908T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMB0","description":"ICD-BHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAF0","description":"ICD-GAAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKC0","description":"ICD-OFKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise palsy hand tendon(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25315","description":"Revise palsy hand tendon(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66989","description":"Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure)_ Manual Or Mechanical Technique (Eg_ Irrigation And Aspiration Or Phacoemulsif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of tongue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41120","description":"Partial removal of tongue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc foot/toe tum sc 1.5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28039","description":"Exc foot/toe tum sc 1.5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRD0","description":"ICD-GCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee control condylar pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2810","description":"Knee control condylar pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIC0","description":"ICD-MCIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/cont_ chest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8909","description":"Mra w/cont_ chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVD1","description":"ICD-KBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEC1","description":"ICD-ICEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystometrogram w/vp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51728","description":"Cystometrogram w/vp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temp fml iu vlv-pmp 1st insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0596T","description":"Temp fml iu vlv-pmp 1st insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0349U","description":"Drug metabolism or processing (multiple conditions)_ whole blood or buccal specimen_ DNA analysis_ 27 gene report_ with variant analysis_ including reported phenotypes and imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscpy inj agent for incont","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0377T","description":"Anoscpy inj agent for incont","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pelvis lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38770","description":"Remove pelvis lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc visit unspecified nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9055","description":"Onc visit unspecified nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foam filled drive wheel tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2386","description":"Foam filled drive wheel tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAME0","description":"ICD-FAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPB1","description":"ICD-GAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYB1","description":"ICD-OKYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEXA1","description":"ICD-FEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHLF1","description":"ICD-FHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETF1","description":"ICD-EETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFC1","description":"ICD-BAFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE1","description":"ICD-JFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDC0","description":"ICD-JHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical boot each child","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3209","description":"Surgical boot each child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC101","description":"Clinically Complex _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEED0","description":"ICD-EEED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFA1","description":"ICD-BFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BITA0","description":"ICD-BITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE154","description":"Special Care High _ ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHIE1","description":"ICD-AHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC25","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart first pass add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78496","description":"Heart first pass add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB1","description":"ICD-LAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9762","description":"Patient had at least two HPV vaccines (with at least 146 days between the two) or three HPV vaccines on or between the patient_s 9th and 13th birthdays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Counsel prov driving risks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6110F","description":"Counsel prov driving risks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay duodenal fluid trypsin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84485","description":"Assay duodenal fluid trypsin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0125U","description":"Anesthesia for intraoral procedures_ including biopsy; not otherwise specif","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81542","description":"Oncology (Prostate)_ Mrna_ Microarray Gene Expression Profiling Of 22 Content Genes_ Utilizing Formalin-Fixed Paraffin-Embedded Tissue_ Algorithm Reported As Metastasis Risk S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE0","description":"ICD-FEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat wrist bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25622","description":"Treat wrist bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXB0","description":"ICD-FIXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHAD1","description":"ICD-FHAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSA1","description":"ICD-CDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYD1","description":"ICD-ODYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CISA0","description":"ICD-CISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBF0","description":"ICD-FDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lincomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2010","description":"Lincomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXE0","description":"ICD-NHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFLE0","description":"ICD-OFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTD1","description":"ICD-GBTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHD0","description":"ICD-FCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87484","description":"Infectious agent detection by nucleic acid (DNA or RNA); Ehrlichia chaffeensis_ amplified probe technique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inpt implant pros dev_no cov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9899","description":"Inpt implant pros dev_no cov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBC0","description":"ICD-MJBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB1","description":"ICD-OLPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA0","description":"ICD-PERA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"INTRAORIFICE BARRIER","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3911","description":"INTRAORIFICE BARRIER","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9143","description":"Cocaine hydrochloride nasal solution (numbrino)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGF0","description":"ICD-OAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAC0","description":"ICD-IIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interp both jaw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0367","description":"Cone beam ct interp both jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hyoid bone fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21495","description":"Treat hyoid bone fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKRD1","description":"ICD-PKRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair fibula nonunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27726","description":"Repair fibula nonunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HERB0","description":"ICD-HERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEE1","description":"ICD-EAEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF0","description":"ICD-BHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBD0","description":"ICD-IIBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0361U","description":"Neurofilament light chain_ digital immunoassay_ plasma_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAB0","description":"ICD-FBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGF1","description":"ICD-CAGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev soft tiss 1st imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10035","description":"Perq dev soft tiss 1st imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUB1","description":"ICD-NLUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore inner ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69806","description":"Explore inner ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUC0","description":"ICD-BBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tongue nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64740","description":"Incision of tongue nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCQB1","description":"ICD-PCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIB0","description":"ICD-AIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of amikacin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80150","description":"Assay of amikacin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC1","description":"ICD-OHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15945","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUE0","description":"ICD-OGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBD0","description":"ICD-OLBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTB1","description":"ICD-MBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28225","description":"Release of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens gas impermeable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2530","description":"Contact lens gas impermeable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Galectin-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82777","description":"Galectin-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9737","description":"Patient unable to complete the FOTO elbow_ wrist or hand intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFD1","description":"ICD-OJFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRA0","description":"ICD-CDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8F","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ans parasymp & symp w/tilt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95924","description":"Ans parasymp & symp w/tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered w/c cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2610","description":"Powered w/c cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Lefamulin (Xenleta)_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9054","description":"Injection_ Lefamulin (Xenleta)_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIE0","description":"ICD-NGIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplants of thigh tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27397","description":"Transplants of thigh tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt doc no events on discharg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8907","description":"Pt doc no events on discharg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srch for ct w in 12 mos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9341","description":"Srch for ct w in 12 mos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMC1","description":"ICD-BGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Visual field assmnt rev/rprt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0378T","description":"Visual field assmnt rev/rprt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX01","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4386","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","description":"HCPCS-Q4386","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4388","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","description":"HCPCS-Q4388","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14A","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo flexion glove pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3912","description":"Hfo flexion glove pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIUA0","description":"ICD-MIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8694","description":"Auditory osseointegrated device_ transducer/actuator_ replacement only_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair by enlargement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33610","description":"Repair by enlargement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA0","description":"ICD-PAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35111","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct cranial bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21184","description":"Reconstruct cranial bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAC1","description":"ICD-GFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rxt breast appl place/remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9726","description":"Rxt breast appl place/remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear high roll cu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2550","description":"Thigh/wght bear high roll cu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERD0","description":"ICD-KERD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone marrow harvest allogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38230","description":"Bone marrow harvest allogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair hallux rigidus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28289","description":"Repair hallux rigidus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDB0","description":"ICD-BEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBC0","description":"ICD-GHBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFF0","description":"ICD-OAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1353","description":"Patients who did not have a completed suicide safety plan initiated_ reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index cli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLE0","description":"ICD-NCLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWF0","description":"ICD-HFWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq cardiac angioplast 1 art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92920","description":"Prq cardiac angioplast 1 art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRB1","description":"ICD-GFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4AB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4AB31","description":"ICD-4AB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj excisn of joint membrane","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7854","description":"Tmj excisn of joint membrane","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERC1","description":"ICD-CERC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA0","description":"ICD-FDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Streptokinase antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86590","description":"Streptokinase antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFKB0","description":"ICD-CFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplcmt defib w/lead(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33249","description":"Insj/rplcmt defib w/lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES336","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEE1","description":"ICD-MEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLF1","description":"ICD-MDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA55","description":"High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"L/s ratio fetal lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83661","description":"L/s ratio fetal lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEGE1","description":"ICD-GEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95707","description":"Electroencephalogram (Eeg)_ Without Video_ Review Of Data_ Technical Description By Eeg Technologist_ 2-12 Hours; With Continuous_ Real-Time Monitoring And Maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove jaw joint cartilage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21060","description":"Remove jaw joint cartilage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX42","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXB1","description":"ICD-KDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat lift incorp lift-chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0627","description":"Seat lift incorp lift-chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEC0","description":"ICD-OAEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"JK GNOTYP SLC14A1 EXON 9","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0192U","description":"JK GNOTYP SLC14A1 EXON 9","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTE1","description":"ICD-NJTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Finger tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26498","description":"Finger tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth procedure on mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17051","description":"Anesth procedure on mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC1","description":"ICD-JEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retinal tamp_ silicone oil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1814","description":"Retinal tamp_ silicone oil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj chem not pres rsn spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8928","description":"Adj chem not pres rsn spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spinal cord lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63600","description":"Remove spinal cord lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w foot","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1221","description":"Wheelchair spec size w foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJF0","description":"ICD-OGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERD1","description":"ICD-CERD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19371","description":"Removal of breast capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDLA0","description":"ICD-KDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHF1","description":"ICD-OKHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pcv13 vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90670","description":"Pcv13 vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQE0","description":"ICD-KBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIC0","description":"ICD-ICIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block inj intercost mlt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64421","description":"N block inj intercost mlt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXB1","description":"ICD-GBXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMD1","description":"ICD-AEMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8I","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMC0","description":"ICD-MLMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup long leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4030","description":"Cast sup long leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKDE0","description":"ICD-MKDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLD1","description":"ICD-GHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBF1","description":"ICD-GDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA0","description":"ICD-ECEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKE0","description":"ICD-NDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYD0","description":"ICD-CFYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6522","description":"Gradient compression garment_ arm_ padded_ for nighttime use_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUD1","description":"ICD-JIUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE0","description":"ICD-NGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYE0","description":"ICD-OHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Planar seat for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2292","description":"Planar seat for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQF0","description":"ICD-PEQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0D","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger_ single mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2366","description":"Battery charger_ single mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC14C","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB0","description":"ICD-NHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterovirus antibody dfa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87267","description":"Enterovirus antibody dfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB2C","description":"High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No disc tx choices","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9401","description":"No disc tx choices","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHLB1","description":"ICD-OHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47120","description":"Partial removal of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thoracic lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38746","description":"Remove thoracic lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28X","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tumor imaging whole body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78804","description":"Tumor imaging whole body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSB1","description":"ICD-DCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas ext receiver","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1037","description":"Art pancreas ext receiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9847","description":"Patient received chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneuma/vac walk boot pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4361","description":"Pneuma/vac walk boot pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCF1","description":"ICD-CFCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of unstable kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27422","description":"Revision of unstable kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/stent plcmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45389","description":"Colonoscopy w/stent plcmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDA0","description":"ICD-OCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQD1","description":"ICD-GHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert heart pm atrial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33206","description":"Insert heart pm atrial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEA1","description":"ICD-ECEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFC1","description":"ICD-NDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETD1","description":"ICD-IETD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ostomy accessory convex inse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5093","description":"Ostomy accessory convex inse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOE0","description":"ICD-PHOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0B","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap trunk","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15600","description":"Delay flap trunk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTC0","description":"ICD-GBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVC1","description":"ICD-FFVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Waist belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2190","description":"Waist belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE104","description":"Clinically Complex _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopy of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44385","description":"Endoscopy of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interscapular-thor switch ct","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6970","description":"Interscapular-thor switch ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIBC0","description":"ICD-NIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFD1","description":"ICD-NGFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDB1","description":"ICD-CCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX31","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj octafluoropropane mic_ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9956","description":"Inj octafluoropropane mic_ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLE1","description":"ICD-BGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anifrolumab-fnia_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0491","description":"Injection_ anifrolumab-fnia_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling indiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99402","description":"Preventive counseling indiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLB1","description":"ICD-ACLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBA0","description":"ICD-CEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther/proph/diag inj sc/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96372","description":"Ther/proph/diag inj sc/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Press pad alternating w/ pum","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0181","description":"Press pad alternating w/ pum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pml/raralpha com breakpoints","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81315","description":"Pml/raralpha com breakpoints","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroesophageal reflux test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91034","description":"Gastroesophageal reflux test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Path consult intraop 1 bloc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88331","description":"Path consult intraop 1 bloc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0390T","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery_ procedure or test with analysis_ review and report_ leadle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHE0","description":"ICD-OHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA0","description":"ICD-IBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coping","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2975","description":"Coping","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAF1","description":"ICD-OGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB15B","description":"Special Care High _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHF1","description":"ICD-JIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evoked auditory test qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92558","description":"Evoked auditory test qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol non-comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7611","description":"Albuterol non-comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC24A","description":"Clinically Complex _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compress burn mask face/neck","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6513","description":"Compress burn mask face/neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0142A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spik","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13D","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDD1","description":"ICD-EDDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSD0","description":"ICD-DCSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHD0","description":"ICD-JGHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTC0","description":"ICD-IHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE260","description":"Clinically Complex _ ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0820","description":"Pwc gp 2 std port seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture type immunologic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87147","description":"Culture type immunologic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB16","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath emboliz microspher","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2095","description":"Transcath emboliz microspher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUB0","description":"ICD-BEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARC1","description":"ICD-CARC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Major Abdominal Blood Vessels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77059","description":"Major Abdominal Blood Vessels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB35","description":"Medium Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE0","description":"ICD-CGGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair sciatic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64858","description":"Repair sciatic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRE0","description":"ICD-DFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelet survival kinetics","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78190","description":"Platelet survival kinetics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NACC0","description":"ICD-NACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYC0","description":"ICD-KFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drsg gel filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6248","description":"Hydrogel drsg gel filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFME0","description":"ICD-FFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemiluminescent assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82397","description":"Chemiluminescent assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICB1","description":"ICD-MICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ureteral embolization/occl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50705","description":"Ureteral embolization/occl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26123","description":"Release palm contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA0","description":"ICD-GELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trim nail(s) any number","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11719","description":"Trim nail(s) any number","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEA0","description":"ICD-AEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy arm/elbow soft tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24066","description":"Biopsy arm/elbow soft tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAUF1","description":"ICD-MAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74247","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYC0","description":"ICD-CGYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB0","description":"ICD-OBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAWE0","description":"ICD-CAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28306","description":"Incision of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAB1","description":"ICD-JDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIE0","description":"ICD-MKIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91302","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ DNA_ spike protein_ chimpanzee adenovirus Oxford 1 (ChAdOx1) vector_ pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC1","description":"ICD-ABCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDMA0","description":"ICD-CDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitatereducedplasma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9044","description":"Cryoprecipitatereducedplasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES345","description":"Extensive Services _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam abdo back wall lim","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76775","description":"Us exam abdo back wall lim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHA1","description":"ICD-EGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24B","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKB1","description":"ICD-FBKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1067T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1067T","description":"CPT-1067T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAHE1","description":"ICD-EAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim cancer treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0766","description":"Elec stim cancer treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Carbidopa levodopa enteral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7340","description":"Carbidopa levodopa enteral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"SurFactor or NuDyn_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4233","description":"SurFactor or NuDyn_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD1","description":"ICD-EAUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIE0","description":"ICD-FCIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2005","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2005","description":"HCPCS-A2005","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHBF1","description":"ICD-GHBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1302","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1302","description":"HCPCS-B1302","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28G","description":"Clinically Complex _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA23A","description":"Clinically Complex _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0B","description":"Medium Rehab _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ft insert ucb berkeley shell","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3000","description":"Ft insert ucb berkeley shell","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement breastpump tube","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4281","description":"Replacement breastpump tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFJD1","description":"ICD-FFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9085","description":"Injection_ Avalglucosidase Alfa-Ngpt_ 4 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiologic study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93624","description":"Electrophysiologic study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBHF1","description":"ICD-FBHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family psytx w/o patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90846","description":"Family psytx w/o patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce hip bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27187","description":"Reinforce hip bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVB0","description":"ICD-GCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF1","description":"ICD-GHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEF1","description":"ICD-BGEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9914","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9914","description":"CDT-D9914","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHD0","description":"ICD-MFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20972","description":"Bone/skin graft metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O shoe add instep velcro clo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3580","description":"O shoe add instep velcro clo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EACB1","description":"ICD-EACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457U","description":"Perfluoroalkyl substances (PFAS) (eg_ perfluorooctanoic acid_ perfluorooctane sulfonic acid)_ 9 PFAS compounds by LC-MS/MS_ plasma or serum_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of anal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46070","description":"Incision of anal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVC1","description":"ICD-BGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSA1","description":"ICD-HHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBE0","description":"ICD-FBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corf skilled nursing service","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0128","description":"Corf skilled nursing service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr trunk 10 sq cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14000","description":"Tis trnfr trunk 10 sq cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8610","description":"Ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare donor heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33944","description":"Prepare donor heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal scalp blood sample","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59030","description":"Fetal scalp blood sample","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office emergency care","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99058","description":"Office emergency care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOD0","description":"ICD-KBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKE1","description":"ICD-GGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq vertebral augmentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22514","description":"Perq vertebral augmentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DB11","description":"ICD-2DB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMF1","description":"ICD-BDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHUD1","description":"ICD-GHUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0862T","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing_ including device interrogation and programming; battery component only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES226","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote 30 day ecg rev/report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93228","description":"Remote 30 day ecg rev/report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ maintenance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9005","description":"Mccd_ risk adj_ maintenance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92313","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Barium swallow test ordered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3142F","description":"Barium swallow test ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAJD0","description":"ICD-JAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAD0","description":"ICD-MCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDRD1","description":"ICD-KDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19316","description":"Suspension of breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxygen concentrator_ dual","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1391","description":"Oxygen concentrator_ dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylprednisolone 80 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1040","description":"Methylprednisolone 80 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC13A","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54860","description":"Removal of epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWC1","description":"ICD-KCWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whchr litwt det arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1240","description":"Whchr litwt det arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9313","description":"Amoxicillin_ with or without clavulanate_ not prescribed as first line antibiotic at the time of diagnosis for documented reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODUD1","description":"ICD-ODUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLF1","description":"ICD-MKLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD1","description":"ICD-CCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc shoulder les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23075","description":"Exc shoulder les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYC1","description":"ICD-HIYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLD0","description":"ICD-AGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0779T","description":"Gastrointestinal myoelectrical activity study_ stomach through colon_ with interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30460","description":"Revision of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPF0","description":"ICD-JGPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKF0","description":"ICD-KBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair maxillofacial defects","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7955","description":"Repair maxillofacial defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAA1","description":"ICD-AEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1602","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1602","description":"HCPCS-B1602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCE0","description":"ICD-GHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Socket insert below knee","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5655","description":"Socket insert below knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pituitary evaluation panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80418","description":"Pituitary evaluation panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft tissue graft firsttooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4277","description":"Soft tissue graft firsttooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXD0","description":"ICD-OIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Opioid &opiate analog 5/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80364","description":"Opioid &opiate analog 5/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmnioBind_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4225","description":"AmnioBind_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC216","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9019","description":"Platelets_ each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUC1","description":"ICD-OEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp <5 yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99143","description":"Mod sedat phys/qhp <5 yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWF0","description":"ICD-LBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAVA0","description":"ICD-GAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHJB1","description":"ICD-NHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFIC1","description":"ICD-IFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMD1","description":"ICD-FGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo probably bengn docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3343F","description":"Mammo probably bengn docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA113","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHLF0","description":"ICD-JHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn pt cath >=90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9266","description":"Norsn pt cath >=90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 25%_ 20 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9046","description":"Albumin (human)_ 25%_ 20 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Who cock-up nonmolde pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3908","description":"Who cock-up nonmolde pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB1","description":"ICD-KGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AHKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft eye lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66225","description":"Repair/graft eye lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Odontics eposteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6040","description":"Odontics eposteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Store prev froz embryos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4027","description":"Store prev froz embryos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair liver wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47360","description":"Repair liver wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGND0","description":"ICD-JGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDDC0","description":"ICD-GDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove torus mandibularis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7473","description":"Remove torus mandibularis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel graft defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35870","description":"Repair vessel graft defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB0","description":"ICD-FAAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited autopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88036","description":"Limited autopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AATD0","description":"ICD-AATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB0","description":"ICD-NKPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHJB1","description":"ICD-KHJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE1","description":"ICD-LCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NADD1","description":"ICD-NADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mr angiography neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70548","description":"Mr angiography neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2B","description":"Ultra High Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJWF0","description":"ICD-PJWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c revrs trnscrpj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87522","description":"Hepatitis c revrs trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOC1","description":"ICD-KFOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFF0","description":"ICD-NJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation oocyte(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89337","description":"Cryopreservation oocyte(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA0","description":"ICD-JHXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Delay flap eye/nos/ear/lip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15630","description":"Delay flap eye/nos/ear/lip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prp i/hern init block >5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49507","description":"Prp i/hern init block >5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDC1","description":"ICD-CBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bile duct endoscopy add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47550","description":"Bile duct endoscopy add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4GA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4GA21","description":"ICD-4GA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA21","description":"ICD-4FA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0195","description":"Pneumococcal conjugate vaccine_ polyvalent_ intramuscular_ for children from five years to nine years of age who have not previously received the vaccine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3406","description":"HCPCS-J3406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC0","description":"ICD-IGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental tmj arthrogram incl i","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0320","description":"Dental tmj arthrogram incl i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC21B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24566","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDHB1","description":"ICD-CDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLC1","description":"ICD-MGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrst mld sck flx hng tri pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6050","description":"Wrst mld sck flx hng tri pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA1","description":"ICD-FEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96156","description":"Health Behavior Assessment_ Or Re-Assessment (Ie_ Health-Focused Clinical Interview_ Behavioral Observations_ Clinical Decision Making)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place needle in vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36000","description":"Place needle in vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA8E","description":"Ultra High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX0D","description":"High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0457T","description":"Removal of permanently implantable aortic counterpulsation ventricular assist system; mechano-electrical skin interface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ONC SLD TUM ALYS BRCA1 BRCA2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0172U","description":"ONC SLD TUM ALYS BRCA1 BRCA2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADC0","description":"ICD-AADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB13B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disp fee inhal drugs/30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0513","description":"Disp fee inhal drugs/30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brow wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15826","description":"Removal of brow wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMD1","description":"ICD-KBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagus surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43499","description":"Esophagus surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/ultrasound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44406","description":"Colonoscopy w/ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIIC1","description":"ICD-NIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repos prev impltbl subq dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33273","description":"Repos prev impltbl subq dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0802","description":"HCPCS-B0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBAF1","description":"ICD-NBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00320","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","description":"CPT-00320","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDC1","description":"ICD-EEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd tube/cath insertion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43241","description":"Egd tube/cath insertion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc 2x re-assess filt remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9543","description":"Doc 2x re-assess filt remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAF1","description":"ICD-MCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I125 serum albumin_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9532","description":"I125 serum albumin_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ CROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5170","description":"Hearing aid_ CROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99439","description":"Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More) Chronic Conditions Expected To Last At Least 12 Months_ Or Until The Death Of The","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ evinacumab-dgnb_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9079","description":"Injection_ evinacumab-dgnb_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX21","description":"Low Rehab plus Extensive _ ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBC0","description":"ICD-GFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA1","description":"ICD-BAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6603","description":"Gradient compression bandaging supply_ low density channel foam sheet_ per 250 square centimeters_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenervation anal musc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46505","description":"Chemodenervation anal musc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65275","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFSD0","description":"ICD-DFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18X","description":"Special Care High _ ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILE0","description":"ICD-KILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBC1","description":"ICD-IEBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMC1","description":"ICD-AEMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extremity study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93965","description":"Extremity study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFE0","description":"ICD-BBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHID0","description":"ICD-KHID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DA21","description":"ICD-2DA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB10C","description":"Special Care Low _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood gases w/o2 saturation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82805","description":"Blood gases w/o2 saturation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIJC0","description":"ICD-GIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0235U","description":"PTEN (phosphatase and tensin homolog) (eg_ Cowden syndrome_ PTEN hamartoma tumor syndrome)_ full gene analysis_ including small sequence changes in exonic and intronic regions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace aortic valve perq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33361","description":"Replace aortic valve perq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29892","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB1","description":"ICD-KHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 4 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0400","description":"Home sleep test/type 4 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CENF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CENF0","description":"ICD-CENF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD0","description":"ICD-MCUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAC0","description":"ICD-CAAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tricyclic & cyclicals 6/more","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80337","description":"Tricyclic & cyclicals 6/more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGC1","description":"ICD-GCGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ granisetron_ extended-release_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1627","description":"Injection_ granisetron_ extended-release_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBB0","description":"ICD-CCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0293U","description":"Psychiatry (Suicidal Ideation)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 54 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCXF1","description":"ICD-JCXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHMA1","description":"ICD-BHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYA0","description":"ICD-LEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA1B","description":"Ultra High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPD1","description":"ICD-CEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8H","description":"Medium Rehab _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKB1","description":"ICD-FEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB12","description":"High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICB1","description":"ICD-CICB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF1","description":"ICD-MJBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAD1","description":"ICD-JBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61510","description":"Removal of brain lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELF1","description":"ICD-GELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUA1","description":"ICD-CAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0451U","description":"Oncology (multiple myeloma)_ LC-MS/MS_ peptide ion quantification_ serum_ results compared with baseline to determine monoclonal paraprotein abundance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of skull arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61711","description":"Fusion of skull arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fentanyl citrate injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3010","description":"Fentanyl citrate injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAC0","description":"ICD-JCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card revasc mi 1 vsl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92941","description":"Prq card revasc mi 1 vsl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pp eval/edu not perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9358","description":"Pp eval/edu not perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVB1","description":"ICD-NDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITF0","description":"ICD-JITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPE1","description":"ICD-KBPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCEC1","description":"ICD-MCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reusable pull-on any size","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4536","description":"Reusable pull-on any size","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thromboxane urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84431","description":"Thromboxane urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of eyelid fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67715","description":"Incision of eyelid fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYF1","description":"ICD-DDYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice in inpatient psych","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5008","description":"Hospice in inpatient psych","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of umbilicus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49250","description":"Excision of umbilicus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWD1","description":"ICD-DGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQB0","description":"ICD-HBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEE1","description":"ICD-FCEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGC0","description":"ICD-JEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCPC1","description":"ICD-JCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX06","description":"Medium Rehab plus Extensive_ ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lower leg tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27675","description":"Repair lower leg tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX35","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJB0","description":"ICD-NJJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGD0","description":"ICD-CEGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy debridement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7877","description":"Tmj arthroscopy debridement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIC0","description":"ICD-GEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLE0","description":"ICD-JFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ionm in operatng room 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95940","description":"Ionm in operatng room 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J7530","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7530","description":"HCPCS-J7530","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIB0","description":"ICD-BHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29900","description":"Mcp joint arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray bile/panc endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74330","description":"X-ray bile/panc endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67112","description":"Repair of retinal detachment; by scleral buckling or vitrectomy_ on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA20","description":"Low Rehab_ ADL Index 0-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBC0","description":"ICD-FFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCFA1","description":"ICD-JCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0235","description":"Pet not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who died during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1342","description":"Patients who died during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2166","description":"Patient Refused To Participate At Admission And/Or Discharge; Patient Unable To Complete The Neck Fs Prom At Admission Or Discharge Due To Cognitive Deficit_ Visual Deficit_ M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAE0","description":"ICD-AAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWD0","description":"ICD-LAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1275","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXD1","description":"ICD-GAXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glycosylated hb home device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83037","description":"Glycosylated hb home device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHD0","description":"ICD-NDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22A","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLB0","description":"ICD-KHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2145","description":"Functional Status Measured By The Oswestry Disability Index (Odi Version 2.1A) At Three Months (6 ? 20 Weeks) Postoperatively Was Greater Than 22 And Functional Status Measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGA1","description":"ICD-FFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0791T","description":"Motor-cognitive_ semi-immersive virtual reality-facilitated gait training_ each 15 minutes (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj follitropin beta 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0128","description":"Inj follitropin beta 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD255","description":"Reduced Physical Function _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHGD1","description":"ICD-JHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUB0","description":"ICD-NJUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABA0","description":"ICD-OABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXD1","description":"ICD-ODXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIF1","description":"ICD-OFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient achieved a PDC of at least 75% for their asthma controller medication","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9810","description":"Patient achieved a PDC of at least 75% for their asthma controller medication","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIC0","description":"ICD-KBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF1","description":"ICD-KBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWD0","description":"ICD-LFWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81343","description":"PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHRC1","description":"ICD-PHRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGIE1","description":"ICD-OGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular stress test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93017","description":"Cardiovascular stress test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IETC0","description":"ICD-IETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OACF0","description":"ICD-OACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHD0","description":"ICD-KDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBA1","description":"ICD-BDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hexagnal phosph pltlt neutrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85598","description":"Hexagnal phosph pltlt neutrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFHB0","description":"ICD-IFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinal female jug-type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0326","description":"Urinal female jug-type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE1","description":"ICD-NAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIA1","description":"ICD-EHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHF0","description":"ICD-NLHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BETF0","description":"ICD-BETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cefiderocol_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0693","description":"Injection_ cefiderocol_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRC0","description":"ICD-PCRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMA0","description":"ICD-FCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gadofosveset trisodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9583","description":"Gadofosveset trisodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA0","description":"ICD-KEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL17","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHD1","description":"ICD-JFHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcysteine comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7604","description":"Acetylcysteine comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1124","description":"Ongoing Care Not Indicated_ Patient Discharged After Only 1-2 Visits Due To Specific Medical Events_ Documented In The Medical Record That Make The Treatment Episode Impossibl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary pouch w/barrier","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5071","description":"Urinary pouch w/barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKA0","description":"ICD-BDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewho erbs palsey design abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3962","description":"Sewho erbs palsey design abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50557","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive sternum surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21630","description":"Extensive sternum surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63086","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL13","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX25","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBMB0","description":"ICD-KBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0528","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0528","description":"HCPCS-J0528","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sp bone agrft morsel add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20937","description":"Sp bone agrft morsel add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6595","description":"Gradient compression bandaging supply_ bandage liner_ upper extremity_ any size or length_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA1","description":"ICD-FGFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAA1","description":"ICD-BFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAF0","description":"ICD-IFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cadaver donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50300","description":"Remove cadaver donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDID0","description":"ICD-JDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC236","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","description":"HCPCS-J0165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB1","description":"ICD-NEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41005","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18I","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVC1","description":"ICD-NEVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comp multiplane ext fixation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20696","description":"Comp multiplane ext fixation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA2B","description":"Very High Rehab _ ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHB1","description":"ICD-CAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo molded ankle gauntlet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1904","description":"Afo molded ankle gauntlet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINB0","description":"ICD-JINB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00145","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","description":"CPT-00145","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWA1","description":"ICD-CHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv adduct vocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2341","description":"Chemodenerv adduct vocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBIB1","description":"ICD-OBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAB1","description":"ICD-KAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9382","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","description":"HCPCS-J9382","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF1","description":"ICD-EIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet image skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78812","description":"Pet image skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMC0","description":"ICD-OCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXC1","description":"ICD-FBXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERF0","description":"ICD-OERF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGQB0","description":"ICD-KGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Routine ophthalmological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0621","description":"Routine ophthalmological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periacetabular osteotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2115","description":"Periacetabular osteotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJE0","description":"ICD-NLJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implt/rpl crtd sns dev total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0266T","description":"Implt/rpl crtd sns dev total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODWB0","description":"ICD-ODWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA1","description":"ICD-OHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVB0","description":"ICD-NFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAB1","description":"ICD-FAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAA0","description":"ICD-JDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA1","description":"ICD-GBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCC0","description":"ICD-KBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEHB1","description":"ICD-MEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flow cyto done b/4 tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3170F","description":"Flow cyto done b/4 tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNA1","description":"ICD-KFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGB0","description":"ICD-KCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGD1","description":"ICD-FEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTA1","description":"ICD-GDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCAD0","description":"ICD-OCAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34718","description":"Endovascular Repair Of Iliac Artery_ Not Associated With Placement Of An Aorto-Iliac Artery Endograft At The Same Session_ By Deployment Of An Iliac Branched Endograft_ Includ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart-vein defect(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33730","description":"Repair heart-vein defect(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject r ventr/atrial angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93566","description":"Inject r ventr/atrial angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB1","description":"ICD-EBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0935T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","description":"CPT-0935T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coude tip urinary catheter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4352","description":"Coude tip urinary catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3D","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC0","description":"ICD-BHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE1","description":"ICD-BILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHD0","description":"ICD-GCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAB1","description":"ICD-AEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB117","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLA1","description":"ICD-GHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVA1","description":"ICD-OFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36013","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GERE0","description":"ICD-GERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIC1","description":"ICD-NBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rn services up to 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1002","description":"Rn services up to 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLA1","description":"ICD-AGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGTB1","description":"ICD-MGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auto interm peritoneal dialy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1592","description":"Auto interm peritoneal dialy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74010","description":"X-ray exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBDE0","description":"ICD-GBDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECE0","description":"ICD-AECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBC1","description":"ICD-EHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable catheter tips","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4860","description":"Disposable catheter tips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHK6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEB0","description":"ICD-KDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKB1","description":"ICD-GCKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDC1","description":"ICD-BBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMF1","description":"ICD-OCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJB0","description":"ICD-NKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEF1","description":"ICD-KDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ guselkumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9029","description":"Injection_ guselkumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAND0","description":"ICD-NAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSD0","description":"ICD-KHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81184","description":"CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg_ spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF0","description":"ICD-JGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post 3 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2393","description":"Post 3 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa complexed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84152","description":"Assay of psa complexed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCXD0","description":"ICD-NCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ivf canc a stim case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4017","description":"Ivf canc a stim case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJD1","description":"ICD-CCJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo hormon antineopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96402","description":"Chemo hormon antineopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQA0","description":"ICD-KBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0736T","description":"Colonic lavage_ 35 or more liters of water_ gravity-fed_ with induced defecation_ including insertion of rectal catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Device handling phys/qhp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99002","description":"Device handling phys/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nose to lip fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42260","description":"Repair nose to lip fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of vein clot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34471","description":"Removal of vein clot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDE1","description":"ICD-ACDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYA0","description":"ICD-KEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast plstr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4003","description":"Cast sup shoulder cast plstr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vol reduction of blood/prod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86960","description":"Vol reduction of blood/prod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFA0","description":"ICD-BHFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIXD0","description":"ICD-NIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDBD0","description":"ICD-BDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC1","description":"ICD-JFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF0","description":"ICD-NFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQE1","description":"ICD-CDQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gel-one","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7326","description":"Gel-one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABA0","description":"ICD-FABA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8939","description":"Pain assessment documented as positive_ follow-up plan not documented_ documentation the patient is not eligible at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX23","description":"Very High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ready gradient sleeve","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8424","description":"Ready gradient sleeve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDE0","description":"ICD-IFDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCCE0","description":"ICD-JCCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWA0","description":"ICD-DDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blastomyces antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86612","description":"Blastomyces antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISF1","description":"ICD-KISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply short leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29425","description":"Apply short leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic eye other type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2629","description":"Prosthetic eye other type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOF1","description":"ICD-CIOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRF0","description":"ICD-HDRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEB1","description":"ICD-EGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYC1","description":"ICD-PHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD0","description":"ICD-OAMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise temple bone implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69718","description":"Revise temple bone implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1390","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","description":"HCPCS-M1390","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJXA0","description":"ICD-OJXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fun stat score knee pt noelg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8649","description":"Fun stat score knee pt noelg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36582","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC16","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7534","description":"Revascularization_ endovascular_ open or percutaneous_ femoral_ popliteal artery(ies)_ unilateral_ with atherectomy_ includes angioplasty within the same vessel_ when performe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0609","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","description":"HCPCS-J0609","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE1","description":"ICD-ADTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEED1","description":"ICD-JEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVD0","description":"ICD-KCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of hip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73525","description":"Contrast x-ray of hip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1100T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1100T","description":"CPT-1100T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBDB1","description":"ICD-EBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art trnsposj carotid subclav","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35695","description":"Art trnsposj carotid subclav","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUF1","description":"ICD-JBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIA0","description":"ICD-KBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJC1","description":"ICD-KFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAC1","description":"ICD-AEAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26600","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBEF1","description":"ICD-EBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28465","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB1","description":"ICD-AALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion 2 or more 3d images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0395","description":"Fusion 2 or more 3d images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTE0","description":"ICD-EFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAMF1","description":"ICD-MAMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAID1","description":"ICD-IAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of volatiles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84600","description":"Assay of volatiles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGLA1","description":"ICD-MGLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCIA0","description":"ICD-FCIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert pulse gen dual leads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33213","description":"Insert pulse gen dual leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65110","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADTE0","description":"ICD-ADTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0590U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","description":"CPT-0590U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX4D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoskeletal axial rotation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5984","description":"Endoskeletal axial rotation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEIE0","description":"ICD-JEIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA110","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE245","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5168","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5168","description":"HCPCS-Q5168","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGF1","description":"ICD-ODGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFKD1","description":"ICD-OFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTF0","description":"ICD-GHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC1","description":"ICD-BGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTE0","description":"ICD-AGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplan desig abdu pos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3960","description":"Sewho airplan desig abdu pos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Filtered speech hearing test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92571","description":"Filtered speech hearing test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBA1","description":"ICD-ECBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEC1","description":"ICD-FHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53200","description":"Biopsy of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSA1","description":"ICD-KHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DB31","description":"ICD-4DB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays pelvis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75736","description":"Artery x-rays pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL50","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral sol amino acid &","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4189","description":"Parenteral sol amino acid &","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"H pylori (c-13) breath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83013","description":"H pylori (c-13) breath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE255","description":"Clinically Complex _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHA1","description":"ICD-ACHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAB1","description":"ICD-IDAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOD1","description":"ICD-OJOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPD1","description":"ICD-JEPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNB1","description":"ICD-NBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCPE0","description":"ICD-BCPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPB1","description":"ICD-BEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYD1","description":"ICD-PFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5615","description":"Addition_ endoskeletal knee-shin system_ 4 bar linkage or multiaxial_ fluid swing and stance phase control","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELA1","description":"ICD-GELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMA1","description":"ICD-GAMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA02","description":"Low Rehab_ ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPF1","description":"ICD-BFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58600","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHWE0","description":"ICD-OHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4020","description":"Ophthalmology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC0","description":"ICD-BDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEE0","description":"ICD-OFEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd us exam duodenum/jejunum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43259","description":"Egd us exam duodenum/jejunum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCE0","description":"ICD-IHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFTE1","description":"ICD-FFTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFD0","description":"ICD-OCFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33853","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNB0","description":"ICD-JFNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLTA1","description":"ICD-NLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC0","description":"ICD-JCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABB1","description":"ICD-EABB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59151","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of toe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28153","description":"Partial removal of toe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRE1","description":"ICD-CFRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC1","description":"ICD-GIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0797T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GANC0","description":"ICD-GANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIYE1","description":"ICD-CIYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA16","description":"Low Rehab_ ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFKB0","description":"ICD-KFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scr c/v cyto_thinlayer_rescr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0144","description":"Scr c/v cyto_thinlayer_rescr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14302","description":"Adjacent tissue transfer or rearrangement_ any area; each additional 30.0 sq cm_ or part thereof (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCC0","description":"ICD-FFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFME1","description":"ICD-AFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of gland abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56420","description":"Drainage of gland abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMC0","description":"ICD-BFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMA0","description":"ICD-CHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABUA0","description":"ICD-ABUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2122","description":"Psychosis_ Depression_ Anxiety_ Apathy_ And Impulse Control Disorder Not Assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLCA1","description":"ICD-OLCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVF0","description":"ICD-OCVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC55","description":"Medium Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44384","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDC0","description":"ICD-EHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJB0","description":"ICD-GDJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHJC0","description":"ICD-OHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrogel drg >16<=48 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6243","description":"Hydrogel drg >16<=48 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEB0","description":"ICD-EAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEMF1","description":"ICD-AEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33903","description":"Percutaneous pulmonary artery revascularization by stent placement_ initial; abnormal connections_ bilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYB1","description":"ICD-CFYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLD0","description":"ICD-MKLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86364","description":"Tissue Transglutaminase_ Each Immunoglobulin (Ig) Class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspir/inj thyroid cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60300","description":"Aspir/inj thyroid cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l addl 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13122","description":"Cmplx rpr s/a/l addl 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC1","description":"ICD-PIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEB0","description":"ICD-MLEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATA0","description":"ICD-MATA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTE1","description":"ICD-BCTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00792","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","description":"CPT-00792","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Salivary gland function exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78232","description":"Salivary gland function exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl semi/precision attach","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6091","description":"Repl semi/precision attach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocollator unit portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0239","description":"Hydrocollator unit portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydralazine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0360","description":"Hydralazine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm adapt/boot couplin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5289","description":"Ald fm/dm adapt/boot couplin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJA0","description":"ICD-OAJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPF0","description":"ICD-OBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pdgfra gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81314","description":"Pdgfra gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Washed red blood cells unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9022","description":"Washed red blood cells unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231U","description":"CACNA1A (calcium voltage-gated channel subunit alpha 1A) (eg_ spinocerebellar ataxia)_ full gene analysis_ including small sequence changes in exonic and intronic regions_ del","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEUD1","description":"ICD-IEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec knee-shin swing/stance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5856","description":"Elec knee-shin swing/stance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE1","description":"ICD-ICHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt trans to hosp post d/c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8914","description":"Pt trans to hosp post d/c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIA1","description":"ICD-OJIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAQD1","description":"ICD-DAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIC0","description":"ICD-ACIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJA1","description":"ICD-BFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGB1","description":"ICD-FCGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDE0","description":"ICD-MDDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD1","description":"ICD-JEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB4C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHC0","description":"ICD-EEHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC12D","description":"Special Care High _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXE1","description":"ICD-GFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHMF0","description":"ICD-CHMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9589","description":"Instillation_ hexaminolevulinate hydrochloride_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0887T","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toc dur aneth to icu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9657","description":"Toc dur aneth to icu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCC0","description":"ICD-GHCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic colonoscopy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9937","description":"Diagnostic colonoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc neck les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21555","description":"Exc neck les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0201","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","description":"HCPCS-E0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGNE0","description":"ICD-KGNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOF0","description":"ICD-PCOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVA1","description":"ICD-OIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILC1","description":"ICD-MILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFM1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27659","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA03","description":"Medium Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFGF1","description":"ICD-NFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aminophyllin 250 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0280","description":"Aminophyllin 250 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0675","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","description":"HCPCS-J0675","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQD1","description":"ICD-OGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUF1","description":"ICD-JHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dtap-ipv-hib-hepb vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90697","description":"Dtap-ipv-hib-hepb vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFEA0","description":"ICD-EFEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUE1","description":"ICD-JCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB0","description":"ICD-JCNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC25A","description":"Special Care High _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reposition l ventric lead","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33226","description":"Reposition l ventric lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUD1","description":"ICD-CEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOD1","description":"ICD-PCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9275","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","description":"HCPCS-J9275","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach supply noc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8189","description":"Trach supply noc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seizure type& frequ docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1200F","description":"Seizure type& frequ docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHTA1","description":"ICD-JHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drill skull for implantation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61107","description":"Drill skull for implantation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYF1","description":"ICD-KGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0101","description":"HCPCS-C0101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg monitor technol attended","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95956","description":"Eeg monitor technol attended","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22840","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF1","description":"ICD-FFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC1","description":"ICD-GCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIQC0","description":"ICD-PIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD1","description":"ICD-LCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18X","description":"Clinically Complex _ ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrned for inj drug use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4290F","description":"Pt scrned for inj drug use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEB1","description":"ICD-OLEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB23","description":"Medium Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFLE0","description":"ICD-KFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA1","description":"ICD-NDDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB1","description":"ICD-OHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB11A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7615","description":"Levalbuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOE1","description":"ICD-PIOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FB21","description":"ICD-1FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKIB1","description":"ICD-MKIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGTF1","description":"ICD-KGTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of tear sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68525","description":"Biopsy of tear sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dipyridamole injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1245","description":"Dipyridamole injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX13","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate hand at wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25922","description":"Amputate hand at wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAA1","description":"ICD-CEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9949","description":"Leg pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 to 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGF1","description":"ICD-NHGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD201","description":"Clinically Complex _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mmrv vaccine sc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90710","description":"Mmrv vaccine sc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATB1","description":"ICD-CATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJF0","description":"ICD-NLJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90377","description":"Rabies Immune Globulin_ Heat- And Solvent/Detergent-Treated (Rig-Ht S/D)_ Human_ For Intramuscular And/Or Subcutaneous Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/pleurectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32656","description":"Thoracoscopy w/pleurectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart image spect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78494","description":"Heart image spect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB1B","description":"Low Rehab_ ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap esoph lengthening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43283","description":"Lap esoph lengthening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8G","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40840","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD0","description":"ICD-OBAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF0","description":"ICD-JIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6039","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","description":"HCPCS-L6039","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cont pas motion exercise dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0935","description":"Cont pas motion exercise dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB1","description":"ICD-FGUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg sacrococ teratoma","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2405","description":"Fetal surg sacrococ teratoma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHMA0","description":"ICD-KHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALF0","description":"ICD-BALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision malig lesion<=1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7413","description":"Excision malig lesion<=1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF1","description":"ICD-NGMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBJC1","description":"ICD-FBJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mechlorethamine hcl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9230","description":"Mechlorethamine hcl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUD0","description":"ICD-IAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCUC0","description":"ICD-OCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVB0","description":"ICD-NKVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBHE0","description":"ICD-IBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical path gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88300","description":"Surgical path gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC0","description":"ICD-CBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft subclav-vertbrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35515","description":"Art byp grft subclav-vertbrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen crosslinking cornea","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0402T","description":"Collagen crosslinking cornea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQA1","description":"ICD-CIQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCLC0","description":"ICD-JCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCWE1","description":"ICD-OCWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVF1","description":"ICD-GIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-35602","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","description":"CPT-35602","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRD0","description":"ICD-LCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXB0","description":"ICD-CGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILA1","description":"ICD-EILA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0170U","description":"Neurology (autism spectrum disorder ASD) RNA next-generation sequencing saliva algorithmic analysis and results reported as predictive probability of ASD diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHD0","description":"ICD-OKHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGC0","description":"ICD-NDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco use txmnt counseling","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4000F","description":"Tobacco use txmnt counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBND1","description":"ICD-BBND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETA1","description":"ICD-OETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA1","description":"ICD-CDCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXC1","description":"ICD-NFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJD1","description":"ICD-KIJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXE0","description":"ICD-BBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7543","description":"Endoscopic retrograde cholangiopancreatography (ercp) with sphincterotomy/papillotomy_ with endoscopic cannulation of papilla with direct visualization of pancreatic/common bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQF1","description":"ICD-LDQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psori tool doc w/benchmk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9649","description":"Psori tool doc w/benchmk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHUA0","description":"ICD-AHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bld glucose monitor w lance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2101","description":"Bld glucose monitor w lance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01656","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","description":"CPT-01656","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBBF0","description":"ICD-CBBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer tub rail attachment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0246","description":"Transfer tub rail attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQB1","description":"ICD-DBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0426","description":"Als 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth neck vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35251","description":"Anesth neck vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9696","description":"Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1832","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","description":"HCPCS-E1832","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73540","description":"Radiologic examination_ pelvis and hips_ infant or child_ minimum of two views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88016","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKB1","description":"ICD-NDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEB0","description":"ICD-BGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81513","description":"Infectious Disease_ Bacterial Vaginosis_ Quantitative Real-Time Amplification Of Rna Markers For Atopobium Vaginae_ Gardnerella Vaginalis_ And Lactobacillus Species_ Utilizing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVA0","description":"ICD-JCVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NINA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NINA0","description":"ICD-NINA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of split wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12021","description":"Closure of split wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0479T","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof_ or 1% of body surface area of infants and childre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD1","description":"ICD-GDJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rec ace/arb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8506","description":"Pt rec ace/arb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ortho shoe add full sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3540","description":"Ortho shoe add full sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML0B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACC0","description":"ICD-IACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEBB1","description":"ICD-NEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCLD0","description":"ICD-OCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24650","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJBA0","description":"ICD-NJBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIF0","description":"ICD-MLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYB1","description":"ICD-OLYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAF1","description":"ICD-CBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin tags add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11201","description":"Remove skin tags add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBUF1","description":"ICD-BBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYE1","description":"ICD-PFYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHIE1","description":"ICD-EHIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28B","description":"Clinically Complex _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHID1","description":"ICD-GHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBND0","description":"ICD-OBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEB1","description":"ICD-EHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc medrsn no hist type rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9288","description":"Doc medrsn no hist type rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJE1","description":"ICD-GHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94619","description":"Exercise Test For Bronchospasm_ Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCDD0","description":"ICD-NCDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXA0","description":"ICD-GAXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93569","description":"Injection procedure during cardiac catheterization including imaging supervision_ interpretation_ and report; for selective pulmonary arterial angiography_ unilateral (List se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIE0","description":"ICD-GDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0504U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","description":"CPT-0504U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete max","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0366","description":"Cone beam ct interprete max","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAC0","description":"ICD-EHAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MELA1","description":"ICD-MELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advnc care plan tlk docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1158F","description":"Advnc care plan tlk docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CALD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CALD1","description":"ICD-CALD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9051","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0136","description":"Administration of a standardized_ evidence-based social determinants of health risk assessment tool_ 5-15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOE1","description":"ICD-GHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KATA1","description":"ICD-KATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXB0","description":"ICD-KEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sps wrist device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1806","description":"Sps wrist device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8442","description":"Pain assessment not documented as being performed_ documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLC1","description":"ICD-JGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dermal filler inj px/suppl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9800","description":"Dermal filler inj px/suppl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bunion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28293","description":"Correction of bunion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAHF0","description":"ICD-MAHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAPD1","description":"ICD-GAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision benign lesion>1.25c","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7411","description":"Excision benign lesion>1.25c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLF0","description":"ICD-EGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5150","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","description":"HCPCS-Q5150","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAA1","description":"ICD-OGAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFID1","description":"ICD-OFID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNA1","description":"ICD-OKNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF1","description":"ICD-FDMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove pulmonary shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33924","description":"Remove pulmonary shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust wrist ext/flex device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1805","description":"Adjust wrist ext/flex device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4217","description":"Woundfix_ BioWound_ Woundfix Plus_ BioWound Plus_ Woundfix Xplus or BioWound Xplus_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GA31","description":"ICD-2GA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJRC0","description":"ICD-OJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBA0","description":"ICD-EFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCF1","description":"ICD-FBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD140","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0015M","description":"Adrenal cortical tumor_ biochemical assay of 25 steroid markers_ utilizing 24-hour urine specimen and clinical parameters_ prognostic algorithm reported as a clinical risk and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLB1","description":"ICD-KGLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial allergy tests","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95070","description":"Bronchial allergy tests","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRD0","description":"ICD-LDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFTB1","description":"ICD-EFTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0150U","description":"Drug assay_ definitive_ 120 or more drugs or metabolites_ urine_ quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Power module combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0479","description":"Power module combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"W/c component-accessory nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0108","description":"W/c component-accessory nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic casts","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0470","description":"Diagnostic casts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl nstim apnea stimj ld","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0430T","description":"Rmvl nstim apnea stimj ld","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36590","description":"Removal tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shortening of thigh bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27465","description":"Shortening of thigh bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND0","description":"ICD-KHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAFD1","description":"ICD-GAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disease progn ra good docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3476F","description":"Disease progn ra good docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHF1","description":"ICD-CCHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC0","description":"ICD-LDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC31","description":"ICD-4CC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFMF1","description":"ICD-NFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC13A","description":"Clinically Complex _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx prostate t3b-t4noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9079","description":"Onc dx prostate t3b-t4noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVE1","description":"ICD-OAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRF0","description":"ICD-KBRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDMC1","description":"ICD-EDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX0A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conform band n/s w>=3in<5in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6443","description":"Conform band n/s w>=3in<5in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA225","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAE0","description":"ICD-NLAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIED1","description":"ICD-FIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serial tonometry exam(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92100","description":"Serial tonometry exam(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFFB1","description":"ICD-BFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFC1","description":"ICD-BDFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical food oral 100% nutr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9433","description":"Medical food oral 100% nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ezderm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4136","description":"Ezderm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group therapeutic procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97150","description":"Group therapeutic procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmptr ophth img optic nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92133","description":"Cmptr ophth img optic nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJB1","description":"ICD-FEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct injured chest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32820","description":"Reconstruct injured chest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOD1","description":"ICD-KHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSC0","description":"ICD-GHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analys placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88267","description":"Chromosome analys placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQB1","description":"ICD-HIQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGIC1","description":"ICD-AGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIC1","description":"ICD-NHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVE0","description":"ICD-JHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBB1","description":"ICD-GGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cerliponase alfa_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9014","description":"Injection_ cerliponase alfa_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1068T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1068T","description":"CPT-1068T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWE1","description":"ICD-DEWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Potassium hydroxide preps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0112","description":"Potassium hydroxide preps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILC0","description":"ICD-NILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixed wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0435","description":"Fixed wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Food thickener oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4100","description":"Food thickener oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSF1","description":"ICD-LHSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endometrial sampling or hysteroscopy with biopsy and results documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9823","description":"Endometrial sampling or hysteroscopy with biopsy and results documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31528","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHB0","description":"ICD-BIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8D","description":"High Rehab _ ADL Index 0-5/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDMC1","description":"ICD-JDMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove intrauterine device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58301","description":"Remove intrauterine device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2779","description":"Injection_ ranibizumab_ via intravitreal implant (Susvimo)_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES320","description":"Extensive Services _ ADL Index 2-16/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGLX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUA0","description":"ICD-BCUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6910","description":"Hand restoration no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYE0","description":"ICD-GDYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5D","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDUD0","description":"ICD-KDUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectourethral fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45820","description":"Repair rectourethral fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of foot at ankle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27888","description":"Amputation of foot at ankle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9130","description":"Temproromandibular Joint Dysfunction - non-invasive physical therapies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mntr io press 24hrs/> uni/bi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0329T","description":"Mntr io press 24hrs/> uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0869T","description":"Injection(s)_ bone-substitute material for bone and/or soft tissue hardware fixation augmentation_ including intraoperative imaging guidance_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC131","description":"Special Care High _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDA0","description":"ICD-NDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLED1","description":"ICD-NLED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFLA1","description":"ICD-NFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove self-contd penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54415","description":"Remove self-contd penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEME1","description":"ICD-EEME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mltispectrl digital les alys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0400T","description":"Mltispectrl digital les alys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace duod/jej tube perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49451","description":"Replace duod/jej tube perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUE0","description":"ICD-FFUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Z7610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Z7610","description":"HCPCS-Z7610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct pelvis w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72194","description":"Ct pelvis w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0804","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0804","description":"HCPCS-B0804","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2010","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g._ store and forward)_ including inte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spirom fev/fvc <70% w/copd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3025F","description":"Spirom fev/fvc <70% w/copd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKVB1","description":"ICD-OKVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBD1","description":"ICD-KIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13D","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC210","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/ stablj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21320","description":"Closed tx nose fx w/ stablj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation therapy planning","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77261","description":"Radiation therapy planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLB0","description":"ICD-JFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYB0","description":"ICD-OHYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj filgrastim excl biosimil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1442","description":"Inj filgrastim excl biosimil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB1","description":"ICD-FDGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIAF0","description":"ICD-IIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D6193","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D6193","description":"CDT-D6193","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAA0","description":"ICD-JEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7322","description":"Hyaluronan or derivative_ hymovis_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA0","description":"ICD-JGGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97172","description":"Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient_s current functional status when there is a documented change;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0933T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","description":"CPT-0933T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"removal of non-resorbable barrier","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4286","description":"removal of non-resorbable barrier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDD1","description":"ICD-MHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGPF1","description":"ICD-NGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Silvr oxide batt glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4236","description":"Silvr oxide batt glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB3A","description":"Ultra High Rehab _ ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMC1","description":"ICD-MCMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thoracolmb 2/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72080","description":"X-ray exam thoracolmb 2/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD0","description":"ICD-GACD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMA0","description":"ICD-BAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72126","description":"Ct neck spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81338","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Common Variants (Eg_ W515A_ W515K_ W515L_ W515R)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD136","description":"Clinically Complex _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genvisc_ inj_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9980","description":"Genvisc_ inj_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95721","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHED1","description":"ICD-AHED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXB0","description":"ICD-BFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF1","description":"ICD-NGIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBF0","description":"ICD-BGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFF0","description":"ICD-GDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF0","description":"ICD-CCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery for hearing device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5266","description":"Battery for hearing device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICID0","description":"ICD-ICID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDE0","description":"ICD-OGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Teriparatide injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3110","description":"Teriparatide injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFF1","description":"ICD-NCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression garment_ toe caps_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6572","description":"Gradient compression garment_ toe caps_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ear protector evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92596","description":"Ear protector evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treprostinil_ non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7686","description":"Treprostinil_ non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWD1","description":"ICD-LDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck/chest surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21899","description":"Neck/chest surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgicl dress hold non-reuse","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4461","description":"Surgicl dress hold non-reuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEE0","description":"ICD-MHEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evaluation of wheezing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94070","description":"Evaluation of wheezing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE1","description":"ICD-ADIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2164","description":"Patient Had A Prior Influenza Virus Vaccine Adverse Reaction Any Time Before Or During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAB0","description":"ICD-FEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAF1","description":"ICD-IBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8E","description":"Medium Rehab _ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp grade elec breast pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0604","description":"Hosp grade elec breast pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESD0","description":"ICD-PESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9806","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9806","description":"HCPCS-C9806","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenting class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9444","description":"Parenting class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYF1","description":"ICD-CEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFDB0","description":"ICD-OFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDJE1","description":"ICD-BDJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of halo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20664","description":"Application of halo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHC1","description":"ICD-MHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0305","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0305","description":"CDT-D0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rechanneling of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35351","description":"Rechanneling of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9705","description":"AJCC breast cancer stage I: T1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKB0","description":"ICD-JCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77285","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove armpit lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38740","description":"Remove armpit lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation patient unable to communicate and informant not available","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2183","description":"Documentation patient unable to communicate and informant not available","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBSD0","description":"ICD-DBSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1406","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","description":"HCPCS-M1406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHMA1","description":"ICD-FHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBD1","description":"ICD-EBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUF0","description":"ICD-NGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5212","description":"Hearing aid_ contralateral routing system_ binaural_ ITE/ITC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPA1","description":"ICD-FCPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 pentetreotide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9572","description":"Indium in-111 pentetreotide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD1","description":"ICD-BGUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIAC0","description":"ICD-EIAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWC1","description":"ICD-HEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBLD1","description":"ICD-BBLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0512","description":"Rural health clinic or federally qualified health center (RHC/FQHC) only_ psychiatric collaborative care model (psychiatric COCM)_ 60 minutes or more of clinical staff time fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE251","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWF1","description":"ICD-LFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion/graft of wrist joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25805","description":"Fusion/graft of wrist joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCF1","description":"ICD-GDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nicardipine_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2404","description":"Injection_ nicardipine_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAF1","description":"ICD-OBAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ankle arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29891","description":"Ankle arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGKD1","description":"ICD-JGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft axill-brachial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35522","description":"Art byp grft axill-brachial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD21A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBF0","description":"ICD-KDBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIYF1","description":"ICD-LIYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBHC0","description":"ICD-JBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJCE0","description":"ICD-NJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPA1","description":"ICD-CAPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBA1","description":"ICD-FFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of tobramycin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80200","description":"Assay of tobramycin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBB1","description":"ICD-NFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHD1","description":"ICD-IDHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMA1","description":"ICD-MLMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decitabine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0894","description":"Decitabine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thyroid met uptake","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78020","description":"Thyroid met uptake","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDF0","description":"ICD-NJDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove ankle joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27625","description":"Remove ankle joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWE1","description":"ICD-GIWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Norsn incomp inf antibio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9302","description":"Norsn incomp inf antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrist arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29843","description":"Wrist arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Benesch boot pair infant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3212","description":"Benesch boot pair infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJC1","description":"ICD-GAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gingival flap proc w/ planin","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4240","description":"Gingival flap proc w/ planin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In111 oxyquinoline","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9547","description":"In111 oxyquinoline","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90624","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","description":"CPT-90624","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17451","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA4C","description":"Default_ /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26548","description":"Reconstruct finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKF1","description":"ICD-JBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCNE1","description":"ICD-CCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extra heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0007","description":"Extra heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHC1","description":"ICD-NLHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLUC1","description":"ICD-OLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sc ther infusion reset pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96371","description":"Sc ther infusion reset pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLF0","description":"ICD-MCLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nursing fac care subseq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99308","description":"Nursing fac care subseq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMA0","description":"ICD-OCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1038T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1038T","description":"CPT-1038T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of big toe joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28755","description":"Fusion of big toe joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIF1","description":"ICD-GEIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57410","description":"Pelvic examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0465","description":"Autologous Platelet Rich Plasma (Prp) For Diabetic Chronic Wounds/Ulcers_ Using An Fda-Cleared Device (Includes Administration_ Dressings_ Phlebotomy_ Centrifug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mycobacteria dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87550","description":"Mycobacteria dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDIA1","description":"ICD-FDIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom abutment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6057","description":"Custom abutment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth kidney stone destruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87251","description":"Anesth kidney stone destruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress eye socket","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61330","description":"Decompress eye socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQB1","description":"ICD-LCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFVE1","description":"ICD-OFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GC11","description":"ICD-2GC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTC0","description":"ICD-MFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGFA0","description":"ICD-FGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE0","description":"ICD-OILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibio rx w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9286","description":"Antibio rx w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28435","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSD0","description":"ICD-KDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fosaprepitant injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1453","description":"Fosaprepitant injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD1","description":"ICD-IGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hla class i semiquant panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86834","description":"Hla class i semiquant panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEF1","description":"ICD-GHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine cord vsl thrlmb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63252","description":"Revise spine cord vsl thrlmb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2175","description":"Episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date (e.g._ tuberculosis_ neutropenia_ cystic fibrosis_ chronic b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRB0","description":"ICD-GGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphc trifo 7.25-12/4.25","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2313","description":"Lens sphc trifo 7.25-12/4.25","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vert xdrl body thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63301","description":"Remove vert xdrl body thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYC1","description":"ICD-PLYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMF0","description":"ICD-BCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0518","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription drug_ per 90-days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Matrion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4201","description":"Matrion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23462","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKA1","description":"ICD-BGKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWA1","description":"ICD-GCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA115","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection into spinal artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62294","description":"Injection into spinal artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FC21","description":"ICD-4FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPB0","description":"ICD-OLPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA1","description":"ICD-HGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp3 std sing pow opt s/b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0856","description":"Pwc gp3 std sing pow opt s/b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88333","description":"Intraop cyto path consult 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFIE0","description":"ICD-EFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hallux implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8642","description":"Hallux implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF0","description":"ICD-LFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit prenatal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99500","description":"Home visit prenatal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA0","description":"ICD-EBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHE0","description":"ICD-EBHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD1","description":"ICD-HHWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEA0","description":"ICD-ADEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPC1","description":"ICD-OLPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAF1","description":"ICD-MIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA12","description":"High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0459U","description":"B-amyloid (Abeta42) and total tau (tTau)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pathology","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1815","description":"Insulin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMA0","description":"ICD-MEMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam thorac spine 3vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72072","description":"X-ray exam thorac spine 3vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCWA1","description":"ICD-DCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise hip joint replacement","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27134","description":"Revise hip joint replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKQB0","description":"ICD-PKQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac cond noadd by guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9061","description":"Onc prac cond noadd by guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rigid ped wc adjustable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1235","description":"Rigid ped wc adjustable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTD0","description":"ICD-KDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Papaverin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2440","description":"Papaverin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Voltage-Gated Calcium Channel Antibody_ Each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86596","description":"Voltage-Gated Calcium Channel Antibody_ Each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD0","description":"ICD-MIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDYA0","description":"ICD-PDYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc abd tum over 10 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49205","description":"Exc abd tum over 10 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF1","description":"ICD-LEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD0","description":"ICD-KDBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL4C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYA0","description":"ICD-PHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25A","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFSE0","description":"ICD-HFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFB1","description":"ICD-NHFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNE1","description":"ICD-JFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEA0","description":"ICD-OJEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDD0","description":"ICD-EFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE240","description":"Special Care High _ ADL Index 15-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFA1","description":"ICD-CCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGD0","description":"ICD-KHGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13A","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis access system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1881","description":"Dialysis access system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematopoietic nuclear tx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79403","description":"Hematopoietic nuclear tx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVB0","description":"ICD-BEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser surg penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54057","description":"Laser surg penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFD0","description":"ICD-KBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay ph body fluid nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83986","description":"Assay ph body fluid nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIVD1","description":"ICD-CIVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCC1","description":"ICD-OHCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of ovarian cyst(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58800","description":"Drainage of ovarian cyst(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGLF1","description":"ICD-OGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt fixed arm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1087","description":"Wheelchair lightwt fixed arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37285","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","description":"CPT-37285","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esoph bx rprt w/dyspl info","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3126F","description":"Esoph bx rprt w/dyspl info","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFBD0","description":"ICD-CFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOD1","description":"ICD-DAOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUB1","description":"ICD-KAUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFA0","description":"ICD-JGFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21085","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of finger tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26474","description":"Fusion of finger tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Metered dose inhaler drug","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3535","description":"Metered dose inhaler drug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE0","description":"ICD-KELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ anesthetic agent; spinal accessory nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64412","description":"Injection_ anesthetic agent; spinal accessory nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF1","description":"ICD-IAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of triglycerides","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84478","description":"Assay of triglycerides","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTA0","description":"ICD-CFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b surface antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86706","description":"Hep b surface antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKC1","description":"ICD-NEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQC1","description":"ICD-CGQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB230","description":"Special Care Low _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARA0","description":"ICD-DARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transport portable ekg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"R0076","description":"Transport portable ekg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Man w/c push-rim powr system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0986","description":"Man w/c push-rim powr system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBD0","description":"ICD-JEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cult skin grft f/n/hfg add","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15156","description":"Cult skin grft f/n/hfg add","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3HB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3HB31","description":"ICD-3HB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVB0","description":"ICD-FBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2high risk no ord","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9368","description":"2high risk no ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KILC0","description":"ICD-KILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not achieve flat retinas six months post surgery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9379","description":"Patient did not achieve flat retinas six months post surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCA0","description":"ICD-IFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","description":"HCPCS-M1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFC0","description":"ICD-KFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDE1","description":"ICD-FHDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBVF1","description":"ICD-NBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC23D","description":"Special Care High _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFGC1","description":"ICD-BFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-routine bl draw 3/> yrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36410","description":"Non-routine bl draw 3/> yrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oasis tri-layer wound matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4124","description":"Oasis tri-layer wound matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth trachea bronchi surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54851","description":"Anesth trachea bronchi surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTB0","description":"ICD-ABTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA1","description":"ICD-OFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA12B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIJA1","description":"ICD-JIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAE0","description":"ICD-MGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPD0","description":"ICD-OIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","description":"HCPCS-J9024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1CA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1CA21","description":"ICD-1CA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEF0","description":"ICD-IDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88000","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB246","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sodium fluoride f-18","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9580","description":"Sodium fluoride f-18","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28450","description":"Treat midfoot fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALE1","description":"ICD-OALE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55714","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","description":"CPT-55714","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQE1","description":"ICD-CCQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral antiplat thx rx dischrg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4073F","description":"Oral antiplat thx rx dischrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EATF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EATF0","description":"ICD-EATF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIC1","description":"ICD-ODIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBB0","description":"ICD-IDBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC0","description":"ICD-KCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHSC1","description":"ICD-CHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBF0","description":"ICD-FIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDF0","description":"ICD-CEDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB0","description":"ICD-OFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC11","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87802","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Streptococcus_ group B","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOB1","description":"ICD-OKOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx l/r atrial fib addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93657","description":"Tx l/r atrial fib addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCD1","description":"ICD-FBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFA0","description":"ICD-OFFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEHE0","description":"ICD-KEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPD0","description":"ICD-FHPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aprepitant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0185","description":"Injection_ aprepitant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBCC1","description":"ICD-BBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCD0","description":"ICD-EFCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD0","description":"ICD-GIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAB1","description":"ICD-NLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sho lift taper to metatarsal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3300","description":"Sho lift taper to metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCHC1","description":"ICD-JCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFWE0","description":"ICD-HFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBE0","description":"ICD-NBBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDF0","description":"ICD-FDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA0","description":"ICD-PGRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRC0","description":"ICD-OIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/svc dme non-oxygen eq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0739","description":"Repair/svc dme non-oxygen eq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA1","description":"ICD-FANA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAA1","description":"ICD-MJAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dicom format doc on rpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9340","description":"Dicom format doc on rpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AALB0","description":"ICD-AALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBC0","description":"ICD-NLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDUA1","description":"ICD-IDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sex transformation f to m","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55980","description":"Sex transformation f to m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfusion procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86999","description":"Transfusion procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0367U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ diagnostic algorithm reported as a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB210","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stance phase only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5858","description":"Stance phase only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00546","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","description":"CPT-00546","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKC1","description":"ICD-OBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFD0","description":"ICD-CIFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC204","description":"Special Care Low _ ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES35B","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bowel to bowel fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44130","description":"Bowel to bowel fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA1","description":"ICD-KCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQA0","description":"ICD-PJQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9801","description":"Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99342","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUB0","description":"ICD-ECUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIDB1","description":"ICD-IIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQF1","description":"ICD-DGQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHDB0","description":"ICD-MHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Porcelain/ceramic inlay 2srf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6600","description":"Porcelain/ceramic inlay 2srf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CINC0","description":"ICD-CINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDF1","description":"ICD-BHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parenteral 50% dextrose solu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4164","description":"Parenteral 50% dextrose solu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Femoral lgth sock fx or equa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2850","description":"Femoral lgth sock fx or equa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKPD1","description":"ICD-OKPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histoplasma antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86698","description":"Histoplasma antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC17","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELD0","description":"ICD-BELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1043","description":"Functional status measurement with score was not obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of small intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44125","description":"Removal of small intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cough stimulating device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0482","description":"Cough stimulating device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BFK5","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLLE0","description":"ICD-NLLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hinge extension/flex wrist/f","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3900","description":"Hinge extension/flex wrist/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSD0","description":"ICD-KFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRB0","description":"ICD-OFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth pharyngeal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17651","description":"Anesth pharyngeal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient refused to participate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9726","description":"Patient refused to participate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAE1","description":"ICD-CAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPC0","description":"ICD-GCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35216","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JILB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JILB0","description":"ICD-JILB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFF1","description":"ICD-NGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA0","description":"ICD-NEUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Othe therapist at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9478","description":"Othe therapist at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSD1","description":"ICD-GGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDB1","description":"ICD-FBDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJC0","description":"ICD-NLJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE244","description":"Special Care High _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB1","description":"ICD-ODBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375U","description":"Oncology (ovarian)_ biochemical assays of 7 proteins (follicle stimulating hormone_ human epididymis protein 4_ apolipoprotein A-1_ transferrin_ beta-2 macroglobulin_ prealbum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52320","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDA1","description":"ICD-EEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMA0","description":"ICD-ABMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheeled cart_ port cyl/conc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1354","description":"Wheeled cart_ port cyl/conc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CHLAMYDIA TRACHOMATIS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87320","description":"IAAD IA CHLAMYDIA TRACHOMATIS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEE1","description":"ICD-BHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24560","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNC1","description":"ICD-FGNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endocerv curettage w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57456","description":"Endocerv curettage w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0702","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0702","description":"HCPCS-A0702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC136","description":"Special Care High _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB0","description":"ICD-FAJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKB1","description":"ICD-BEKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cycler dialysis machine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1594","description":"Cycler dialysis machine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKXB1","description":"ICD-NKXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx gastric unknown nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9104","description":"Onc dx gastric unknown nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC244","description":"Clinically Complex _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmt harv/transpl 28d pkg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2150","description":"Bmt harv/transpl 28d pkg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Re-evalest ptproblem focus","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0170","description":"Re-evalest ptproblem focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLDC1","description":"ICD-NLDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0677U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677U","description":"CPT-0677U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antistreptolysin o screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86063","description":"Antistreptolysin o screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB220","description":"Clinically Complex _ ADL Index 2-5/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0874","description":"Injection_ daptomycin (Baxter)_ not therapeutically equivalent to J0878_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFME0","description":"ICD-BFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx contour defects 5.1-10cc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11952","description":"Tx contour defects 5.1-10cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQC0","description":"ICD-DEQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCMA0","description":"ICD-BCMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAEA1","description":"ICD-NAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXB0","description":"ICD-NBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJD0","description":"ICD-OIJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cnslng chldbrng women epi","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4340F","description":"Cnslng chldbrng women epi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE24A","description":"Special Care High _ ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF1","description":"ICD-OFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA22B","description":"Reduced Physical Function _ ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE213","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Septal defect imp sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1817","description":"Septal defect imp sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFK5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0316","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA SHIGA-LIKE TOXIN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87427","description":"IAAD IA SHIGA-LIKE TOXIN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow disart myoelectronic c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6945","description":"Elbow disart myoelectronic c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNA1","description":"ICD-KBNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0497U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","description":"CPT-0497U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thigh pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15953","description":"Remove thigh pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEKD1","description":"ICD-NEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCEA0","description":"ICD-KCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth hernia repair < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83451","description":"Anesth hernia repair < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of uvula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42140","description":"Excision of uvula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVB1","description":"ICD-JGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGE0","description":"ICD-KAGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFC0","description":"ICD-OFFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52281","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRF0","description":"ICD-KHRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHA1","description":"ICD-GFHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22207","description":"Incis spine 3 column lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIQE0","description":"ICD-CIQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFVB1","description":"ICD-BFVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1600","description":"Catheter_ transluminal intravascular lesion preparation device_ bladed_ sheathed (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLD0","description":"ICD-JFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGCA0","description":"ICD-IGCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCD1","description":"ICD-EGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","description":"HCPCS-E1808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD25C","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELC0","description":"ICD-KELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD18F","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-molded lacer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2320","description":"Non-molded lacer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYC0","description":"ICD-CFYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Zanamivir_inhalation pwd 10m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9018","description":"Zanamivir_inhalation pwd 10m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE1","description":"ICD-BFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA0","description":"ICD-KDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB117","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNC1","description":"ICD-JBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDB1","description":"ICD-OJDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBE1","description":"ICD-MJBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0466T","description":"Insertion of chest wall respiratory sensor electrode or electrode array_ including connection to pulse generator (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEB0","description":"ICD-BEEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alteplase recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2997","description":"Alteplase recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGB1","description":"ICD-FGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFC0","description":"ICD-JHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of spermatic ducts","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54900","description":"Fusion of spermatic ducts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21246","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGF1","description":"ICD-OLGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBTF0","description":"ICD-FBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28C","description":"Special Care High _ ADL Index 15-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQE0","description":"ICD-DEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supported employ_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2024","description":"Supported employ_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skeletal muscle relaxant 1/2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80369","description":"Skeletal muscle relaxant 1/2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release palm & finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26442","description":"Release palm & finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDD0","description":"ICD-NKDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clot factor xiii fibrin stab","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85290","description":"Clot factor xiii fibrin stab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIA0","description":"ICD-IAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0134A","description":"IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC5C","description":"Medium Rehab _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reimplantation of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50380","description":"Reimplantation of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATE1","description":"ICD-NATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28F","description":"Special Care High _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC15C","description":"Special Care Low _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIFC1","description":"ICD-CIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of leg tendon each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27664","description":"Repair of leg tendon each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1606","description":"Adapter_ single-use (i.e._ disposable)_ for attaching ultrasound system to upper gastrointestinal endoscope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M0236","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","description":"HCPCS-M0236","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPB0","description":"ICD-FHPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF1","description":"ICD-GFDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTC1","description":"ICD-JCTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJC0","description":"ICD-OBJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMF0","description":"ICD-MIMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom grad glove med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8425","description":"Custom grad glove med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGC0","description":"ICD-KHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWA1","description":"ICD-LHWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBE1","description":"ICD-ECBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHLD0","description":"ICD-KHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald fm/dm system_ monaural","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5281","description":"Ald fm/dm system_ monaural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remov vert idrl bdy thrclmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63306","description":"Remov vert idrl bdy thrclmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat neck spine fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22326","description":"Treat neck spine fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrst x-ray uppr gi tract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74249","description":"Contrst x-ray uppr gi tract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAJD1","description":"ICD-GAJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNF1","description":"ICD-JCNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOC0","description":"ICD-HIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC1","description":"ICD-NCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert major vessel graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33330","description":"Insert major vessel graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of hip tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27005","description":"Incision of hip tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of thigh brace","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20663","description":"Application of thigh brace","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYE0","description":"ICD-CFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair testis injury","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54670","description":"Repair testis injury","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA0","description":"ICD-MAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair septal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33852","description":"Repair septal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sinusitis intent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9463","description":"Sinusitis intent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1115","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFM4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRA0","description":"ICD-GDRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE134","description":"Clinically Complex _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCD1","description":"ICD-MKCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUC1","description":"ICD-CHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLYF1","description":"ICD-PLYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel bulge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57268","description":"Repair of bowel bulge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lacer molded to patient mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2330","description":"Lacer molded to patient mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVC0","description":"ICD-CCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUD1","description":"ICD-FCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gi/renal risk assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1008F","description":"Gi/renal risk assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip bone les super","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27065","description":"Remove hip bone les super","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIC1","description":"ICD-ABIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAA0","description":"ICD-CAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v interpret","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88141","description":"Cytopath c/v interpret","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYD0","description":"ICD-HGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking garter belt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6544","description":"Gc stocking garter belt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETA1","description":"ICD-AETA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-70472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","description":"CPT-70472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC0","description":"ICD-KCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teplizumab-mzwv_ 5 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9149","description":"Injection_ teplizumab-mzwv_ 5 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFK3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLKE1","description":"ICD-OLKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEF1","description":"ICD-JDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMB0","description":"ICD-IBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28226","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJOB0","description":"ICD-PJOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHE1","description":"ICD-OJHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl >/= 13 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3279F","description":"Hgb lvl >/= 13 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contact lens fitting","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92311","description":"Contact lens fitting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28E","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHE0","description":"ICD-IAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB0A","description":"Low Rehab_ ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHJC0","description":"ICD-BHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chorion biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59015","description":"Chorion biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0019M","description":"Cardiovascular disease_ plasma_ analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populatio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/curett of cervix w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57454","description":"Bx/curett of cervix w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0041A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine_ recombinant sp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBAC0","description":"ICD-CBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2009","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Granisetron hcl 1 mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0166","description":"Granisetron hcl 1 mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDHA1","description":"ICD-KDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0505T","description":"Endovenous femoral-popliteal arterial revascularization_ with transcatheter placement of intravascular stent graft(s) and closure by any method_ including percutaneous or open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd digitized pre-rec <=8min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2500","description":"Sgd digitized pre-rec <=8min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVF0","description":"ICD-CBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stereoscopic x-ray guidance","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6002","description":"Stereoscopic x-ray guidance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3AA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3AA31","description":"ICD-3AA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAED0","description":"ICD-AAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tilt table evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93660","description":"Tilt table evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLUC1","description":"ICD-NLUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUA1","description":"ICD-AGUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQC0","description":"ICD-HIQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRB0","description":"ICD-OLRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCA1","description":"ICD-CFCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYB0","description":"ICD-PKYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1027T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1027T","description":"CPT-1027T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body from eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65265","description":"Remove foreign body from eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF0","description":"ICD-BGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA4A","description":"High Rehab _ ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWB0","description":"ICD-HHWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27495","description":"Reinforce thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLC0","description":"ICD-GHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIF1","description":"ICD-MFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microvolt t-wave assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93025","description":"Microvolt t-wave assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKE0","description":"ICD-JEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHSB1","description":"ICD-PHSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE0","description":"ICD-ACCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8E","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00474","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","description":"CPT-00474","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28475","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEF0","description":"ICD-AAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHND1","description":"ICD-KHND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUA0","description":"ICD-CGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTD1","description":"ICD-JDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx_ non-str_hdr ir-192","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1717","description":"Brachytx_ non-str_hdr ir-192","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLFE1","description":"ICD-OLFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5A","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJA1","description":"ICD-GCJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD0","description":"ICD-IHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC1","description":"ICD-FDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test larynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95865","description":"Muscle test larynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWE0","description":"ICD-PFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43502","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELF1","description":"ICD-IELF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBTF1","description":"ICD-OBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alglucerase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0205","description":"Alglucerase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ full gene sequence (List separately in addition to code for primary procedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tear duct system surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68899","description":"Tear duct system surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUE1","description":"ICD-NKUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMD0","description":"ICD-MLMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFC1","description":"ICD-BCFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXF1","description":"ICD-NEXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tamoxifen 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0187","description":"Tamoxifen 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dark adaptation eye exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92284","description":"Dark adaptation eye exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEC0","description":"ICD-GBEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC0","description":"ICD-OJQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE1","description":"ICD-IDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of mastoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70120","description":"X-ray exam of mastoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sps knee device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1811","description":"Sps knee device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1018T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","description":"CPT-1018T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE0","description":"ICD-KHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx of cervix w/scope leep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57460","description":"Bx of cervix w/scope leep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJD1","description":"ICD-OFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCA0","description":"ICD-NFCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43113","description":"Removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Who w/nontorsion jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3905","description":"Who w/nontorsion jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGUE0","description":"ICD-EGUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00752","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","description":"CPT-00752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE146","description":"Reduced Physical Function _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"In Hospice Or Using Hospice Services During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2153","description":"In Hospice Or Using Hospice Services During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB40","description":"High Rehab _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVD1","description":"ICD-KAVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prenatal at risk education","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1003","description":"Prenatal at risk education","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCBE1","description":"ICD-CCBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove transplanted kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50370","description":"Remove transplanted kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFHB0","description":"ICD-CFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFND0","description":"ICD-KFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise bladder/drain ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51045","description":"Incise bladder/drain ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1096","description":"Dexamethasone_ lacrimal ophthalmic insert_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lymph nodes neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38700","description":"Removal of lymph nodes neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Audiometry for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0618","description":"Audiometry for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF1","description":"ICD-IBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cpap full face mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7030","description":"Cpap full face mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28G","description":"Special Care Low _ ADL Index 11-14/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVB1","description":"ICD-FHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom power whlchr base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0013","description":"Custom power whlchr base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAWB0","description":"ICD-KAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt queried symp resp insuff","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1503F","description":"Pt queried symp resp insuff","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-1/hiv-2 1 result antbdy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86703","description":"Hiv-1/hiv-2 1 result antbdy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of testis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54640","description":"Suspension of testis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv col supp adj bar & thor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0200","description":"Cerv col supp adj bar & thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No surg proc w/in 30 days","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8628","description":"No surg proc w/in 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate/strip short leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37718","description":"Ligate/strip short leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hf assessment tool completed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3117F","description":"Hf assessment tool completed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand tendon reconstruction","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26502","description":"Hand tendon reconstruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA1","description":"ICD-EHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear rx iv admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"79101","description":"Nuclear rx iv admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLB0","description":"ICD-FCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0453U","description":"Oncology (colorectal cancer)_ cell-free DNA (cfDNA)_ methylation-based quantitative PCR assay (SEPTIN9_ IKZF1_ BCAT1_ Septin9-2_ VAV3_ BCAN)_ plasma_ reported as presence or a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHB1","description":"ICD-EIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXC1","description":"ICD-CCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Saliva test_ hormone level;","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3650","description":"Saliva test_ hormone level;","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAE1","description":"ICD-NKAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD1","description":"ICD-GBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of psa total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84153","description":"Assay of psa total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat fracture of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25505","description":"Treat fracture of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5228","description":"Immediate mandibular partial denture - flexible base (including any clasps_ rests and teeth)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Degarelix injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9155","description":"Degarelix injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFJD1","description":"ICD-BFJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNC1","description":"ICD-FDNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQC1","description":"ICD-KEQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCXC1","description":"ICD-KCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBXC0","description":"ICD-BBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRE0","description":"ICD-OFRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAJB1","description":"ICD-FAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEE0","description":"ICD-ACEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOB0","description":"ICD-HAOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASC0","description":"ICD-HASC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0970T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","description":"CPT-0970T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTF1","description":"ICD-FHTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD22B","description":"Reduced Physical Function _ ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVC1","description":"ICD-KGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous ppi or h2ra rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4185F","description":"Continuous ppi or h2ra rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEGD1","description":"ICD-JEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCB0","description":"ICD-IHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBE0","description":"ICD-GFBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create tear duct drain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68745","description":"Create tear duct drain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0224","description":"Intravenous infusion_ pemivibart_ for the pre-exposure prophylaxis only_ for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFB0","description":"ICD-OKFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWE0","description":"ICD-GCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Walker leg extenders set of4","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0158","description":"Walker leg extenders set of4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYF1","description":"ICD-DCYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQE0","description":"ICD-GDQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pemetrexed injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9305","description":"Pemetrexed injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Water circ cold pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0218","description":"Water circ cold pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tc99m apcitide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9504","description":"Tc99m apcitide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGF0","description":"ICD-NDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were in hospice at any time during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1022","description":"Patients who were in hospice at any time during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43290","description":"Esophagogastroduodenoscopy_ flexible_ transoral; with deployment of intragastric bariatric balloon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81112","description":"Human Platelet Antigen 15 genotyping (HPA-15)_ CD109 (CD109 molecule) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post-transfusion purpura)_ gene analysis_ common varian","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEKD1","description":"ICD-CEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPD0","description":"ICD-OBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25C","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anticoag clinic per session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9401","description":"Anticoag clinic per session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEWC1","description":"ICD-GEWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of pelvic structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51597","description":"Removal of pelvic structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wc planar back cush wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2621","description":"Wc planar back cush wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTA0","description":"ICD-BDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKE1","description":"ICD-OAKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18H","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA07","description":"Medium Rehab _ ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTD0","description":"ICD-GDTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place endorectal app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9725","description":"Place endorectal app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKUA0","description":"ICD-OKUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACE0","description":"ICD-IACE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGCE0","description":"ICD-MGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAB0","description":"ICD-FFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVF0","description":"ICD-OEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diabetic management program_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9465","description":"Diabetic management program_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6593","description":"Accessory for gradient compression garment or wrap with adjustable straps_ non-otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90706","description":"Rubella virus vaccine_ live_ for subcutaneous or jet injection use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat hand bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26034","description":"Treat hand bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQB1","description":"ICD-GEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES251","description":"Extensive Services _ ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDIF0","description":"ICD-CDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onsite Ac C Tx Nsg Fac Res Uti Bill Sid-Benef","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9684","description":"Onsite Ac C Tx Nsg Fac Res Uti Bill Sid-Benef","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI lwr extremity w/o&w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73720","description":"MRI lwr extremity w/o&w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKC1","description":"ICD-GDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFEB0","description":"ICD-AFEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA1","description":"ICD-FIUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28320","description":"Repair of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB1","description":"ICD-ACHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPE0","description":"ICD-FAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant supported retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6076","description":"Implant supported retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED0","description":"ICD-FDED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had only urgent care visits during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1054","description":"Patient had only urgent care visits during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJA0","description":"ICD-NBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX4C","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detect agent nos dna dir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87797","description":"Detect agent nos dna dir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGJC0","description":"ICD-OGJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD201","description":"Reduced Physical Function _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA0","description":"ICD-OJWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup sht leg splnt fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4046","description":"Cast sup sht leg splnt fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVE1","description":"ICD-JGVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press not prescribe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8853","description":"Pos air press not prescribe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA0A","description":"High Rehab _ ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Creatine isoforms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82554","description":"Creatine isoforms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.25d/12-2d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2107","description":"Spherocylinder 4.25d/12-2d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5271","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Precision attachment","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6950","description":"Precision attachment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0626U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","description":"CPT-0626U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC154","description":"Special Care Low _ ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDMD1","description":"ICD-BDMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60271","description":"Removal of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFDE1","description":"ICD-EFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Weight record","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2001F","description":"Weight record","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJA1","description":"ICD-CIJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFTE0","description":"ICD-OFTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27442","description":"Revision of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFMC0","description":"ICD-IFMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72147","description":"MRI chest spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13C","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXD1","description":"ICD-OBXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHFF1","description":"ICD-KHFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Miniature knee joint","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5826","description":"Miniature knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB4C","description":"Low Rehab_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHB0","description":"ICD-CBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMA1","description":"ICD-NKMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGRA1","description":"ICD-DGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAC0","description":"ICD-KCAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES312","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTC1","description":"ICD-BDTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adj skin pro wc cus wd>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2623","description":"Adj skin pro wc cus wd>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECF1","description":"ICD-IECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDE1","description":"ICD-OBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert uteri tandem/ovoids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57155","description":"Insert uteri tandem/ovoids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1HC21","description":"ICD-1HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ground mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0425","description":"Ground mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCMB1","description":"ICD-OCMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flu immunize no admin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8484","description":"Flu immunize no admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRE0","description":"ICD-CBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic dysfunction/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81411","description":"Aortic dysfunction/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA1","description":"ICD-CIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sialoendoscopy capt & interp","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0371","description":"Sialoendoscopy capt & interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFM3","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC105","description":"Clinically Complex _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVD1","description":"ICD-BDVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFNC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFNC0","description":"ICD-JFNC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smoking & 2nd hand assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1031F","description":"Smoking & 2nd hand assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDC0","description":"ICD-JEDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB0","description":"ICD-OFQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX03","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fqhc visit_ mh new pt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0469","description":"Fqhc visit_ mh new pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA144","description":"Reduced Physical Function _ ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33647","description":"Repair heart septum defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBA1","description":"ICD-FCBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AstraZeneca COVID-19 vaccine administration — second dose","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1706","description":"AstraZeneca COVID-19 vaccine administration — second dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ascent_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4213","description":"Ascent_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0507","description":"Care management services for behavioral health conditions_ at least 20 minutes of clinical staff time_ directed by a physician or other qualified health care professional_ per","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4DC11","description":"ICD-4DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHNF1","description":"ICD-JHNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peristomal hernia supprt blt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4396","description":"Peristomal hernia supprt blt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHKT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDMF0","description":"ICD-FDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay aminolevulinic acid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82135","description":"Assay aminolevulinic acid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caster fork","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2396","description":"Caster fork","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJF1","description":"ICD-KIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9324","description":"Injection_ pemetrexed (pemrydi rtu)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinary suspensory","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5105","description":"Urinary suspensory","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACF1","description":"ICD-FACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture interm cmplt mandbl","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5811","description":"Denture interm cmplt mandbl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim 6mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2505","description":"Injection_ pegfilgrastim 6mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIBE1","description":"ICD-MIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXE0","description":"ICD-JFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of tear duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70170","description":"X-ray exam of tear duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB141","description":"Clinically Complex _ ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF1","description":"ICD-CGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00756","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","description":"CPT-00756","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCND0","description":"ICD-JCND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAE1","description":"ICD-EEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF0","description":"ICD-FCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUD0","description":"ICD-BGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venous thrombosis imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78457","description":"Venous thrombosis imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAD1","description":"ICD-OBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNF1","description":"ICD-NGNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSD1","description":"ICD-HBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0615","description":"Hospital Special Treatment Room Support Component (Hstrsc) Cystoscopy/Transurethral Procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSE0","description":"ICD-HGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLEE1","description":"ICD-OLEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release foot/toe nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64726","description":"Release foot/toe nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD0","description":"ICD-BEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"5% dextrose in lactated ringer_s_ 1000 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5011","description":"5% dextrose in lactated ringer_s_ 1000 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FINB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FINB1","description":"ICD-FINB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGIE1","description":"ICD-EGIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSD1","description":"ICD-PGSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70140","description":"X-ray exam of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJC0","description":"ICD-GHJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cog&behav imprmnt scrng done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3755F","description":"Cog&behav imprmnt scrng done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93248","description":"External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Review And Interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD0","description":"ICD-MLHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFME0","description":"ICD-IFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDA0","description":"ICD-JIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve init insert","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31647","description":"Bronchial valve init insert","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0299U","description":"Oncology (Pan Tumor)_ Whole Genome Optical Genome Mapping Of Paired Malignant And Normal Dna Specimens_ Fresh Frozen Tissue_ Blood_ Or Bone Marrow_ Comparative Structural Vari","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUE1","description":"ICD-BEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1IC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1IC31","description":"ICD-1IC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOD1","description":"ICD-KCOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68550","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJF0","description":"ICD-GFJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITC1","description":"ICD-FITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2B","description":"Very High Rehab _ ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intranasal biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30100","description":"Intranasal biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3929","description":"Hfo nontorsion jnts pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHLC0","description":"ICD-AHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFBF1","description":"ICD-NFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTC1","description":"ICD-IGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIC0","description":"ICD-OHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF1","description":"ICD-OICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC141","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHKD1","description":"ICD-NHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction lipectomy lwr extrem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15879","description":"Suction lipectomy lwr extrem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj multihance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9578","description":"Inj multihance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-87638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87638","description":"CPT-87638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA214","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABE1","description":"ICD-OABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44605","description":"Repair of bowel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAB1","description":"ICD-ODAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECB1","description":"ICD-OECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVC1","description":"ICD-CAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB1","description":"ICD-BALB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISA0","description":"ICD-LISA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA3D","description":"Low Rehab_ ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA S","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove electrode/thoracotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33237","description":"Remove electrode/thoracotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antibody; Zika virus_ IgM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86794","description":"Antibody; Zika virus_ IgM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLD0","description":"ICD-OBLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vital signs recorded","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2010F","description":"Vital signs recorded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKF0","description":"ICD-FCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMB0","description":"ICD-NGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHYC1","description":"ICD-KHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine screen for bacteria","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81007","description":"Urine screen for bacteria","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35236","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot exam performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2028F","description":"Foot exam performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDB1","description":"ICD-EIDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2134","description":"Patients 66 Years Of Age Or Older With At Least One Claim/Encounter For Frailty During The Measurement Period And A Dispensed Medication For Dementia During The Measurement Pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00326","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","description":"CPT-00326","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6098","description":"Implant Supported Retainer - Porcelain Fused To Predominantly Base Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC241","description":"Special Care High _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDA0","description":"ICD-CBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXA1","description":"ICD-JIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLA0","description":"ICD-EHLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluphenazine decanoate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2680","description":"Fluphenazine decanoate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE18B","description":"Special Care High _ ADL Index 15-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval self-assess depression","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3005","description":"Eval self-assess depression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOE1","description":"ICD-GCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Referred for an av fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4051F","description":"Referred for an av fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Near ifr guide of vasc site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0287T","description":"Near ifr guide of vasc site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp axillary-axillary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35650","description":"Art byp axillary-axillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEC0","description":"ICD-BIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBB0","description":"ICD-EFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADD1","description":"ICD-MADD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of thigh tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27390","description":"Incision of thigh tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIED1","description":"ICD-KIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7189","description":"Factor viia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOB0","description":"ICD-HHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dent appl desensitizing med","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9910","description":"Dent appl desensitizing med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKC0","description":"ICD-KAKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJD0","description":"ICD-FDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of body cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29015","description":"Application of body cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMB1","description":"ICD-OEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conformal radn thxpy rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4181F","description":"Conformal radn thxpy rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBCC1","description":"ICD-JBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4372","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","description":"HCPCS-Q4372","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGID1","description":"ICD-OGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBC1","description":"ICD-EBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4340","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","description":"HCPCS-Q4340","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEGA0","description":"ICD-FEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No strk cabg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8574","description":"No strk cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightweight det a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1088","description":"Wheelchair lightweight det a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA1","description":"ICD-CIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bp out of nrml limits","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9274","description":"Bp out of nrml limits","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD18A","description":"Special Care High _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAGB1","description":"ICD-OAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD204","description":"Special Care High _ ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE12C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESF1","description":"ICD-HESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML55","description":"Medium Rehab plus Extensive_ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFNE1","description":"ICD-NFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB1","description":"ICD-ODQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Auricular prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5914","description":"Auricular prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0268U","description":"Hematology (atypical hemolytic uremic syndrome [aHUS])_ genomic sequence analysis of 15 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ aHUS Genetic Evaluation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1EB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1EB21","description":"ICD-1EB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nose lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30125","description":"Removal of nose lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODHF1","description":"ICD-ODHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCF0","description":"ICD-OBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWD0","description":"ICD-HHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC10A","description":"Clinically Complex _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQC0","description":"ICD-KDQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1087T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1087T","description":"CPT-1087T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28C","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3C","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 0.6-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11621","description":"Exc s/n/h/f/g mal+mrg 0.6-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPF0","description":"ICD-JBPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/sm tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34800","description":"Endovas aaa repr w/sm tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of external ear","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69120","description":"Removal of external ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth special head surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21851","description":"Anesth special head surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVC1","description":"ICD-BCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHF1","description":"ICD-EDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMF1","description":"ICD-CCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB0","description":"ICD-GAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWD1","description":"ICD-LCWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemi-wheelchair fixed arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1083","description":"Hemi-wheelchair fixed arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX1A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE24D","description":"Clinically Complex _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBC0","description":"ICD-GEBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSD1","description":"ICD-LCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHID1","description":"ICD-JHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRD0","description":"ICD-CGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement Of Lost Or Broken Retainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8703","description":"Replacement Of Lost Or Broken Retainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EITF0","description":"ICD-EITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97009","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","description":"CPT-97009","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFKB0","description":"ICD-NFKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand/chin ctrl spec joystick","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2373","description":"Hand/chin ctrl spec joystick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIF0","description":"ICD-FGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIVC0","description":"ICD-GIVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urinalysis volume measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81050","description":"Urinalysis volume measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIC1","description":"ICD-CHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect distal humerus tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24150","description":"Resect distal humerus tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 3.1-4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11604","description":"Exc tr-ext mal+marg 3.1-4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHF0","description":"ICD-ADHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit picc insert no supp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5522","description":"Hit picc insert no supp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBB0","description":"ICD-MGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest eye tissue alograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68371","description":"Harvest eye tissue alograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoetharine comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7647","description":"Isoetharine comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBLB1","description":"ICD-EBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0206","description":"Traumatic brain injury with Motor >22.05 & Motor <28.75._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKC1","description":"ICD-GGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0540","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","description":"HCPCS-G0540","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of fetal heart","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76827","description":"Echo exam of fetal heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI lumbar spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72148","description":"MRI lumbar spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBB1","description":"ICD-ADBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCBF1","description":"ICD-NCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reas no adhere pos air pres","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8854","description":"Reas no adhere pos air pres","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0693U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693U","description":"CPT-0693U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOD0","description":"ICD-OGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain thyroid/tongue cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60000","description":"Drain thyroid/tongue cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA1A","description":"Very High Rehab _ ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDD0","description":"ICD-NFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ionm remote/>1 pt or per hr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95941","description":"Ionm remote/>1 pt or per hr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIDF1","description":"ICD-CIDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACIF1","description":"ICD-ACIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2C","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0549T","description":"Transperineal periurethral balloon continence device; unilateral placement_ including cystoscopy and fluoroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHC1","description":"ICD-NEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEA1","description":"ICD-ICEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAC0","description":"ICD-ACAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRE0","description":"ICD-HHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JADF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JADF0","description":"ICD-JADF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAF1","description":"ICD-BIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJE1","description":"ICD-JGJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1007T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","description":"CPT-1007T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PERA1","description":"ICD-PERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAAE0","description":"ICD-IAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec sz spec ht a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1227","description":"Wheelchair spec sz spec ht a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq abltj lvr cryoablation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47383","description":"Perq abltj lvr cryoablation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATE1","description":"ICD-BATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 31/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99449","description":"Interprof phone/online 31/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of sweat sodium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84302","description":"Assay of sweat sodium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECD1","description":"ICD-IECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGJA0","description":"ICD-JGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD13C","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSD0","description":"ICD-DDSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF0","description":"ICD-AGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefabricated resin crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2932","description":"Prefabricated resin crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCA1","description":"ICD-GCCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1AA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1AA21","description":"ICD-1AA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA1","description":"ICD-OIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC15","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DASE0","description":"ICD-DASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Space maintainer_ fixed_ bilateral_ mandibular","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1517","description":"Space maintainer_ fixed_ bilateral_ mandibular","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wet mounts/ w preparations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0111","description":"Wet mounts/ w preparations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy forearm soft tissues","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25066","description":"Biopsy forearm soft tissues","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVB1","description":"ICD-KEVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15261","description":"Skin full graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA34","description":"Default_ /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor xiii recomb a-subunit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7181","description":"Factor xiii recomb a-subunit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fall risk assessment docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3288F","description":"Fall risk assessment docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD28H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUB0","description":"ICD-FGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGYA0","description":"ICD-KGYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHME0","description":"ICD-BHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound prep f/n/hf/g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15004","description":"Wound prep f/n/hf/g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGP2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGE1","description":"ICD-KCGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPC0","description":"ICD-OCPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOD1","description":"ICD-HFOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt prgrm for implt neurostim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8681","description":"Pt prgrm for implt neurostim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE20D","description":"Special Care High _ ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIF1","description":"ICD-BFIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33269","description":"Exclusion Of Left Atrial Appendage_ Thoracoscopic_ Any Method (Eg_ Excision_ Isolation Via Stapling_ Oversewing_ Ligation_ Plication_ Clip)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYD0","description":"ICD-DBYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBUC0","description":"ICD-NBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSA1","description":"ICD-CCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC14B","description":"Special Care High _ ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BC31","description":"ICD-4BC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL4C","description":"Very High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFB0","description":"ICD-BCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA CRYPTOSPORIDIUM","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87328","description":"IAAD IA CRYPTOSPORIDIUM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limb muscle testing manual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95831","description":"Limb muscle testing manual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA224","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Positional nystagmus test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92532","description":"Positional nystagmus test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84181","description":"Western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01969","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","description":"CPT-01969","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL8B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of larynx & pharynx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31390","description":"Removal of larynx & pharynx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise/repair mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40814","description":"Excise/repair mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB0","description":"ICD-CEPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRF0","description":"ICD-OGRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB0","description":"ICD-CFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9746","description":"Trnsprnl Impl Prm Adj Balln Cnt Dvc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc app","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44979","description":"Laparoscope proc app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Filters elec/combo vad_ rep","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0500","description":"Filters elec/combo vad_ rep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endosteal implant","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6012","description":"Endosteal implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Av fistula revision open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36832","description":"Av fistula revision open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC5A","description":"High Rehab _ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOD0","description":"ICD-KDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guide wire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1769","description":"Guide wire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXC1","description":"ICD-BCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCXD0","description":"ICD-CCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLB1","description":"ICD-KBLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACD1","description":"ICD-GACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGAE1","description":"ICD-IGAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37230","description":"Tib/per revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9702","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0805","description":"HCPCS-C0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient screened for future fall risk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1069","description":"Patient screened for future fall risk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRA1","description":"ICD-CGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantable tissue marker","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4648","description":"Implantable tissue marker","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMC0","description":"ICD-CIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sleeve pneumonectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32442","description":"Sleeve pneumonectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJD1","description":"ICD-KBJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE15A","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDUB1","description":"ICD-GDUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBEC1","description":"ICD-MBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64728","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","description":"CPT-64728","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Card MRI w/stress img & dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75563","description":"Card MRI w/stress img & dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ epcoritamab-bysp_ 0.16 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9155","description":"Injection_ epcoritamab-bysp_ 0.16 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC1","description":"ICD-CDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMC1","description":"ICD-FIMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measure ureter pressure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50686","description":"Measure ureter pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anemia plan of care docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0516F","description":"Anemia plan of care docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rv5 vacc 3 dose live oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90680","description":"Rv5 vacc 3 dose live oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDTE0","description":"ICD-BDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDID0","description":"ICD-FDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEED1","description":"ICD-MEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69320","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKC1","description":"ICD-NKKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYD0","description":"ICD-PCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has metastatic disease at diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9842","description":"Patient has metastatic disease at diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Necropsy (autopsy) procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88099","description":"Necropsy (autopsy) procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVE0","description":"ICD-KGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC36","description":"Very High Rehab _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAB1","description":"ICD-MLAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAEA1","description":"ICD-IAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium in urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82340","description":"Assay of calcium in urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 4-7 vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22810","description":"Ant fusion 4-7 vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQB0","description":"ICD-KAQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2IA21","description":"ICD-2IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","description":"HCPCS-M1387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXC0","description":"ICD-OEXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGIF0","description":"ICD-JGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGND0","description":"ICD-OGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAE1","description":"ICD-GDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBB0","description":"ICD-OCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0229U","description":"BCAT1 (Branched chain amino acid transaminase 1) or IKZF1 (IKAROS family zinc finger 1) (eg_ colorectal cancer) promoter methylation analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1102","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1102","description":"CDT-D1102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vim_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4251","description":"Vim_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0233U","description":"FXN (frataxin) (eg_ Friedreich ataxia)_ gene analysis_ including small sequence changes in exonic and intronic regions_ deletions_ duplications_ short tandem repeat (STR) expa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICA0","description":"ICD-JICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49013","description":"Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma_ Including Local Exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD21B","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin sign vol ovrld assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2002F","description":"Clin sign vol ovrld assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERE0","description":"ICD-CERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABDB0","description":"ICD-ABDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAA1","description":"ICD-GAAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXA1","description":"ICD-CEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX25","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tis trnfr f/c/c/m/n/a/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"14041","description":"Tis trnfr f/c/c/m/n/a/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSB0","description":"ICD-LGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc funct no deficiencies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8542","description":"Doc funct no deficiencies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IATB1","description":"ICD-IATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCHC1","description":"ICD-OCHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGDB0","description":"ICD-OGDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq tx malar fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21355","description":"Perq tx malar fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJUF1","description":"ICD-MJUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"39499","description":"Chest procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDC1","description":"ICD-CCDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nras gene variants exon 2&3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81311","description":"Nras gene variants exon 2&3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76831","description":"Echo exam uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen drsg>16<=48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6022","description":"Collagen drsg>16<=48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery of pancreatic cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48500","description":"Surgery of pancreatic cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC0","description":"ICD-KFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg fiberglass","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4038","description":"Cast sup shrt leg fiberglass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHE1","description":"ICD-ACHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen site not esophagus","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8797","description":"Specimen site not esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVE1","description":"ICD-FBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAF0","description":"ICD-OFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB1C","description":"High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest art for cabg add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35600","description":"Harvest art for cabg add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collect blood from picc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36592","description":"Collect blood from picc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58260","description":"Vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelv 1/> regns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74178","description":"Ct abd & pelv 1/> regns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKF1","description":"ICD-BGKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breath recording infant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94772","description":"Breath recording infant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAD1","description":"ICD-KBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open/perq place stent 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37236","description":"Open/perq place stent 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of windpipe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31605","description":"Incision of windpipe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10C","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVF1","description":"ICD-JCVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRD1","description":"ICD-PJRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dxa bone density axial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77080","description":"Dxa bone density axial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHE0","description":"ICD-CEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEA0","description":"ICD-FAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0495U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","description":"CPT-0495U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJAD0","description":"ICD-NJAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIXF0","description":"ICD-FIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Image cath fluid peri/retro","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49406","description":"Image cath fluid peri/retro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKC0","description":"ICD-NCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHD1","description":"ICD-KBHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43117","description":"Partial removal of esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1001","description":"HCPCS-A1001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEPF1","description":"ICD-GEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE1","description":"ICD-CGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBF1","description":"ICD-FBBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc xdrl spine lesn thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63276","description":"Bx/exc xdrl spine lesn thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tob user recd cess interv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9458","description":"Tob user recd cess interv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of blood fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82725","description":"Assay of blood fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0029U","description":"Drug metabolism (adverse drug reactions and drug response)_ targeted sequence analysis (ie_ CYP1A2_ CYP2C19_ CYP2C9_ CYP2D6_ CYP3A4_ CYP3A5_ CYP4F2_ SLCO1B1_ VKORC1 and rs1277","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJDA0","description":"ICD-NJDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part thorax vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22112","description":"Remove part thorax vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ digit_ mon_ bte","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5257","description":"Hearing aid_ digit_ mon_ bte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGB0","description":"ICD-JGGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE134","description":"Special Care Low _ ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy addl cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63043","description":"Laminotomy addl cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0024","description":"Principal illness navigation services_ additional 30 minutes per calendar month (list separately in addition to g0023)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1376","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","description":"HCPCS-M1376","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1466","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","description":"HCPCS-M1466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC146","description":"Special Care High _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBED1","description":"ICD-GBED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63615","description":"Stereotactic biopsy_ aspiration_ or excision of lesion_ spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC1","description":"ICD-CFGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20B","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDF1","description":"ICD-ODDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0201","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0201","description":"CDT-D0201","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open chest heart massage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32160","description":"Open chest heart massage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray esophagus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74220","description":"Contrast x-ray esophagus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCF1","description":"ICD-AGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAXC1","description":"ICD-BAXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9255","description":"Injection_ methotrexate (accord) not therapeutically equivalent to j9250 and j9260_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNB1","description":"ICD-FBNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ mon_ cic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5244","description":"Hearing aid_ prog_ mon_ cic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat trigeminal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61790","description":"Treat trigeminal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt w/dxa results document","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8399","description":"Pt w/dxa results document","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97152","description":"Behavior identification-supporting assessment_ administered by one technician under the direction of a physician or other qualified health care professional_ face-to-face with","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcochlear approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61596","description":"Transcochlear approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47136","description":"Liver allotransplantation; heterotopic_ partial or whole_ from cadaver or living donor_ any age","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albumin (human)_ 5%_ 250 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9045","description":"Albumin (human)_ 5%_ 250 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBYC1","description":"ICD-GBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pin finger dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26776","description":"Pin finger dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE0","description":"ICD-CAJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0636T","description":"Computed Tomography_ Breast_ Including 3D Rendering_ When Performed_ Bilateral; Without Contrast Material(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suction socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6686","description":"Suction socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUC1","description":"ICD-JIUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC156","description":"Special Care Low _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC111","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise & treat bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51030","description":"Incise & treat bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQD1","description":"ICD-LDQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE0","description":"ICD-NGFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7196","description":"Antithrombin recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBKA1","description":"ICD-NBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57500","description":"Biopsy of cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Facility/Er/Emergency Room","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"450U5","description":"Facility/Er/Emergency Room","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVE0","description":"ICD-FDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIID0","description":"ICD-BIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery to stop leg growth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27479","description":"Surgery to stop leg growth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIEA1","description":"ICD-MIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCBD0","description":"ICD-MCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar bolster pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1030","description":"Lumbar bolster pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis scale","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1639","description":"Dialysis scale","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE1","description":"ICD-BDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTC1","description":"ICD-NGTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental film skull/facial bon","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0290","description":"Dental film skull/facial bon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX45","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHF0","description":"ICD-BHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0032U","description":"COMT (catechol-O-methyltransferase)(drug metabolism) gene analysis_ c.472G>A (rs4680) variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA18E","description":"Clinically Complex _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KECB1","description":"ICD-KECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot contracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28270","description":"Release of foot contracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0875T","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCDF1","description":"ICD-KCDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWA1","description":"ICD-OEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_onabotulinumtoxina","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0585","description":"Injection_onabotulinumtoxina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGFC0","description":"ICD-KGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ACApatch_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4325","description":"ACApatch_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIQD1","description":"ICD-KIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIAD1","description":"ICD-GIAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0902","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0902","description":"HCPCS-C0902","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWD1","description":"ICD-HGWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total disc arthrp ant appr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0375T","description":"Total disc arthrp ant appr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAMB0","description":"ICD-GAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYF0","description":"ICD-CGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD1","description":"ICD-CCVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMA1","description":"ICD-NGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD23D","description":"Special Care Low _ ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transab esoph hiat hern rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43332","description":"Transab esoph hiat hern rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICC0","description":"ICD-NICC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plasma_ frz between 8-24hour","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9059","description":"Plasma_ frz between 8-24hour","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNA0","description":"ICD-CFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUE0","description":"ICD-OHUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ipilimumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9228","description":"Ipilimumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGGF0","description":"ICD-KGGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARA0","description":"ICD-OARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24665","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone imaging (3d)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78320","description":"Bone imaging (3d)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCFF0","description":"ICD-BCFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9069","description":"Injection_ belantamab mafodontin-blmf_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81274","description":"HTT (huntingtin) (eg_ Huntington disease) gene analysis; characterization of alleles (eg_ expanded size)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGTF0","description":"ICD-FGTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0445U","description":"B-amyloid (Abeta42) and phospho tau (181P) (pTau181)_ electrochemiluminescent immunoassay (ECLIA)_ cerebral spinal fluid_ ratio reported as positive or negative for amyloid pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGK4","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Haloperidol decanoate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1631","description":"Haloperidol decanoate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIAF1","description":"ICD-JIAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0539U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","description":"CPT-0539U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFD0","description":"ICD-BBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner ear nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69950","description":"Incise inner ear nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe heel wedge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3350","description":"Shoe heel wedge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKD1","description":"ICD-BFKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc comp or mort w in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9268","description":"Doc comp or mort w in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYD0","description":"ICD-OLYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKMB0","description":"ICD-NKMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNF1","description":"ICD-KFNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLA0","description":"ICD-FCLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBTF0","description":"ICD-BBTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC140","description":"Clinically Complex _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJE1","description":"ICD-KAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath report non routine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0551F","description":"Cytopath report non routine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endo ak/hip knee extens assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5850","description":"Endo ak/hip knee extens assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD1","description":"ICD-JBMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1002","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1002","description":"CDT-D1002","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDF1","description":"ICD-KHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB135","description":"Clinically Complex _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wedging of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29740","description":"Wedging of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28B","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69729","description":"Implantation_ osseointegrated implant_ skull; with magnetic transcutaneous attachment to external speech processor_ outside of the mastoid and resulting in removal of greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQD1","description":"ICD-HGQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGE0","description":"ICD-NJGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKF1","description":"ICD-OEKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJF1","description":"ICD-BIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDB0","description":"ICD-CDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Regional block anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9211","description":"Regional block anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1608","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1608","description":"HCPCS-C1608","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIMC0","description":"ICD-KIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBA0","description":"ICD-IDBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIHA0","description":"ICD-BIHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy intraperitoneal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57283","description":"Colpopexy intraperitoneal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGHF0","description":"ICD-BGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSC1","description":"ICD-OFSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTF1","description":"ICD-BCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLD1","description":"ICD-OLLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphenhydramine hcl 50mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0163","description":"Diphenhydramine hcl 50mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDHD0","description":"ICD-EDHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ischial bursa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27060","description":"Removal of ischial bursa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIC1","description":"ICD-BBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHE1","description":"ICD-CHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB25","description":"Ultra High Rehab _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICE1","description":"ICD-OICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1421","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","description":"HCPCS-M1421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF1","description":"ICD-JGXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENB0","description":"ICD-FENB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23125","description":"Removal of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap colectomy part w/ileum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44205","description":"Lap colectomy part w/ileum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGSA1","description":"ICD-CGSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADUC1","description":"ICD-ADUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB146","description":"Special Care Low _ ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPB1","description":"ICD-NKPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef complet w/intact nutrient","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4150","description":"Ef complet w/intact nutrient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDIF0","description":"ICD-GDIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEC1","description":"ICD-IGEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5173","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5173","description":"HCPCS-Q5173","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFXA0","description":"ICD-JFXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC1","description":"ICD-GCCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44373","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIC1","description":"ICD-MGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBRA1","description":"ICD-HBRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BATB1","description":"ICD-BATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACEC1","description":"ICD-ACEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47532","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9939","description":"Pathologist(s)/dermatopathologist(s) is the same clinician who performed the biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calculus assay quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82360","description":"Calculus assay quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47511","description":"Introduction of percutaneous transhepatic stent for internal and external biliary drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCDA1","description":"ICD-JCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLF1","description":"ICD-NDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual fully reclining back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1226","description":"Manual fully reclining back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1403","description":"HCPCS-C1403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMC0","description":"ICD-JHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGJB0","description":"ICD-FGJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9927","description":"Documentation of system reason(s) for not prescribing warfarin or another FDA-approved anticoagulation due to patient being currently enrolled in a clinical trial related to A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJE0","description":"ICD-NCJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0719T","description":"Posterior vertebral joint replacement_ including bilateral facetectomy_ laminectomy_ and radical discectomy_ including imaging guidance_ lumbar spine_ single segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IITC0","description":"ICD-IITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10A","description":"Special Care Low _ ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nutritional support offered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4551F","description":"Nutritional support offered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB1","description":"ICD-AIBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEA1","description":"ICD-BAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKU","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo multilig ank sup pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1906","description":"Afo multilig ank sup pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth insert penis device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93851","description":"Anesth insert penis device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cilastatin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0743","description":"Cilastatin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0673","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0673","description":"HCPCS-G0673","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA22","description":"Default_ /14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIC1","description":"ICD-CAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDMC0","description":"ICD-MDMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDA0","description":"ICD-KIDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDUC1","description":"ICD-CDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAA0","description":"ICD-FEAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA140","description":"Clinically Complex _ ADL Index 0-1/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003U","description":"Onc (ovarian) biocheml assays of five proteins (apolipoprotein A-1_ CA 125 II_ follicle stimulating hormone_ human epididymis protein 4_ transferrin)_ utilizing serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICHE0","description":"ICD-ICHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEF0","description":"ICD-OJEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTE0","description":"ICD-MJTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal stricture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45150","description":"Excision of rectal stricture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCC0","description":"ICD-ABCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MILE1","description":"ICD-MILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHBC1","description":"ICD-NHBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA0","description":"ICD-HFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFLE0","description":"ICD-AFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODXE0","description":"ICD-ODXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAQF0","description":"ICD-KAQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFA0","description":"ICD-BAFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closure of windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31820","description":"Closure of windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMB0","description":"ICD-GBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51570","description":"Removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High compres band w>=3in<5inyd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6452","description":"High compres band w>=3in<5inyd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKB1","description":"ICD-GGKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHA0","description":"ICD-FAHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHB1","description":"ICD-ECHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng anti r-viral thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4271F","description":"Pt rcvng anti r-viral thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01430","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","description":"CPT-01430","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1503","description":"HCPCS-B1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who are receiving comfort care only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9930","description":"Patients who are receiving comfort care only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy bifocal 4.00d/2.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2204","description":"Lens sphcy bifocal 4.00d/2.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGWD0","description":"ICD-OGWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99217","description":"Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHAD0","description":"ICD-EHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPE1","description":"ICD-NKPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVE0","description":"ICD-OIVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLLA1","description":"ICD-OLLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office/outpatient visit est","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99215","description":"Office/outpatient visit est","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sex transformation m to f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55970","description":"Sex transformation m to f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Direct immunofluorescence","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0482","description":"Direct immunofluorescence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whlchr ampu fxd arm leg rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1170","description":"Whlchr ampu fxd arm leg rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pne scrn done doc not ind","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9281","description":"Pne scrn done doc not ind","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulp vitality test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0460","description":"Pulp vitality test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33722","description":"Repair of heart defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB0","description":"ICD-JEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEIA0","description":"ICD-AEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1098","description":"Radiation Therapy For Pancreatic Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67909","description":"Revise eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOA1","description":"ICD-PFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHKB1","description":"ICD-OHKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLEE0","description":"ICD-MLEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ metronidazole_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1836","description":"Injection_ metronidazole_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Level of activity assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1003F","description":"Level of activity assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC3C","description":"High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOE0","description":"ICD-LFOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9798","description":"Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCKC0","description":"ICD-GCKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstetric panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80055","description":"Obstetric panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Betamethasone comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7624","description":"Betamethasone comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDA1","description":"ICD-NKDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME1","description":"ICD-EFME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGP6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARE0","description":"ICD-DARE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBGD1","description":"ICD-BBGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37281","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","description":"CPT-37281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF1","description":"ICD-EFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCB0","description":"ICD-IBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperbaric o2 chamber disps","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4575","description":"Hyperbaric o2 chamber disps","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27347","description":"Remove knee cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVB0","description":"ICD-GDVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem oct rta techl sprt min 8","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0605T","description":"Rem oct rta techl sprt min 8","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1500","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","description":"HCPCS-M1500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODEC0","description":"ICD-ODEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7331","description":"Hyaluronan or derivative_ synojoynt_ for intra-articular injection_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ABO GNOTYP ABO 7 EXONS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0180U","description":"ABO GNOTYP ABO 7 EXONS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRB0","description":"ICD-HDRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICEB1","description":"ICD-ICEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQB0","description":"ICD-OJQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oocyte identification","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89254","description":"Oocyte identification","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mccd_ risk adj_ level 5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9011","description":"Mccd_ risk adj_ level 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrate iv infusion add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96361","description":"Hydrate iv infusion add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHXB1","description":"ICD-CHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBIA0","description":"ICD-GBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHD0","description":"ICD-CCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBXA1","description":"ICD-KBXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXA1","description":"ICD-OLXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electromagnetic therapy onc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0295","description":"Electromagnetic therapy onc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove knee joint lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27335","description":"Remove knee joint lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27832","description":"Treat lower leg dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEEA1","description":"ICD-OEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of skin tags 48 in w/o b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6236","description":"Hydrocolld drg > 48 in w/o b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHTC1","description":"ICD-CHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive vulva surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56640","description":"Extensive vulva surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHM1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICCB1","description":"ICD-ICCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBUC1","description":"ICD-CBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFKT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15730","description":"Midface flap (ie_ zygomaticofacial flap) with preservation of vascular pedicle(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDF0","description":"ICD-JHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc no pt rsk death w/in 1yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1151F","description":"Doc no pt rsk death w/in 1yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTC1","description":"ICD-GHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBB1","description":"ICD-CEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy/dynamometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92260","description":"Ophthalmoscopy/dynamometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDF1","description":"ICD-OBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFB1","description":"ICD-NEFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GADE1","description":"ICD-GADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01820","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","description":"CPT-01820","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GISB0","description":"ICD-GISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise circulation to head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61710","description":"Revise circulation to head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9771","description":"At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Each addtnl prefab post","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2957","description":"Each addtnl prefab post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44143","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIF0","description":"ICD-BAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt adheres guide","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9056","description":"Onc prac mgmt adheres guide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal hysterectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94451","description":"Anesth vaginal hysterectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDFA0","description":"ICD-JDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCQA0","description":"ICD-HCQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIF0","description":"ICD-ABIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIFC1","description":"ICD-KIFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGVC0","description":"ICD-JGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFYA0","description":"ICD-HFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng arm splint fbrg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4018","description":"Cast sup lng arm splint fbrg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acesso dl_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4293","description":"Acesso dl_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0842T","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKJB0","description":"ICD-OKJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJB1","description":"ICD-BIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IADB0","description":"ICD-IADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB14A","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLD1","description":"ICD-ODLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFD0","description":"ICD-OBFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00916","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","description":"CPT-00916","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant/replace hearing aid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69710","description":"Implant/replace hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3310","description":"Anterior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE1","description":"ICD-KIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74320","description":"Cholangiography_ percutaneous_ transhepatic_ radiological supervisionand interpretation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25D","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF1","description":"ICD-OEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy & decompress","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45337","description":"Sigmoidoscopy & decompress","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00148","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","description":"CPT-00148","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27497","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KITA0","description":"ICD-KITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67830","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remv/repl penis contain pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54416","description":"Remv/repl penis contain pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prosthetic type socket molde","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2350","description":"Prosthetic type socket molde","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL60","description":"High Rehab plus Extensive _ ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUE0","description":"ICD-KAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE22C","description":"Clinically Complex _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0291U","description":"Psychiatry (Mood Disorders)_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 144 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEA0","description":"ICD-FGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mitoxantrone hydrochl / 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9293","description":"Mitoxantrone hydrochl / 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEC0","description":"ICD-ABEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4377","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","description":"HCPCS-Q4377","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMF1","description":"ICD-EIMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of sesamoid bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28315","description":"Removal of sesamoid bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft brachial-brchl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35525","description":"Art byp grft brachial-brchl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Daunorubicin citrate inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9151","description":"Daunorubicin citrate inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVD0","description":"ICD-FIVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid plastic cust fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0484","description":"Tlso rigid plastic cust fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1903","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1903","description":"HCPCS-B1903","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBHB1","description":"ICD-KBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAE1","description":"ICD-KFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLC0","description":"ICD-FGLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBC0","description":"ICD-IBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rotary wing air mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0436","description":"Rotary wing air mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFJB0","description":"ICD-JFJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"InnovaMatrix PD_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A2023","description":"InnovaMatrix PD_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWE0","description":"ICD-DBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20520","description":"Removal of foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDFD0","description":"ICD-CDFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGEA1","description":"ICD-BGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBE1","description":"ICD-GEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC1","description":"ICD-GBGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHD0","description":"ICD-NHHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreserve stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38207","description":"Cryopreserve stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay galactose transferase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82775","description":"Assay galactose transferase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEUE0","description":"ICD-MEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Powered air mattress overlay","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0372","description":"Powered air mattress overlay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0137","description":"Injection_ acetaminophen (hikma) not therapeutically equivalent to j0131_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spine disk surgery thorax","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63078","description":"Spine disk surgery thorax","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFOA1","description":"ICD-KFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA0","description":"ICD-FCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC20D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JABF0","description":"ICD-JABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEFC0","description":"ICD-GEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB0","description":"ICD-CACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0554","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","description":"HCPCS-G0554","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBF1","description":"ICD-IEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KENC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KENC1","description":"ICD-KENC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA1","description":"ICD-HEOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGOD0","description":"ICD-KGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTA1","description":"ICD-MLTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHE1","description":"ICD-JFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aphakia prosth service temp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92358","description":"Aphakia prosth service temp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBQA0","description":"ICD-PBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGA1","description":"ICD-GCGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81204","description":"AR (androgen receptor) (eg_ spinal and bulbar muscular atrophy_ Kennedy disease_ X chromosome inactivation) gene analysis; characterization of alleles (eg_ expanded size or me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat/graft heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28420","description":"Treat/graft heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKAC1","description":"ICD-NKAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIDE0","description":"ICD-JIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGF1","description":"ICD-GBGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDD0","description":"ICD-EIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ho post-op hip abduction","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1686","description":"Ho post-op hip abduction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0069","description":"Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28A","description":"Clinically Complex _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB15A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGMD0","description":"ICD-OGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-82233","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","description":"CPT-82233","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mobility d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8980","description":"Mobility d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAD0","description":"ICD-CDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHC1","description":"ICD-KIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX34","description":"High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESC1","description":"ICD-HESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove abdominal lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38747","description":"Remove abdominal lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUD0","description":"ICD-BEUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy cleaning brush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4626","description":"Tracheostomy cleaning brush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult companioncare per 15m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5135","description":"Adult companioncare per 15m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE1","description":"ICD-IELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGUE1","description":"ICD-AGUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87420","description":"IAAD IA RESPIRATORY SYNCTIAL VIRUS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy stent add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31637","description":"Bronchoscopy stent add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDDE1","description":"ICD-IDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTD1","description":"ICD-IDTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9595","description":"Piflufolastat F-18_ Diagnostic_ 1 Millicurie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE114","description":"Special Care Low _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric partial denture fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6985","description":"Pediatric partial denture fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trauma respons w/hosp criti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0390","description":"Trauma respons w/hosp criti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHL3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KADB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KADB0","description":"ICD-KADB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFJD0","description":"ICD-KFJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93586","description":"Venography for congenital heart defect(s)_ including catheter placement_ and radiological supervision and interpretation; coronary sinus (List separately in addition to code f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKWC1","description":"ICD-PKWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28C","description":"Special Care Low _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC1","description":"ICD-OGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLF1","description":"ICD-CDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acylcarnitines qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82016","description":"Acylcarnitines qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0364U","description":"Oncology (hematolymphoid neoplasm)_ genomic sequence analysis using multiplex (PCR) and next-generation sequencing with algorithm_ quantification of dominant clonal sequence(s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPB0","description":"ICD-CAPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGLU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCNF0","description":"ICD-OCNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSE0","description":"ICD-OJSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vit for macular hole","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67042","description":"Vit for macular hole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JINA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JINA1","description":"ICD-JINA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXE0","description":"ICD-JIXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protamine sulfate per 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4802","description":"Protamine sulfate per 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBVE1","description":"ICD-CBVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHCA0","description":"ICD-GHCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interstitial radioelement application; simple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77776","description":"Interstitial radioelement application; simple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd w/transmural drain cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43240","description":"Egd w/transmural drain cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detect agnt mult dna ampli","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87801","description":"Detect agnt mult dna ampli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10C","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extended steel shank","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2360","description":"Extended steel shank","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEND0","description":"ICD-JEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTC0","description":"ICD-KHTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace cover w/c seat cush","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2619","description":"Replace cover w/c seat cush","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0555U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","description":"CPT-0555U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23600","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGA1","description":"ICD-JIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft protect helmet custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A8002","description":"Soft protect helmet custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7507","description":"Percutaneous vertebral augmentations_ first thoracic and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ BICROS_ in the ear","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5210","description":"Hearing aid_ BICROS_ in the ear","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trastuzumab not administered within 12 months of diagnosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9837","description":"Trastuzumab not administered within 12 months of diagnosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESC1","description":"ICD-KESC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee cap medial or lateral p","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2800","description":"Knee cap medial or lateral p","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC1","description":"ICD-MALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transseptal fiberotomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7291","description":"Transseptal fiberotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAPF1","description":"ICD-FAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meals per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9977","description":"Meals per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emerge matrix_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4297","description":"Emerge matrix_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1482","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","description":"HCPCS-M1482","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair heart septum defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33684","description":"Repair heart septum defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVB0","description":"ICD-BHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCPF1","description":"ICD-NCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEB0","description":"ICD-BHEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0513U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","description":"CPT-0513U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGK2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-linked intellectual dblt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81470","description":"X-linked intellectual dblt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap ing hernia repair recur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49651","description":"Lap ing hernia repair recur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug delivery system >=50 ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4305","description":"Drug delivery system >=50 ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALF1","description":"ICD-MALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL12","description":"High Rehab plus Extensive _ ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18D","description":"Clinically Complex _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Statin therapy/currently tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4013F","description":"Statin therapy/currently tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGD1","description":"ICD-KAGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXA1","description":"ICD-CGXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIE1","description":"ICD-BAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trluml perip athrc iliac art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0238T","description":"Trluml perip athrc iliac art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood transfusion service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36430","description":"Blood transfusion service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1083","description":"Radiation Therapy For Cervical Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCQD0","description":"ICD-LCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled nitric oxide meas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95012","description":"Exhaled nitric oxide meas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAC1","description":"ICD-OAAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD0","description":"ICD-CDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKFE1","description":"ICD-OKFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX52","description":"Very High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62322","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPC1","description":"ICD-NKPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 3 yrs+ im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90658","description":"Iiv3 vaccine 3 yrs+ im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-ray each vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75774","description":"Artery x-ray each vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWA0","description":"ICD-GAWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCVA1","description":"ICD-KCVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9921","description":"No screening performed_ partial screening performed or positive screen without recommendations and reason is not given or otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90677","description":"Pneumococcal conjugate vaccine_ 20 valent (PCV20)_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Speech therapy_ in the home_","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9128","description":"Speech therapy_ in the home_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9343","description":"Search for prior patient completed dicom format images not completed due to medical reasons(eg_CT studies performed for radiation treatment planning or image-guided radiation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0953T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","description":"CPT-0953T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIID0","description":"ICD-KIID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl perph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33969","description":"Ecmo/ecls rmvl perph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKC1","description":"ICD-FBKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEAF1","description":"ICD-AEAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01852","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","description":"CPT-01852","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF0","description":"ICD-GFKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of gallbladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47600","description":"Removal of gallbladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7213","description":"Injection_ coagulation factor ix (recombinant)_ ixinity_ 1 i.u.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHYF0","description":"ICD-PHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHBE0","description":"ICD-AHBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBMA0","description":"ICD-CBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEEA1","description":"ICD-NEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7560","description":"Endoscopic retrograde cholangiopancreatography (ercp) with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s) and endoscopic cannulation of papilla with di","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVB1","description":"ICD-GBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transport parking fees/tolls","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0170","description":"Transport parking fees/tolls","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quant nonher2 ihc brst cx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3395F","description":"Quant nonher2 ihc brst cx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBLE1","description":"ICD-OBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXC1","description":"ICD-FCXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diast bp <80 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3078F","description":"Diast bp <80 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWB0","description":"ICD-DEWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA33","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not M","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWF1","description":"ICD-OLWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9913","description":"Hepatitis B virus (HBV) status not assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate arrhythmia add on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93655","description":"Ablate arrhythmia add on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYA1","description":"ICD-LHYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHVC0","description":"ICD-JHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWD1","description":"ICD-DAWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBBA0","description":"ICD-EBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1452","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","description":"HCPCS-M1452","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHD0","description":"ICD-JEHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCRC1","description":"ICD-GCRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise additional leg tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27692","description":"Revise additional leg tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWA0","description":"ICD-GFWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of heart sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33025","description":"Incision of heart sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Egd us fine needle bx/aspir","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43242","description":"Egd us fine needle bx/aspir","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXB1","description":"ICD-BIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iv hanger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0105","description":"Iv hanger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93593","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Normal Native Connection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLA0","description":"ICD-BFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0601","description":"CDT-D0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental inlay metallic 2 surf","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2520","description":"Dental inlay metallic 2 surf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILD0","description":"ICD-BILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCYC0","description":"ICD-CCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBPC1","description":"ICD-CBPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth spine cord surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62051","description":"Anesth spine cord surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIGE1","description":"ICD-OIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBED0","description":"ICD-KBED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAAB1","description":"ICD-CAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUF0","description":"ICD-EEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+cell count <200cells/mm3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3494F","description":"Cd4+cell count <200cells/mm3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB35","description":"Very High Rehab _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC1","description":"ICD-OHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBTA1","description":"ICD-KBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plague vaccine_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90727","description":"Plague vaccine_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OERE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OERE0","description":"ICD-OERE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90692","description":"Typhoid vaccine_ heat- and phenol-inactivated (h-p)_ for subcutaneous orintradermal use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj bulking agent anal canal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8605","description":"Inj bulking agent anal canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB0","description":"ICD-GDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLLA0","description":"ICD-MLLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc h-f-nk-sp b9+marg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11424","description":"Exc h-f-nk-sp b9+marg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA25","description":"High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD0","description":"ICD-GHJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUC1","description":"ICD-IHUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDID0","description":"ICD-CDID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOE0","description":"ICD-DDOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv vacc pandemic adjuvt im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90667","description":"Iiv vacc pandemic adjuvt im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Helicoll_ per square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4164","description":"Helicoll_ per square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9912","description":"Hepatitis B virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid caster tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2391","description":"Solid caster tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PESC0","description":"ICD-PESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD20B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home Adaptations (>$6_000)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0141","description":"Home Adaptations (>$6_000)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC1","description":"ICD-AFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone acet inj nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3301","description":"Triamcinolone acet inj nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGUC0","description":"ICD-BGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB18B","description":"Special Care High _ ADL Index 2-5/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJD0","description":"ICD-ODJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGEB0","description":"ICD-NGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEMB0","description":"ICD-IEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDD0","description":"ICD-NHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB0","description":"ICD-KDPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB1","description":"ICD-KBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81111","description":"Human Platelet Antigen 9 genotyping (HPA-9w)_ ITGA2B (integrin_ alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex_ antigen CD41] [GPIIb]) (eg_ neonatal alloimmune thromb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls rmvl ctr cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33986","description":"Ecmo/ecls rmvl ctr cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL5C","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ abd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8902","description":"Mra w/o fol w/cont_ abd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Childbirth refresher class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9437","description":"Childbirth refresher class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFF0","description":"ICD-FIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual adult wc w tiltinspac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1161","description":"Manual adult wc w tiltinspac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJA0","description":"ICD-JEJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0578T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System With Interim Analysis_ Review(S) And Report(S) By A P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1168","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAJB1","description":"ICD-NAJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHD1","description":"ICD-KIHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC1","description":"ICD-GEEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCA1","description":"ICD-CHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBVB0","description":"ICD-KBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB160","description":"Special Care High _ ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spun microhematocrit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85013","description":"Spun microhematocrit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIB0","description":"ICD-OKIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophageal recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93616","description":"Esophageal recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Semi precision attach abut","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6052","description":"Semi precision attach abut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD15A","description":"Clinically Complex _ ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCTA1","description":"ICD-BCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE1","description":"ICD-KEGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBC0","description":"ICD-OLBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC0","description":"ICD-JDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIAB0","description":"ICD-CIAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94617","description":"Exercise test for bronchospasm_ including pre- and post-spirometry_ electrocardiographic recording(s)_ and pulse oximetry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of facial bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21209","description":"Reduction of facial bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIED1","description":"ICD-AIED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue exam by pathologist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88302","description":"Tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71030","description":"Chest x-ray 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBYD1","description":"ICD-LBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIDA1","description":"ICD-GIDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal finger bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26236","description":"Partial removal finger bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No bp measure doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8756","description":"No bp measure doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9876","description":"Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUD1","description":"ICD-GBUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9369","description":"Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9763","description":"Cardiac magnetic resonance imaging for morphology and function_ quantification of segmental dysfunction; with stress im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB125","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FECE1","description":"ICD-FECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64659","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","description":"CPT-64659","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABEF0","description":"ICD-ABEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE1","description":"ICD-KIJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCSC1","description":"ICD-KCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCE0","description":"ICD-NBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIC0","description":"ICD-GIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXC1","description":"ICD-GGXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAC1","description":"ICD-AGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXC0","description":"ICD-GBXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKD1","description":"ICD-FEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0279","description":"Diagnostic digital breast tomosynthesis_ unilateral or bilateral (list separately in addition to 77065-77067)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSD1","description":"ICD-HCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGF1","description":"ICD-FFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef less than/equal to 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3055F","description":"Lvef less than/equal to 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of apolipoprotein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82172","description":"Assay of apolipoprotein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSE0","description":"ICD-PBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCEC1","description":"ICD-JCEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIC1","description":"ICD-IIIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE25A","description":"Special Care High _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHA0","description":"ICD-CCHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJF0","description":"ICD-KGJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUC1","description":"ICD-FCUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shingrix vaccine not documented as administered_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1066","description":"Shingrix vaccine not documented as administered_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic elbow sequential","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7180","description":"Electronic elbow sequential","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB1","description":"ICD-JHBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA32","description":"Low Rehab_ ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0220","description":"Injection_ tixagevimab and cilgavimab_ for the pre-exposure prophylaxis only_ for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) w","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWB1","description":"ICD-DGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAVA0","description":"ICD-CAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIC1","description":"ICD-FGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVB1","description":"ICD-OBVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0103","description":"CDT-D0103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0584U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","description":"CPT-0584U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUE0","description":"ICD-EDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos back post/lat wdth>=22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2616","description":"Pos back post/lat wdth>=22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2082","description":"Office Or Other Outpatient Visit For The Evaluation And Management Of An Established Patient That Requires The Supervision Of A Physician Or Other Qualified Health Care Profes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of infusion pump","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36262","description":"Removal of infusion pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAOD0","description":"ICD-GAOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISB0","description":"ICD-PISB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD1","description":"ICD-IELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHA1","description":"ICD-MGHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCF1","description":"ICD-ADCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGLE1","description":"ICD-AGLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX1B","description":"Low Rehab plus Extensive _ ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCF0","description":"ICD-GGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRD1","description":"ICD-OFRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat uterus infection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59830","description":"Treat uterus infection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDF1","description":"ICD-CGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rimantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9020","description":"Rimantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITA1","description":"ICD-OITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUF1","description":"ICD-CHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Single visn sphere 4.12-7.00","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2101","description":"Single visn sphere 4.12-7.00","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBOE0","description":"ICD-LBOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1118","description":"Ongoing Care Not Indicated_ Patient Seen Only 1-2 Visits (E.G._ Home Program Only_ Referred To Another Provider Or Facility_ Consultation Only)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQB0","description":"ICD-DIQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPD0","description":"ICD-NDPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray consultation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76140","description":"X-ray consultation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of neck artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37615","description":"Ligation of neck artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insemination of oocytes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89268","description":"Insemination of oocytes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin rapid 5 u","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5550","description":"Insulin rapid 5 u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy & treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50576","description":"Kidney endoscopy & treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB1","description":"ICD-LDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urgent care center global","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9083","description":"Urgent care center global","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFD1","description":"ICD-GIFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHB1","description":"ICD-KCHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXE0","description":"ICD-KEXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCXD0","description":"ICD-FCXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPE1","description":"ICD-NEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA0","description":"ICD-MFTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFB1","description":"ICD-OFFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC0","description":"ICD-BFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKNF1","description":"ICD-NKNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBB0","description":"ICD-JCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0428U","description":"Oncology (breast)_ targeted hybrid-capture genomic sequence analysis panel_ circulating tumor DNA (ctDNA) analysis of 56 or more genes_ interrogation for sequence variants_ ge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETF0","description":"ICD-CETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artacent cord_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4216","description":"Artacent cord_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDB0","description":"ICD-IFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of foot tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28222","description":"Release of foot tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0580T","description":"Removal Of Substernal Implantable Defibrillator Pulse Generator Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy of liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47000","description":"Needle biopsy of liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0454T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of aqueous shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66184","description":"Revision of aqueous shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear antigen antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86235","description":"Nuclear antigen antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home infusion/visit 2 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99601","description":"Home infusion/visit 2 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6123","description":"Implant Supported Retainer For Metal Fpd - Titanium And Titanium Alloys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01937","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","description":"CPT-01937","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22853","description":"Insertion of interbody biomechanical device(s) (eg_ synthetic cage_ mesh) with integral anterior instrumentation for device anchoring (eg_ screws_ flanges)_ when performed_ to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICB0","description":"ICD-FICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLD0","description":"ICD-BFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLTD0","description":"ICD-MLTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLD1","description":"ICD-EFLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKF0","description":"ICD-NCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0931T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","description":"CPT-0931T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB52","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEHA0","description":"ICD-JEHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOC0","description":"ICD-LHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0608U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","description":"CPT-0608U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9752","description":"Destruction of intraosseous basivertebral nerve_ first two vertebral bodies_ including imaging guidance (e.g._ fluoroscopy)_ lu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain neg no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8731","description":"Pain neg no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCC1","description":"ICD-GDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00100","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","description":"CPT-00100","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Water circ heat pad w pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0217","description":"Water circ heat pad w pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIA1","description":"ICD-BEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Msh2 gene dup/delete variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81297","description":"Msh2 gene dup/delete variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEA0","description":"ICD-OGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIC1","description":"ICD-JHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67906","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEHD1","description":"ICD-BEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of collar bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73000","description":"X-ray exam of collar bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"D5w/0.45ns w kcl and mgs04","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5014","description":"D5w/0.45ns w kcl and mgs04","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upr/l xtremity art 2 levels","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93922","description":"Upr/l xtremity art 2 levels","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9310","description":"Injection_ rituximab_ 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1286","description":"Bmi is documented as being outside of normal parameters_ follow-up plan is not completed for documented medical reason","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDE1","description":"ICD-BIDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFCF0","description":"ICD-BFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVE0","description":"ICD-NKVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHXB0","description":"ICD-OHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genotype dna/rna hiv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87906","description":"Genotype dna/rna hiv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92628","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","description":"CPT-92628","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQE0","description":"ICD-HFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLF0","description":"ICD-BGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hx bld transf b/f 1992","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9449","description":"Hx bld transf b/f 1992","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKD0","description":"ICD-NLKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEF0","description":"ICD-NHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8564","description":"Pt ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOF0","description":"ICD-CDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEF0","description":"ICD-MFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJIE0","description":"ICD-OJIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHSA1","description":"ICD-GHSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB105","description":"Clinically Complex _ ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resin-based composite - four or more surfaces (anterior)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2335","description":"Resin-based composite - four or more surfaces (anterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC0","description":"ICD-AIHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYC1","description":"ICD-DCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEC0","description":"ICD-ADEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJMA0","description":"ICD-NJMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHWE0","description":"ICD-LHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of residual cervix","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57540","description":"Removal of residual cervix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc death in hosp aaa repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9262","description":"Doc death in hosp aaa repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCHA1","description":"ICD-FCHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx tfrml eprl w/us lumb/sac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0231T","description":"Njx tfrml eprl w/us lumb/sac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB0","description":"ICD-ODIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4HC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4HC21","description":"ICD-4HC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACC0","description":"ICD-KACC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2207","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of figure eight","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29049","description":"Application of figure eight","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE125","description":"Special Care High _ ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHWD0","description":"ICD-DHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht hemodialysis diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9335","description":"Ht hemodialysis diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of radius","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24145","description":"Partial removal of radius","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADD0","description":"ICD-EADD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE0","description":"ICD-GFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUA0","description":"ICD-KBUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-37289","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","description":"CPT-37289","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAB0","description":"ICD-OBAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dental gold foil two surface","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2420","description":"Dental gold foil two surface","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BENB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BENB1","description":"ICD-BENB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9999","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","description":"HCPCS-Q9999","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr standing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2301","description":"Pwr standing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Polarization_ any lens","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2762","description":"Polarization_ any lens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCF0","description":"ICD-MBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGBC0","description":"ICD-AGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD226","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADAF1","description":"ICD-ADAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF0","description":"ICD-FILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIKC1","description":"ICD-GIKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IABC1","description":"ICD-IABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPC0","description":"ICD-OEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJID0","description":"ICD-OJID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak pelvic control belt light","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5692","description":"Ak pelvic control belt light","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc lpn/rn obs/asses ea 15","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0163","description":"Hhc lpn/rn obs/asses ea 15","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg artery-vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33519","description":"Cabg artery-vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQD0","description":"ICD-PEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFIE1","description":"ICD-FFIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDLC0","description":"ICD-EDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNB1","description":"ICD-FFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPF0","description":"ICD-NEPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gi nuclear procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78299","description":"Gi nuclear procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9306","description":"Injection_ pertuzumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSC1","description":"ICD-OBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUA0","description":"ICD-JHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX13","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHD0","description":"ICD-CBHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fld ped wc tltnspc w/o seat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1234","description":"Fld ped wc tltnspc w/o seat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18I","description":"Clinically Complex _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA14","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8040","description":"Nasal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGD1","description":"ICD-BEGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject spine w/cath lmb/scrl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62319","description":"Inject spine w/cath lmb/scrl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGID0","description":"ICD-KGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAE0","description":"ICD-GGAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFC1","description":"ICD-KBFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIEF0","description":"ICD-FIEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB56","description":"Low Rehab_ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sacral nerve stim test lead","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4290","description":"Sacral nerve stim test lead","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEE1","description":"ICD-AGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA1","description":"ICD-MEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat ectopic pregnancy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59130","description":"Treat ectopic pregnancy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen dressing >48 sq in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6023","description":"Collagen dressing >48 sq in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB13","description":"Ultra High Rehab _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGCF1","description":"ICD-BGCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAD0","description":"ICD-AIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJDA1","description":"ICD-OJDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54420","description":"Revision of penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Provide inr test mater/equip","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0249","description":"Provide inr test mater/equip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4479","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","description":"HCPCS-A4479","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYB0","description":"ICD-LDYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient admitted to a SPU or an ASC for monitoring and observation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"X0597","description":"Patient admitted to a SPU or an ASC for monitoring and observation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDDD0","description":"ICD-FDDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmic endoscope add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66990","description":"Ophthalmic endoscope add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angio abdominal arteries","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75635","description":"Ct angio abdominal arteries","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMB1","description":"ICD-OAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild outer ear canal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69310","description":"Rebuild outer ear canal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc hip pelvis les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27043","description":"Exc hip pelvis les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whirlpool Tub_ Walk-In_ Portable","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1003","description":"Whirlpool Tub_ Walk-In_ Portable","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5946","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5946","description":"CDT-D5946","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCED1","description":"ICD-OCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC1","description":"ICD-OBCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGWC0","description":"ICD-DGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Out of office emerg med serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99060","description":"Out of office emerg med serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95720","description":"Electroencephalogram (Eeg)_ Continuous Recording_ Physician Or Other Qualified Health Care Professional Review Of Recorded Events_ Analysis Of Spike And Seizure Detection_ Eac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMC0","description":"ICD-ECMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBC0","description":"ICD-KIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYC0","description":"ICD-OCYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1260","description":"Patients who were not listed on the kidney-pancreas transplant waitlist or patients who did not receive a living donor transplant within the first year following initiation of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAA1","description":"ICD-KEAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTD0","description":"ICD-NGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0542","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","description":"HCPCS-G0542","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirikizumab-mrkz_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9168","description":"Injection_ mirikizumab-mrkz_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65285","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBF0","description":"ICD-MEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC0","description":"ICD-IFCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHIA0","description":"ICD-CHIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr seat tilt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1002","description":"Pwr seat tilt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA1","description":"ICD-IFBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of spinal herniation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63702","description":"Repair of spinal herniation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGE0","description":"ICD-KDGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Teniposide_ 50 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q2017","description":"Teniposide_ 50 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDD1","description":"ICD-ACDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAIF1","description":"ICD-GAIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50575","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPB1","description":"ICD-KDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETC0","description":"ICD-FETC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No hepc rna after med docrsn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9210","description":"No hepc rna after med docrsn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern block < 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49582","description":"Rpr umbil hern block < 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove lung catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32552","description":"Remove lung catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eeg all night recording","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95827","description":"Eeg all night recording","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4C","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBLE0","description":"ICD-MBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUC0","description":"ICD-OGUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDC0","description":"ICD-ODDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBF1","description":"ICD-GCBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IA21","description":"ICD-3IA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYD1","description":"ICD-LAYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tee w or w/o fol w/cont_ mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8927","description":"Tee w or w/o fol w/cont_ mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2210","description":"Risk-adjusted functional status change residual score for the neck impairment not measured because the patient did not complete the neck fs prom at initial evaluation and/or n","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8E","description":"Low Rehab_ ADL Index 11-16/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Triamcinolone hexacetonl inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3303","description":"Triamcinolone hexacetonl inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical repair of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43501","description":"Surgical repair of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYE0","description":"ICD-LCYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE12B","description":"Reduced Physical Function _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of leg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27892","description":"Decompression of leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRE0","description":"ICD-DBRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shoulder cast fbrgl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4004","description":"Cast sup shoulder cast fbrgl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICF1","description":"ICD-MICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCGF1","description":"ICD-BCGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services provided in urgent","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9088","description":"Services provided in urgent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGQA0","description":"ICD-GGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted case mgmt per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2023","description":"Targeted case mgmt per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML36","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGYF0","description":"ICD-LGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDDE1","description":"ICD-CDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFC1","description":"ICD-CHFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Legion pneumo dna dir prob","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87540","description":"Legion pneumo dna dir prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUD1","description":"ICD-MCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0025U","description":"Tenofovir_ by liquid chromatography with tandem mass spectrometry (LC-MS/MS)_ urine_ quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protein e-phoresis serum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84165","description":"Protein e-phoresis serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB2B","description":"Medium Rehab _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGNU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef greater than 35%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3056F","description":"Lvef greater than 35%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Euglobulin lysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85360","description":"Euglobulin lysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ voriconazole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3465","description":"Injection_ voriconazole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Obstructive sleep apnea mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8900","description":"Obstructive sleep apnea mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJB0","description":"ICD-CHJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES125","description":"Extensive Services _ ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54115","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syst bp >/= 140 mm hg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3077F","description":"Syst bp >/= 140 mm hg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIA1","description":"ICD-OIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAE1","description":"ICD-FDAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDMA0","description":"ICD-GDMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18G","description":"Extensive Services _ ADL Index 2-16/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE1","description":"ICD-CGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGGD0","description":"ICD-OGGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAA1","description":"ICD-JFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18X","description":"Special Care Low _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behind ear binaur hearing ai","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5140","description":"Behind ear binaur hearing ai","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIF0","description":"ICD-MBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CECE1","description":"ICD-CECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML30","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA0","description":"ICD-DAYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLD1","description":"ICD-NHLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28F","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEA0","description":"ICD-JDEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAOA1","description":"ICD-HAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4422","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","description":"HCPCS-Q4422","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep b core antibody igm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86705","description":"Hep b core antibody igm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCSC0","description":"ICD-CCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Risperidone_ long acting","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2794","description":"Risperidone_ long acting","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWC1","description":"ICD-LDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALE0","description":"ICD-IALE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEPE1","description":"ICD-KEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHUF1","description":"ICD-NHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESA1","description":"ICD-OESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of kidney lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50390","description":"Drainage of kidney lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCIC1","description":"ICD-JCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-83884","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","description":"CPT-83884","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36581","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAE0","description":"ICD-FAAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ovine_ up to 999 usp units","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3471","description":"Ovine_ up to 999 usp units","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc cranial intra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61781","description":"Scan proc cranial intra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coronectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7251","description":"Coronectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dactinomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9120","description":"Dactinomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWF0","description":"ICD-KCWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA0","description":"ICD-OLHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIE0","description":"ICD-ADIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GA11","description":"ICD-3GA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCD1","description":"ICD-AFCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKC1","description":"ICD-JAKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBIB1","description":"ICD-MBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEF0","description":"ICD-EDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of breast lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19120","description":"Removal of breast lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21087","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth chest drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52451","description":"Anesth chest drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat knee fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27532","description":"Treat knee fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBD1","description":"ICD-NGBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC07","description":"High Rehab _ ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACCE1","description":"ICD-ACCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI pelvis w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72196","description":"MRI pelvis w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hg a1c level 7.0-9.0%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3045F","description":"Hg a1c level 7.0-9.0%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod or severe osa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8846","description":"Mod or severe osa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Needle biopsy spinal cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62269","description":"Needle biopsy spinal cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGJD1","description":"ICD-GGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"O2/water vapor enrich w/heat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1405","description":"O2/water vapor enrich w/heat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCCC0","description":"ICD-GCCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADID1","description":"ICD-ADID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55882","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","description":"CPT-55882","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFP1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20A","description":"Clinically Complex _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC241","description":"Reduced Physical Function _ ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assess vol mgmt not doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8958","description":"Assess vol mgmt not doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCOC1","description":"ICD-CCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD1","description":"ICD-KAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0317U","description":"Oncology (lung cancer)_ four-probe FISH (3q29_ 3p22.1_ 10q22.3_ 10cen) assay_ whole blood_ predictive algorithm-generated evaluation reported as decreased or increased risk fo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unlisted preventive service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99429","description":"Unlisted preventive service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCSF1","description":"ICD-DCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KACA0","description":"ICD-KACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGJB1","description":"ICD-BGJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove windpipe lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31786","description":"Remove windpipe lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFD1","description":"ICD-CCFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB1","description":"ICD-GBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDQD0","description":"ICD-GDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKD1","description":"ICD-BCKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit intermit chemo diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9331","description":"Hit intermit chemo diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove foreign body adbomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49402","description":"Remove foreign body adbomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0792T","description":"Application of silver diamine fluoride 38%_ by a physician or other qualified health care professional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreas removal/transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48160","description":"Pancreas removal/transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGF1","description":"ICD-JIGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAUE0","description":"ICD-AAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orphenadrine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2360","description":"Orphenadrine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCBF0","description":"ICD-KCBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Talk re uv light pt/crgvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4176F","description":"Talk re uv light pt/crgvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDA1","description":"ICD-CGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonneedle injection device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4210","description":"Nonneedle injection device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx cml chronic phase","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9123","description":"Onc dx cml chronic phase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients receiving high doses of immunosuppressive therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1063","description":"Patients receiving high doses of immunosuppressive therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA2C","description":"Default_ /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc count of ct in 12mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9322","description":"No doc count of ct in 12mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Catheter_ intradiscal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1754","description":"Catheter_ intradiscal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug preventi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0029","description":"Alcohol and/or drug preventi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFYF0","description":"ICD-CFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cool quant sensory test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108T","description":"Cool quant sensory test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLC0","description":"ICD-CDLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGME0","description":"ICD-GGME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped term dev_ hand_ vol clos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6714","description":"Ped term dev_ hand_ vol clos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANF0","description":"ICD-FANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL1B","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9938","description":"Fabrication of a custom removable clear plastic temporary aesthetic appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainable plastic pch w fcpl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4375","description":"Drainable plastic pch w fcpl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERE1","description":"ICD-KERE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCCD1","description":"ICD-CCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGRD0","description":"ICD-OGRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBSA0","description":"ICD-PBSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reinforce pulmonary artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33690","description":"Reinforce pulmonary artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive jaw surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21045","description":"Extensive jaw surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDHA1","description":"ICD-BDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID1","description":"ICD-GGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Peri-px device eval & prgr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93287","description":"Peri-px device eval & prgr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX22","description":"High Rehab plus Extensive _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRB0","description":"ICD-CGRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB20","description":"Medium Rehab _ ADL Index 6-10/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA0","description":"ICD-JAUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIA1","description":"ICD-JAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD0","description":"ICD-OHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTD1","description":"ICD-BFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal donor liver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47140","description":"Partial removal donor liver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rec antivir treat hep c","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8461","description":"Pt rec antivir treat hep c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vis field assmnt tech suppt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0379T","description":"Vis field assmnt tech suppt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8I","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC40","description":"Medium Rehab _ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE1","description":"ICD-EGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDAD0","description":"ICD-KDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyperthermia treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77605","description":"Hyperthermia treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDB0","description":"ICD-FEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0530U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","description":"CPT-0530U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHIC0","description":"ICD-FHIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHE0","description":"ICD-MHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPA1","description":"ICD-BGPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX0B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDB0","description":"ICD-GFDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Current percep threshold tst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0255","description":"Current percep threshold tst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCOB0","description":"ICD-OCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBCD0","description":"ICD-GBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplant ureter to skin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50860","description":"Transplant ureter to skin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22D","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB15C","description":"Special Care Low _ ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj gadoterate meglumi 0.1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9575","description":"Inj gadoterate meglumi 0.1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53080","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intercep dental tx primary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8050","description":"Intercep dental tx primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA0","description":"ICD-NFDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMC0","description":"ICD-JCMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQB1","description":"ICD-CBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye muscle evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92265","description":"Eye muscle evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thumb tendon transfer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26510","description":"Thumb tendon transfer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral place of fix dev","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7998","description":"Intraoral place of fix dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIGD1","description":"ICD-JIGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEAD0","description":"ICD-KEAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPD1","description":"ICD-KBPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15773","description":"Grafting Of Autologous Fat Harvested By Liposuction Technique To Face_ Eyelids_ Mouth_ Neck_ Ears_ Orbits_ Genitalia_ Hands_ And/Or Feet; 25 Cc Or Less Injectate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33279","description":"Removal of phrenic nerve stimulator_ including vessel catheterization_ all imaging guidance_ and interrogation and programming_ when performed; transvenous stimulation or sens","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0683","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","description":"HCPCS-G0683","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amantadine hcl oral brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9033","description":"Amantadine hcl oral brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amobarbital 125 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0300","description":"Amobarbital 125 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hpv high-risk types","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87624","description":"Hpv high-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4613","description":"Battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D0801","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D0801","description":"CDT-D0801","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGPS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Airways surgical procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31899","description":"Airways surgical procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFEF0","description":"ICD-OFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vestibuloplasty exten graft","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7350","description":"Vestibuloplasty exten graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIIA1","description":"ICD-JIIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHWD0","description":"ICD-CHWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs cran les simple addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61797","description":"Srs cran les simple addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETF1","description":"ICD-KETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ilr device eval progr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93285","description":"Ilr device eval progr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUC1","description":"ICD-CGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecg/monitoring and analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93271","description":"Ecg/monitoring and analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAEF0","description":"ICD-EAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJF0","description":"ICD-FCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70496","description":"Ct angiography head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup shrt leg plaster","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4037","description":"Cast sup shrt leg plaster","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ini phq9 >9 remiss <5","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9393","description":"Ini phq9 >9 remiss <5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBE0","description":"ICD-BEBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUA1","description":"ICD-FCUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCMF0","description":"ICD-KCMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFLX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Commode chair pail or pan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0167","description":"Commode chair pail or pan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87637","description":"IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTA0","description":"ICD-IDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEUC1","description":"ICD-EEUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHE1","description":"ICD-BCHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC21","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC10D","description":"Special Care Low _ ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTF0","description":"ICD-BHTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eval aud status rehab add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92627","description":"Eval aud status rehab add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DI GNOTYP SLC4A1 EXON 19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0183U","description":"DI GNOTYP SLC4A1 EXON 19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHQD1","description":"ICD-KHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0624T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"So 8 abd restraint pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3650","description":"So 8 abd restraint pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vertebral body add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63308","description":"Remove vertebral body add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB40","description":"Low Rehab_ ADL Index 11-16/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBA0","description":"ICD-IFBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA0","description":"ICD-LGOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OILE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OILE1","description":"ICD-OILE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFYB0","description":"ICD-PFYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Genital surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58999","description":"Genital surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHF0","description":"ICD-MGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ht inj noc per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9542","description":"Ht inj noc per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit high risk/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9381","description":"Hit high risk/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of rectal abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46060","description":"Incision of rectal abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYE1","description":"ICD-PAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES235","description":"Extensive Services _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCJD0","description":"ICD-FCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54205","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LA21","description":"ICD-1LA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCKE0","description":"ICD-NCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOD1","description":"ICD-OHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATD0","description":"ICD-NATD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"AAA17","description":"Default_ /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69220","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Single vitamin nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9152","description":"Single vitamin nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9294","description":"Injection_ pemetrexed (hospira) not therapeutically equivalent to j9305_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVE1","description":"ICD-BHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL26","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD1","description":"ICD-LHSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHIF1","description":"ICD-JHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of rectocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45560","description":"Repair of rectocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIEE0","description":"ICD-AIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAE0","description":"ICD-ABAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBCE0","description":"ICD-EBCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAE1","description":"ICD-ODAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD113","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54312","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFDD0","description":"ICD-IFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of tmj condyle","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7840","description":"Removal of tmj condyle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHWF0","description":"ICD-PHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCD1","description":"ICD-FGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGMA1","description":"ICD-CGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXB1","description":"ICD-OIXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIC0","description":"ICD-IAIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00539","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","description":"CPT-00539","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anterior gait trainer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E8002","description":"Anterior gait trainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9958","description":"Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair shoulder capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23455","description":"Repair shoulder capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of mouth lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41007","description":"Drainage of mouth lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBNA0","description":"ICD-GBNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHEF0","description":"ICD-IHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB01","description":"Very High Rehab _ ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFB1","description":"ICD-NDFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFA1","description":"ICD-NHFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ monaural_ itc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5243","description":"Hearing aid_ monaural_ itc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFE1","description":"ICD-GBFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABC1","description":"ICD-MABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ESCHERICHIA COLI 0157","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87335","description":"IAAD IA ESCHERICHIA COLI 0157","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC1","description":"ICD-FGVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on med","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4526","description":"Adult size pull-on med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJQD0","description":"ICD-PJQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPA0","description":"ICD-GHPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81168","description":"Ccnd1/Igh (T(11;14)) (Eg_ Mantle Cell Lymphoma) Translocation Analysis_ Major Breakpoint_ Qualitative And Quantitative_ If Performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Somatrem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2940","description":"Somatrem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cor artery disease mrna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81493","description":"Cor artery disease mrna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHTE0","description":"ICD-KHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHD1","description":"ICD-IEHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF0","description":"ICD-ADLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC1","description":"ICD-OJMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA0","description":"ICD-FDHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGC0","description":"ICD-GFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYA0","description":"ICD-DFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVE1","description":"ICD-NAVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXB0","description":"ICD-OEXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intrvasc us noncoronary 1st","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37252","description":"Intrvasc us noncoronary 1st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mild-mod dep symp by deptool","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3353F","description":"Mild-mod dep symp by deptool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0703T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Managem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC34","description":"Medium Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIF0","description":"ICD-MJIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0911","description":"Instillation_ taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of low back nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64862","description":"Repair of low back nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJD0","description":"ICD-GDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14B","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE113","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of insulin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83525","description":"Assay of insulin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screening oxycodone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80365","description":"Drug screening oxycodone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Case presentation_ subsequent to detailed and extensive treatment planning","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9450","description":"Case presentation_ subsequent to detailed and extensive treatment planning","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82247","description":"Bilirubin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8X","description":"Medium Rehab _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE1","description":"ICD-FEKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHWF1","description":"ICD-GHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heredtry nurondcrn tum dsrdr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81437","description":"Heredtry nurondcrn tum dsrdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFRC0","description":"ICD-OFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mod sedat phys/qhp ea 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99145","description":"Mod sedat phys/qhp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQA1","description":"ICD-OAQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGN2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB21","description":"ICD-3GB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHA1","description":"ICD-NJHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHA1","description":"ICD-FDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehen metabolic panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80053","description":"Comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9312","description":"Injection_ rituximab_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trnscrv uterin fibroid abltj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0404T","description":"Trnscrv uterin fibroid abltj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral dexamethasone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8540","description":"Oral dexamethasone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18H","description":"Special Care High _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYC1","description":"ICD-PAYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt ref pulm fx test/peakflow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3758F","description":"Pt ref pulm fx test/peakflow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDAA1","description":"ICD-CDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprssion thxpy prescribed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4267F","description":"Comprssion thxpy prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLC1","description":"ICD-IFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFE0","description":"ICD-JBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB1","description":"ICD-JGCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96136","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional_ two or more tests_ any method; first 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICUC1","description":"ICD-ICUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maxilla open reduct compound","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7710","description":"Maxilla open reduct compound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFMV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILE0","description":"ICD-AILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDB0","description":"ICD-AHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC28G","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28103","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAGD0","description":"ICD-CAGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8E","description":"Very High Rehab _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE204","description":"Special Care Low _ ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIB0","description":"ICD-OIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1051T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1051T","description":"CPT-1051T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc hep gene risk classifier","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0006M","description":"Onc hep gene risk classifier","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Larynx surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31599","description":"Larynx surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of foot bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28288","description":"Partial removal of foot bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34707","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection_ all nonselective catheterization(s)_ all","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDF0","description":"ICD-FFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9761","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cstm dme other than wheelchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0900","description":"Cstm dme other than wheelchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive mastoid surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69511","description":"Extensive mastoid surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cath_ ep_ 19 or few elect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1730","description":"Cath_ ep_ 19 or few elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJE1","description":"ICD-NJJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTA1","description":"ICD-GFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJB0","description":"ICD-FIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd srv 2-3 vsts p mo 2-11","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90955","description":"Esrd srv 2-3 vsts p mo 2-11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFYE0","description":"ICD-DFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDGB0","description":"ICD-FDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEE1","description":"ICD-CFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTF1","description":"ICD-JDTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGUA0","description":"ICD-NGUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBOB1","description":"ICD-KBOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEWA0","description":"ICD-DEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHC0","description":"ICD-JFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare heart-aorta conduit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33404","description":"Prepare heart-aorta conduit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue and mouth surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41599","description":"Tongue and mouth surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIA1","description":"ICD-MCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEQE1","description":"ICD-GEQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGJA0","description":"ICD-NGJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSC0","description":"ICD-OJSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCBB0","description":"ICD-GCBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCDA0","description":"ICD-CCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Angiotensin i enzyme test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82164","description":"Angiotensin i enzyme test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB125","description":"Special Care Low _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDDC0","description":"ICD-BDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0697T","description":"Quantitative Magnetic Resonance For Analysis Of Tissue Composition (Eg_ Fat_ Iron_ Water Content)_ Including Multiparametric Data Acquisition_ Data Preparation And Transmissio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treponema pallidum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86780","description":"Treponema pallidum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCE0","description":"ICD-CDCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abdominal pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1270","description":"Abdominal pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC13B","description":"Special Care Low _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm order/admin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4037F","description":"Influenza imm order/admin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Full sole/heel wedge btween","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3420","description":"Full sole/heel wedge btween","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKB0","description":"ICD-OKKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC235","description":"Clinically Complex _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECHD0","description":"ICD-ECHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc order given stop antibio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4049F","description":"Doc order given stop antibio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHIF0","description":"ICD-MHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GITE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GITE1","description":"ICD-GITE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spine eltrd perq aray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63663","description":"Revise spine eltrd perq aray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump optical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0477","description":"Drug test presump optical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug screen quan lamotrigine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80175","description":"Drug screen quan lamotrigine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA1","description":"ICD-BACA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD0","description":"ICD-IHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifo 7.25-12/4.2","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2213","description":"Lens sphcyl bifo 7.25-12/4.2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVF0","description":"ICD-FFVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDDE1","description":"ICD-NDDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Install spinal shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63740","description":"Install spinal shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQF0","description":"ICD-LFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGID1","description":"ICD-EGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIE1","description":"ICD-IEIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of mouth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"40842","description":"Reconstruction of mouth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDPB1","description":"ICD-NDPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec site no cutaneous","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9430","description":"Spec site no cutaneous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc hernia repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49659","description":"Laparo proc hernia repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13133","description":"Cmplx rpr f/c/c/m/n/ax/g/h/f","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWC0","description":"ICD-LFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD1","description":"ICD-ACUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise/remove neuroreceiver","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63688","description":"Revise/remove neuroreceiver","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC135","description":"Reduced Physical Function _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue localization-excision","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1819","description":"Tissue localization-excision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vagus n eltrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64570","description":"Remove vagus n eltrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPA0","description":"ICD-OIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILA0","description":"ICD-IILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFLT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINE1","description":"ICD-OINE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair degenerated kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27418","description":"Repair degenerated kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGE1","description":"ICD-KFGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBCA0","description":"ICD-FBCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXD1","description":"ICD-GCXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGFB1","description":"ICD-OGFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antepartum manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59412","description":"Antepartum manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc viral load >=200","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9242","description":"Doc viral load >=200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD10B","description":"Reduced Physical Function _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXE1","description":"ICD-OCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hi enrgy eswt plantar fascia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28890","description":"Hi enrgy eswt plantar fascia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01829","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","description":"CPT-01829","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC112","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFKX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lactate (ld) (ldh) enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83615","description":"Lactate (ld) (ldh) enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Use of speech device service","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92609","description":"Use of speech device service","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGE1","description":"ICD-OKGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cimetidine hydroc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0023","description":"Injection_ cimetidine hydroc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGOB0","description":"ICD-OGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD0","description":"ICD-FIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIE0","description":"ICD-FAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEXA1","description":"ICD-KEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBD0","description":"ICD-MGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9059","description":"Injection_ bendamustine hydrochloride (baxter)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuroeltrd stim post tibial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64566","description":"Neuroeltrd stim post tibial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0452T","description":"Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system_ endovascular approach_ and programming of sensing and therapeutic para","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rimantadine hcl_ brand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9036","description":"Rimantadine hcl_ brand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of face wrinkles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15828","description":"Removal of face wrinkles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEC1","description":"ICD-OIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFC0","description":"ICD-OEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjv hrmnl thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4164F","description":"Adjv hrmnl thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKCC0","description":"ICD-MKCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTA1","description":"ICD-JDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBB1","description":"ICD-BBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC0","description":"ICD-OIJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydroxyprogesterone caproate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1725","description":"Hydroxyprogesterone caproate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBSC1","description":"ICD-KBSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain stem w/o & w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70553","description":"MRI brain stem w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed semi-elect w/o matt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0295","description":"Hosp bed semi-elect w/o matt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDOE1","description":"ICD-CDOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch drain for barrier fl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4425","description":"Ost pch drain for barrier fl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0135U","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting proced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB217","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEEE1","description":"ICD-EEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANF0","description":"ICD-KANF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD0","description":"ICD-IAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAEC1","description":"ICD-AAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWE0","description":"ICD-KHWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAEA1","description":"ICD-MAEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMA0","description":"ICD-OBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion supplies with pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4222","description":"Infusion supplies with pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotherapy by infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0084","description":"Chemotherapy by infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ omadacycline_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0121","description":"Injection_ omadacycline_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVF0","description":"ICD-CHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E0721","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0721","description":"HCPCS-E0721","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ropivacaine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2795","description":"Ropivacaine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBPC0","description":"ICD-OBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDEF1","description":"ICD-BDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUD0","description":"ICD-ACUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom gradient sleev/glov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8420","description":"Custom gradient sleev/glov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLVA1","description":"ICD-OLVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crotalidae poly immune fab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0840","description":"Crotalidae poly immune fab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHIB1","description":"ICD-GHIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHKD1","description":"ICD-GHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHFD0","description":"ICD-CHFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGA0","description":"ICD-NDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov comp bony","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7240","description":"Impact tooth remov comp bony","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHFC0","description":"ICD-FHFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF1","description":"ICD-KEVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening of a patient","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0190","description":"Screening of a patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX12","description":"Very High Rehab plus Extensive _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82487","description":"Chromatography_ qualitative; paper_ 1-dimensional_ analyte not elsewhere specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice continuous home care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2043","description":"Hospice continuous home care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF1","description":"ICD-HGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41500","description":"Fixation of tongue_ mechanical_ other than suture (eg_ K-wire)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47560","description":"Laparoscopy_ surgical; with guided transhepatic cholangiography_ without biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC3D","description":"Very High Rehab _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of web finger","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26560","description":"Repair of web finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red cell sequestration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78140","description":"Red cell sequestration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis spine 3 column adl seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22208","description":"Incis spine 3 column adl seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15769","description":"Grafting Of Autologous Soft Tissue_ Other_ Harvested By Direct Excision (Eg_ Fat_ Dermis_ Fascia)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTD0","description":"ICD-AFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1306","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWD0","description":"ICD-HAWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of penis lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54060","description":"Excision of penis lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDB0","description":"ICD-MDDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelid lining","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68362","description":"Revise eyelid lining","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC12D","description":"Clinically Complex _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESB0","description":"ICD-CESB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther injection carp tunnel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20526","description":"Ther injection carp tunnel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFAA0","description":"ICD-IFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1341","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE28F","description":"Special Care Low _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFB0","description":"ICD-BEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tte w or w/o fol w/cont_ com","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8921","description":"Tte w or w/o fol w/cont_ com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pontic-indirect resin based","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6205","description":"Pontic-indirect resin based","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGB1","description":"ICD-BEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchial valve remov addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31649","description":"Bronchial valve remov addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","description":"HCPCS-J2601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI chest w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71551","description":"MRI chest w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21310","description":"Closed tx nose fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAF1","description":"ICD-ABAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGB0","description":"ICD-KBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE0","description":"ICD-IFLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC14","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB22C","description":"Special Care High _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61860","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gi tract capsule endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91110","description":"Gi tract capsule endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPB1","description":"ICD-OEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPD0","description":"ICD-OFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine infusion device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62365","description":"Remove spine infusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGCA1","description":"ICD-CGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whole mitochondrial genome","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81465","description":"Whole mitochondrial genome","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC125","description":"Special Care Low _ ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIOB0","description":"ICD-CIOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pegloticase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2507","description":"Pegloticase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC0","description":"ICD-JGFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rcm celulr subcelulr img skn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96935","description":"Rcm celulr subcelulr img skn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2208","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA1","description":"ICD-FBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKF1","description":"ICD-KDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAB1","description":"ICD-AGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening for sleep related breathing disorders","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9957","description":"Screening for sleep related breathing disorders","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHOD1","description":"ICD-LHOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of scrotum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55150","description":"Removal of scrotum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDCD0","description":"ICD-KDCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Grp a strep test performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3210F","description":"Grp a strep test performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fistulization of sclera for glaucoma_ through ciliary body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0123T","description":"Fistulization of sclera for glaucoma_ through ciliary body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUA0","description":"ICD-FIUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHC0","description":"ICD-OKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-medical Transportation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W6110","description":"Non-medical Transportation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECF1","description":"ICD-BECF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYA1","description":"ICD-PAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9987","description":"Bundled Payments for Care Improvement Advanced (BPCI Advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDA0","description":"ICD-EHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61480","description":"Craniectomy_ suboccipital; for mesencephalic tractotomy or pedunculotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE1","description":"ICD-HGOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50572","description":"Kidney endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUA1","description":"ICD-NAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEPE1","description":"ICD-OEPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laronidase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1931","description":"Laronidase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXF0","description":"ICD-GFXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGN4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewhfo airplane w/o jnts cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3976","description":"Sewhfo airplane w/o jnts cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGID0","description":"ICD-BGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHIC1","description":"ICD-BHIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVB1","description":"ICD-OAVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein two","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33511","description":"Cabg vein two","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESC0","description":"ICD-LESC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA1","description":"ICD-NLJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA1C","description":"Low Rehab_ ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct capture tmj","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0384","description":"Cone beam ct capture tmj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCYA0","description":"ICD-KCYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALC1","description":"ICD-BALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0997T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","description":"CPT-0997T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBGB0","description":"ICD-OBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATB0","description":"ICD-JATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFSA0","description":"ICD-CFSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0140U","description":"Infectious disease (fungi)_ fungal pathogen identification_ DNA (15 fungal targets)_ blood culture_ amplified probe technique_ each target reported as detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX0D","description":"Very High Rehab plus Extensive _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of long leg cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29345","description":"Application of long leg cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty battery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4611","description":"Heavy duty battery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic myomectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58545","description":"Laparoscopic myomectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGME1","description":"ICD-EGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD130","description":"Clinically Complex _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420U","description":"Oncology (urothelial)_ mRNA expression profiling by real-time quantitative PCR of MDK_ HOXA13_ CDC2_ IGFBP5_ and CXCR2 in combination with droplet digital PCR (ddPCR) analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise middle ear & mastoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69644","description":"Revise middle ear & mastoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2151","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","description":"HCPCS-J2151","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath closure of vsd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93581","description":"Transcath closure of vsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES356","description":"Extensive Services _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABE0","description":"ICD-FABE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower leg bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27607","description":"Treat lower leg bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISC1","description":"ICD-LISC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIMB0","description":"ICD-AIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low (or very low) risk of recurrence_ prostate cancer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9706","description":"Low (or very low) risk of recurrence_ prostate cancer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tympanometry","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92567","description":"Tympanometry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resin infiltration of lesion","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2990","description":"Resin infiltration of lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEE0","description":"ICD-FAEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lefort i-2 piece w/ graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21146","description":"Lefort i-2 piece w/ graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGID1","description":"ICD-NGID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0647U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0647U","description":"CPT-0647U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/endoscopic fnb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45392","description":"Colonoscopy w/endoscopic fnb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJB1","description":"ICD-JEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD246","description":"Special Care Low _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"GE GNOTYP GYPC EXONS 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0188U","description":"GE GNOTYP GYPC EXONS 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep renal graft/arterial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50328","description":"Prep renal graft/arterial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9227","description":"Functional outcome assessment documented_ care plan not documented_ documentation the patient is not eligible for a care plan at the time of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUE1","description":"ICD-AIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEF0","description":"ICD-GFEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBCA1","description":"ICD-KBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGSE0","description":"ICD-PGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93590","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device_ mitral valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multi den insert custom mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5513","description":"Multi den insert custom mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLQD1","description":"ICD-PLQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot yrs cpap 4/> parm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95811","description":"Polysom 6/>yrs cpap 4/> parm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq cardiac angio addl art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92921","description":"Prq cardiac angio addl art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX45","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDNF0","description":"ICD-CDNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abscess imaging ltd area","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78805","description":"Abscess imaging ltd area","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull for surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61460","description":"Incise skull for surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGUF1","description":"ICD-GGUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ givosiran_ 0.5mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9056","description":"Injection_ givosiran_ 0.5mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-care ed provided to pt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4450F","description":"Self-care ed provided to pt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIPA1","description":"ICD-KIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHAA0","description":"ICD-MHAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKE1","description":"ICD-JDKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPX","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA1","description":"ICD-JITA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDD1","description":"ICD-MJDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als iv drug therapy supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0394","description":"Als iv drug therapy supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prenatalcare enhanced srv pk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H1005","description":"Prenatalcare enhanced srv pk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBIB0","description":"ICD-EBIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient compression gauntlet_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6582","description":"Gradient compression gauntlet_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BACA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BACA0","description":"ICD-BACA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGKW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl met band kafo-afo prox","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4080","description":"Repl met band kafo-afo prox","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALC1","description":"ICD-GALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icm/ilr remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93299","description":"Icm/ilr remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXE0","description":"ICD-KDXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of biotinidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82261","description":"Assay of biotinidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHE0","description":"ICD-GCHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Int mam art used for cabg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4110F","description":"Int mam art used for cabg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest stem cell concentrte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38215","description":"Harvest stem cell concentrte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKA1","description":"ICD-NKKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKXC0","description":"ICD-OKXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDOF0","description":"ICD-GDOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA126","description":"Reduced Physical Function _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADCA1","description":"ICD-ADCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKHB1","description":"ICD-OKHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open aortic tube prosth repr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34830","description":"Open aortic tube prosth repr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23155","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFF0","description":"ICD-FAFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Co57/58","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9546","description":"Co57/58","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEID0","description":"ICD-EEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Major vessel shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33750","description":"Major vessel shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath c/v automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88147","description":"Cytopath c/v automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAIA0","description":"ICD-BAIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHPF0","description":"ICD-OHPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C1738","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1738","description":"HCPCS-C1738","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Velaglucerase alfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3385","description":"Velaglucerase alfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CITC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CITC0","description":"ICD-CITC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHE1","description":"ICD-NHHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOB1","description":"ICD-DCOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lube sterile packet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4332","description":"Lube sterile packet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIXA0","description":"ICD-OIXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc prac mgmt dif pt comorb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9060","description":"Onc prac mgmt dif pt comorb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9778","description":"Colpopexy_ vaginal; minimally invasive extra-peritoneal approach (sacrospinous)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHEF1","description":"ICD-EHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tubular dressing","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6457","description":"Tubular dressing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bumetanide_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1939","description":"Injection_ bumetanide_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUB0","description":"ICD-IAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJEB0","description":"ICD-NJEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q9997","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","description":"HCPCS-Q9997","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-sterile gloves","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4927","description":"Non-sterile gloves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEEF1","description":"ICD-MEEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKYA0","description":"ICD-PKYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antisperm antibodies test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3655","description":"Antisperm antibodies test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIEC0","description":"ICD-GIEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove thyroid duct lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60280","description":"Remove thyroid duct lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bilirubin total transcut","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88720","description":"Bilirubin total transcut","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX16","description":"Low Rehab plus Extensive _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA5D","description":"High Rehab _ ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no ref oto reas no spec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8563","description":"Pt no ref oto reas no spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2CC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2CC11","description":"ICD-2CC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEYA1","description":"ICD-DEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18I","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIUB1","description":"ICD-FIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD201","description":"Special Care High _ ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL25","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Felbamate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80167","description":"Felbamate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGFF0","description":"ICD-BGFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL24","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Uvl replacement bulb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4633","description":"Uvl replacement bulb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA3D","description":"Ultra High Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD240","description":"Reduced Physical Function _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGNW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB124","description":"Special Care High _ ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAC1","description":"ICD-FFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMF1","description":"ICD-MEMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGGB1","description":"ICD-NGGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller with sequential calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0680","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLB0","description":"ICD-NBLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Penicillin g benzathine inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0561","description":"Penicillin g benzathine inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AHN5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHC0","description":"ICD-FHHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTD0","description":"ICD-BHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBB1","description":"ICD-JBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tmj arthroscopy synovectomy","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7875","description":"Tmj arthroscopy synovectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGA0","description":"ICD-GDGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX2D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIAD0","description":"ICD-FIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upgrade of pacemaker system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33214","description":"Upgrade of pacemaker system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng esa thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4171F","description":"Pt rcvng esa thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRB1","description":"ICD-PGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWC1","description":"ICD-KIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFF1","description":"ICD-FEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIFF1","description":"ICD-GIFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTC1","description":"ICD-BHTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BB21","description":"ICD-1BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of vulva/perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"56605","description":"Biopsy of vulva/perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0012U","description":"Germline disorders_ gene rearrangement detection by whole genome next-generation sequencing_ DNA_ whole blood_ report of specific gene rearrangement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAD0","description":"ICD-BHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Us exam k transpl w/doppler","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76776","description":"Us exam k transpl w/doppler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0318","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC23","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB1","description":"ICD-HGWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complex cystometrogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51726","description":"Complex cystometrogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sewho airplane w/jnt(s) cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3973","description":"Sewho airplane w/jnt(s) cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation toe & metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28810","description":"Amputation toe & metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject sinus tract for x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20501","description":"Inject sinus tract for x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAFD1","description":"ICD-BAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No electrodiag polyneuro 6mn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3752F","description":"No electrodiag polyneuro 6mn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (Uzedy)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9158","description":"Injection_ risperidone_ (Uzedy)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUB1","description":"ICD-KCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIC0","description":"ICD-JBIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PuraPly XT_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4197","description":"PuraPly XT_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl water chamber_ pap dev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7046","description":"Repl water chamber_ pap dev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81335","description":"TPMT (thiopurine S-methyltransferase) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mcp joint repl 2 pc or more","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8631","description":"Mcp joint repl 2 pc or more","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAXE1","description":"ICD-NAXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of feces/urobilinogen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84577","description":"Assay of feces/urobilinogen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA217","description":"Reduced Physical Function _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ak/knee disartic pelvic band","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5697","description":"Ak/knee disartic pelvic band","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSB1","description":"ICD-HCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDE0","description":"ICD-IGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct urethra/penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54352","description":"Reconstruct urethra/penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tib/per revasc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37232","description":"Tib/per revasc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0281","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","description":"HCPCS-J0281","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC12B","description":"Special Care Low _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation sperm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89259","description":"Cryopreservation sperm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIMB1","description":"ICD-JIMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDE1","description":"ICD-FBDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEE1","description":"ICD-GHEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEA0","description":"ICD-GAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCC0","description":"ICD-CDCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0733T","description":"Remote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support_ per 30 days","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIHB0","description":"ICD-OIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAF0","description":"ICD-NLAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29838","description":"Elbow arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDBF1","description":"ICD-CDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGL1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPC0","description":"ICD-OIPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSF1","description":"ICD-HCSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coagulation time otr method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85348","description":"Coagulation time otr method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIIC0","description":"ICD-OIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28D","description":"Clinically Complex _ ADL Index 0-1/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31290","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd serv 1 visit p mo 20+","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90962","description":"Esrd serv 1 visit p mo 20+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHFD1","description":"ICD-JHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRF1","description":"ICD-OHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFTB0","description":"ICD-GFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5D","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFDB1","description":"ICD-CFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elbow mold doub splt soc ste","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6120","description":"Elbow mold doub splt soc ste","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD1","description":"ICD-OABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No eval riskk vte card prior","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9299","description":"No eval riskk vte card prior","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD213","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBID1","description":"ICD-BBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEPC1","description":"ICD-BEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87651","description":"Strep a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBKF1","description":"ICD-FBKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD255","description":"Special Care High _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBFF0","description":"ICD-KBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDF1","description":"ICD-FHDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYD0","description":"ICD-HHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHF1","description":"ICD-ACHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRE1","description":"ICD-OLRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBYE1","description":"ICD-CBYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release of shoulder ligament","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23415","description":"Release of shoulder ligament","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Other counselor at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9475","description":"Other counselor at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCFA1","description":"ICD-GCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB07","description":"High Rehab _ ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AICF0","description":"ICD-AICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRC0","description":"ICD-CBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLB1","description":"ICD-CFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CATE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CATE0","description":"ICD-CATE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vasectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92151","description":"Anesth vasectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICD1","description":"ICD-OICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKC1","description":"ICD-KDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt preterm labor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9208","description":"Home mgmt preterm labor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0982","description":"Back upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat humerus fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23620","description":"Treat humerus fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPB1","description":"ICD-JGPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEJB1","description":"ICD-CEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOF0","description":"ICD-HIOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTB0","description":"ICD-CFTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND1","description":"ICD-OLND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt no doc hear loss","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8567","description":"Pt no doc hear loss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGAC0","description":"ICD-KGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CELB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CELB0","description":"ICD-CELB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFF1","description":"ICD-ODFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flowcytometry/tc add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88185","description":"Flowcytometry/tc add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIE0","description":"ICD-NDIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICD0","description":"ICD-MICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQD1","description":"ICD-DCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAA0","description":"ICD-EFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAD0","description":"ICD-NHAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EILF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EILF0","description":"ICD-EILF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aspirin/clopidogrel rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4086F","description":"Aspirin/clopidogrel rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCE0","description":"ICD-OJCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBKE1","description":"ICD-GBKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1748","description":"Endoscope_ single-use (i.e. disposable)_ upper GI_ imaging/illumination device (insertable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDPD1","description":"ICD-CDPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21245","description":"Reconstruction of jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGLC1","description":"ICD-EGLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sphyg/bp app w cuff and stet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4660","description":"Sphyg/bp app w cuff and stet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB24C","description":"Special Care High _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0992T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","description":"CPT-0992T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6020","description":"Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00928","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","description":"CPT-00928","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3372","description":"Injection_ vancomycin hcl (xellia) not therapeutically equivalent to j3370_ 500 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE201","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYE0","description":"ICD-OLYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC25B","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLE0","description":"ICD-ODLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABE1","description":"ICD-EABE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33999","description":"Cardiac surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alginate drsg wound filler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6199","description":"Alginate drsg wound filler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGC1","description":"ICD-JGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAXB0","description":"ICD-KAXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYB0","description":"ICD-LCYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0159U","description":"MSH2 (mutS homolog 2) (eg_ hereditary colon cancer_ Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18G","description":"Clinically Complex _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL8X","description":"Very High Rehab plus Extensive _ ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Multiple family group psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90849","description":"Multiple family group psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB4D","description":"Medium Rehab _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrogastrography w/test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91133","description":"Electrogastrography w/test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNB1","description":"ICD-BHNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9490","description":"Comprehensive care for joint replacement model_ home visit for patient assemssment performed by clinical staff for an individual not considered homebound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA0","description":"ICD-LDQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPA0","description":"ICD-BIPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB114","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBD0","description":"ICD-MFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCE1","description":"ICD-MCCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev care mg qual act perfrm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8496","description":"Prev care mg qual act perfrm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No tob assess or cess inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9460","description":"No tob assess or cess inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anaphylaxis due to the vaccine on or before the date of the encounter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1219","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAUC1","description":"ICD-NAUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESD1","description":"ICD-CESD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C-1 esterase_ cinryze","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0598","description":"C-1 esterase_ cinryze","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NITD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NITD0","description":"ICD-NITD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N-et; stretcher van_ mileage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2049","description":"N-et; stretcher van_ mileage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDOD0","description":"ICD-DDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannula nasal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4615","description":"Cannula nasal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIF0","description":"ICD-NGIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd inhal anesthetic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4554F","description":"Pt recvd inhal anesthetic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0399U","description":"Neurology (cerebral folate deficiency)_ serum_ detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA)_ q","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFC1","description":"ICD-JEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj iron dextran","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1750","description":"Inj iron dextran","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CFKS","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFXE1","description":"ICD-NFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing care not medically possible because the patient was discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1147","description":"Ongoing care not medically possible because the patient was discharged early due to specific medical events_ documented in the medical record_ such as the patient became hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sbsq nb em per day hosp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99462","description":"Sbsq nb em per day hosp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFKU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0752","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","description":"HCPCS-J0752","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB55","description":"Ultra High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFTC0","description":"ICD-AFTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8E","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCE1","description":"ICD-OBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46604","description":"Anoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILE0","description":"ICD-BILE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0374T","description":"Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); each additional 30 minutes of technicians","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAJE1","description":"ICD-OAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAKD0","description":"ICD-KAKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc no daily aspirin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9278","description":"Doc no daily aspirin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD0","description":"ICD-NGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDHC1","description":"ICD-JDHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ lurbinectedin_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9223","description":"Injection_ lurbinectedin_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FACE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FACE1","description":"ICD-FACE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aortic aneurysm 5-5.4cm diam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"9002F","description":"Aortic aneurysm 5-5.4cm diam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAEC1","description":"ICD-BAEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF0","description":"ICD-BIBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC14A","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85004","description":"Automated diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aquatic therapy/exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97113","description":"Aquatic therapy/exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDIA0","description":"ICD-IDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWD1","description":"ICD-HIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF0","description":"ICD-PJRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMB1","description":"ICD-EHMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDID1","description":"ICD-BDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOA1","description":"ICD-LCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDA1","description":"ICD-IGDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFQE0","description":"ICD-KFQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGDE1","description":"ICD-BGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid exam both ears","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92591","description":"Hearing aid exam both ears","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ benralizumab_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0517","description":"Injection_ benralizumab_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electric stimulation therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97014","description":"Electric stimulation therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00142","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","description":"CPT-00142","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92201","description":"Ophthalmoscopy_ Extended; With Retinal Drawing And Scleral Depression Of Peripheral Retinal Disease (Eg_ For Retinal Tear_ Retinal Detachment_ Retinal Tumor) With Interpretati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD230","description":"Reduced Physical Function _ ADL Index 11-14/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Impact tooth remov soft tiss","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7220","description":"Impact tooth remov soft tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98971","description":"Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service_ For An Established Patient_ For Up To 7 Days_ Cumulative Time During The 7 Da","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6035","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","description":"HCPCS-L6035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JITA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JITA0","description":"ICD-JITA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0498T","description":"External patient-activated_ physician- or other qualified health care professional-prescribed_ electrocardiographic rhythm derived event recording without 24 hour attended mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTE0","description":"ICD-GDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip bone les deep","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27066","description":"Remove hip bone les deep","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92629","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","description":"CPT-92629","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0502","description":"Initial psychiatric collaborative care management_ first 70 minutes in the first calendar month of behavioral health care manager activities_ in consultation with a psychiatri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo proc spermatic cord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55559","description":"Laparo proc spermatic cord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of stomach","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43620","description":"Removal of stomach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVC0","description":"ICD-BBVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt couns 4 txmnt opt prost","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4163F","description":"Pt couns 4 txmnt opt prost","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMD1","description":"ICD-GFMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBB1","description":"ICD-AFBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIRF0","description":"ICD-LIRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00170","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","description":"CPT-00170","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTB0","description":"ICD-IGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFCC1","description":"ICD-IFCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQD1","description":"ICD-LHQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of heel fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28406","description":"Treatment of heel fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA11","description":"ICD-4JA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL44","description":"Very High Rehab plus Extensive _ ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFWC1","description":"ICD-PFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRD1","description":"ICD-CDRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBRB1","description":"ICD-CBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODPB1","description":"ICD-ODPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFWC1","description":"ICD-GFWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICMF1","description":"ICD-ICMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEA1","description":"ICD-CFEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lifestyle mod 1st stage","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0340","description":"Lifestyle mod 1st stage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald transmitter microphone","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5290","description":"Ald transmitter microphone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of frontal sinus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31081","description":"Removal of frontal sinus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spin/brain pump refil & main","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95991","description":"Spin/brain pump refil & main","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J2802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","description":"HCPCS-J2802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis g dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87525","description":"Hepatitis g dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQD1","description":"ICD-GIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQF1","description":"ICD-PHQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice services provided to patient any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1191","description":"Hospice services provided to patient any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHDB1","description":"ICD-JHDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4FA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4FA31","description":"ICD-4FA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC0","description":"ICD-FFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD12D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv 1 extremity 1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64642","description":"Chemodenerv 1 extremity 1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc new diag 1st/addl mdd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3093F","description":"Doc new diag 1st/addl mdd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular prosthesis interim","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5923","description":"Ocular prosthesis interim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ant resin-based cmpst crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2390","description":"Ant resin-based cmpst crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEWF0","description":"ICD-CEWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE117","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDYA1","description":"ICD-LDYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpt doc class histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9422","description":"Rpt doc class histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sitz type bath or equipment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0160","description":"Sitz type bath or equipment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDD1","description":"ICD-MFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complex drainage wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10180","description":"Complex drainage wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM2","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIME0","description":"ICD-JIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB215","description":"Reduced Physical Function _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90695","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","description":"CPT-90695","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit enteral per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9340","description":"Hit enteral per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lithium batt for glucose mon","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4235","description":"Lithium batt for glucose mon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODGD0","description":"ICD-ODGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWF1","description":"ICD-CIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE255","description":"Reduced Physical Function _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADE1","description":"ICD-BADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOC1","description":"ICD-DHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDVA0","description":"ICD-GDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N-et; per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2002","description":"N-et; per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of omentum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49255","description":"Removal of omentum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28X","description":"Special Care High _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDYD1","description":"ICD-DDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral body tethering_ anterior; 8 or more vertebral segments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0657T","description":"Vertebral body tethering_ anterior; 8 or more vertebral segments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 1999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4722","description":"Dialys sol fld vol > 1999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace tunneled cv cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36583","description":"Replace tunneled cv cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay infectious agent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86317","description":"Immunoassay infectious agent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2104","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEC0","description":"ICD-FDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB0","description":"ICD-ICBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1503","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","description":"HCPCS-M1503","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat finger fracture each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26725","description":"Treat finger fracture each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24430","description":"Repair of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCWE0","description":"ICD-LCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVD0","description":"ICD-GFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAME0","description":"ICD-KAME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgery for liver lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47300","description":"Surgery for liver lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18X","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tooth pin retention","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2951","description":"Tooth pin retention","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD18B","description":"Special Care Low _ ADL Index 11-14/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DEQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DEQA0","description":"ICD-DEQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPD1","description":"ICD-CHPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00810","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","description":"CPT-00810","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDSE1","description":"ICD-HDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKD1","description":"ICD-NJKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUD0","description":"ICD-FFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBGD0","description":"ICD-NBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63052","description":"LAMINECTOMY_ FACETECTOMY_ OR FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD_ CAUDA EQUINA AND/OR NERVE ROOT[S] [EG_ SPINAL OR LATERAL RECESS STENOSIS]","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEBF0","description":"ICD-OEBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEB1","description":"ICD-OKEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHHF0","description":"ICD-NHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81413","description":"Cardiac ion channelopathies (eg_ Brugada syndrome_ long QT syndrome_ short QT syndrome_ catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGBA1","description":"ICD-BGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interprof phone/online 5-10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99446","description":"Interprof phone/online 5-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97129","description":"Therapeutic Interventions That Focus On Cognitive Function (Eg_ Attention_ Memory_ Reasoning_ Executive Function_ Problem Solving_ And/Or Pragmatic Functioning) And Compensato","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reimplant ureter in bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50780","description":"Reimplant ureter in bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthroscopy dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29860","description":"Hip arthroscopy dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMA0","description":"ICD-OFMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc rehab svcs considered","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4079F","description":"Doc rehab svcs considered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSA1","description":"ICD-KDSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1954","description":"Injection_ leuprolide acetate for depot suspension (lutrate)_ 7.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemo anti-neopl sq/im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96401","description":"Chemo anti-neopl sq/im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJE0","description":"ICD-KIJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIAD0","description":"ICD-MIAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment Benefits Counseling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1740","description":"Employment Benefits Counseling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF0","description":"ICD-FHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHFD1","description":"ICD-OHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FB21","description":"ICD-3FB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGWC0","description":"ICD-GGWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBPB1","description":"ICD-GBPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1823","description":"Generator_ neurostimulator (implantable)_ non-rechargeable_ with transvenous sensing and stimulation leads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAA0","description":"ICD-NFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plasminogen_ human-tvmh_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2998","description":"Injection_ plasminogen_ human-tvmh_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAWE1","description":"ICD-LAWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHB1","description":"ICD-GHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o&w/dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8936","description":"Mra_ w/o&w/dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No reason_ no refer hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9526","description":"No reason_ no refer hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urine shunt to intestine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50815","description":"Urine shunt to intestine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phospholipid pltlt neutraliz","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85597","description":"Phospholipid pltlt neutraliz","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGWB0","description":"ICD-HGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin tolerance panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80434","description":"Insulin tolerance panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEMD0","description":"ICD-GEMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj ferric carboxymaltos 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1439","description":"Inj ferric carboxymaltos 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFCE1","description":"ICD-CFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HER2-targeted therapies not administered during the initial course of treatment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9827","description":"HER2-targeted therapies not administered during the initial course of treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orchiectomy partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54522","description":"Orchiectomy partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4431","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","description":"HCPCS-Q4431","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXA1","description":"ICD-JHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Musculoskeletal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20999","description":"Musculoskeletal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHTB0","description":"ICD-OHTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOE0","description":"ICD-HGOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hair analysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P2031","description":"Hair analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBDD1","description":"ICD-JBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEC1","description":"ICD-EIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBNF0","description":"ICD-KBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ belinostat_ 10mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9032","description":"Injection_ belinostat_ 10mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC1A","description":"High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFB0","description":"ICD-JAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA44","description":"High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAQD1","description":"ICD-PAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Satisfy with care","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0916","description":"Satisfy with care","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86849","description":"Immunology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hocm 150-199mg/ml iodine_1ml","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9959","description":"Hocm 150-199mg/ml iodine_1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NECE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NECE1","description":"ICD-NECE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Soft interface above knee se","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2830","description":"Soft interface above knee se","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIKF1","description":"ICD-KIKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFEC0","description":"ICD-IFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEPB1","description":"ICD-CEPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-15018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","description":"CPT-15018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAWA1","description":"ICD-PAWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICD1","description":"ICD-EICD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOF0","description":"ICD-PHOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets_ pheresis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9034","description":"Platelets_ pheresis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL34","description":"High Rehab plus Extensive _ ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace thrc unit hrt syst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0052T","description":"Replace thrc unit hrt syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGCD0","description":"ICD-NGCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYE0","description":"ICD-KBYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nondisposable nebulizer set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7005","description":"Nondisposable nebulizer set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKID1","description":"ICD-OKID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAHD1","description":"ICD-GAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC18E","description":"Special Care Low _ ADL Index 6-10/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Residual limb support system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1020","description":"Residual limb support system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGHE0","description":"ICD-AGHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCOC0","description":"ICD-PCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUC0","description":"ICD-MCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leg vein fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34530","description":"Leg vein fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQD0","description":"ICD-CHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMC1","description":"ICD-IGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB18G","description":"Reduced Physical Function _ ADL Index 2-5/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHB0","description":"ICD-KIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHOE1","description":"ICD-HHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSA0","description":"ICD-OGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enteral ng tubing w/ stylet","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4081","description":"Enteral ng tubing w/ stylet","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDTB1","description":"ICD-JDTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trismus appliance","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5937","description":"Trismus appliance","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDNE1","description":"ICD-JDNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagoplasty congenital","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43313","description":"Esophagoplasty congenital","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy oocyte polar body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89290","description":"Biopsy oocyte polar body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGLE0","description":"ICD-KGLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sedation (non-iv)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9248","description":"Sedation (non-iv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE1","description":"ICD-FAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEIA1","description":"ICD-GEIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE214","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63001","description":"Remove spine lamina 1/2 crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1x scrn hcv infect","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9451","description":"1x scrn hcv infect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUC1","description":"ICD-OFUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGYF0","description":"ICD-DGYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of leg vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37780","description":"Revision of leg vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLB1","description":"ICD-OKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tobacco nonsmoker nor 2ndhnd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1033F","description":"Tobacco nonsmoker nor 2ndhnd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc breast risk score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0008M","description":"Onc breast risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA11C","description":"Reduced Physical Function _ ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFC1","description":"ICD-GFFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44345","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOE1","description":"ICD-HFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFTC1","description":"ICD-CFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko double upright pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0902","description":"Ko double upright pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBDD0","description":"ICD-BBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBVF1","description":"ICD-BBVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPA0","description":"ICD-JBPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0506U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","description":"CPT-0506U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHUB1","description":"ICD-CHUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCCD1","description":"ICD-MCCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HB11","description":"ICD-2HB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWF1","description":"ICD-HIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of cyanide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82600","description":"Assay of cyanide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11462","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKB0","description":"ICD-BCKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0071","description":"Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cold agglutinin screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86156","description":"Cold agglutinin screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep < 5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24076","description":"Ex arm/elbow tum deep < 5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKC0","description":"ICD-NDKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Isoproterenol non-comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7659","description":"Isoproterenol non-comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECBC0","description":"ICD-ECBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA GIARDIA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87329","description":"IAAD IA GIARDIA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PAYB1","description":"ICD-PAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCCF0","description":"ICD-FCCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICTA0","description":"ICD-ICTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAND0","description":"ICD-JAND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fusion of foot bones","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28730","description":"Fusion of foot bones","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0671T","description":"Insertion Of Anterior Segment Aqueous Drainage Device Into The Trabecular Meshwork_ Without External Reservoir_ And Without Concomitant Cataract Removal_ One Or More","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIE0","description":"ICD-NHIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE1","description":"ICD-NLBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBIE1","description":"ICD-NBIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fabric wrapping of aneurysm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0301","description":"Fabric wrapping of aneurysm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86003","description":"Allergen specific IgE; quantitative or semiquantitative_ crude allergen extract_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB215","description":"Clinically Complex _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETE1","description":"ICD-GETE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES38B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise sperm duct pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55600","description":"Incise sperm duct pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEDB1","description":"ICD-EEDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFOF0","description":"ICD-CFOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBCD1","description":"ICD-NBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LESA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LESA1","description":"ICD-LESA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adenoma detected screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3775F","description":"Adenoma detected screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pet image w/ct skull-thigh","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78815","description":"Pet image w/ct skull-thigh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDWF0","description":"ICD-PDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hgb lvl 11-12.9 g/dl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3280F","description":"Hgb lvl 11-12.9 g/dl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1KB11","description":"ICD-1KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osseous surgl-3teethperquad","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4261","description":"Osseous surgl-3teethperquad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHD1","description":"ICD-GHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interro eval npgs sleep apne","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0434T","description":"Interro eval npgs sleep apne","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUF1","description":"ICD-FHUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWA0","description":"ICD-KEWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFGD1","description":"ICD-JFGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve graft hand/foot >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64896","description":"Nerve graft hand/foot >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11A","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE18A","description":"Special Care Low _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25111","description":"Remove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1502","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1502","description":"CDT-D1502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTF1","description":"ICD-KCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49622","description":"Repair of parastomal hernia_ any approach (ie_ open_ laparoscopic_ robotic)_ initial or recurrent_ including implantation of mesh or other prosthesis_ when performed; incarcer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise foot tendon sheath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28088","description":"Excise foot tendon sheath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe susceptible diffuse","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87181","description":"Microbe susceptible diffuse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0388U","description":"Oncology (non-small cell lung cancer)_ next-generation sequencing with identification of single nucleotide variants_ copy number variants_ insertions and deletions_ and struct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lead_ aicd_ endo dual coil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1895","description":"Lead_ aicd_ endo dual coil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aurothioglucose injeciton","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2910","description":"Aurothioglucose injeciton","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAHD0","description":"ICD-KAHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FENE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FENE0","description":"ICD-FENE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Matristem burn matrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4120","description":"Matristem burn matrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFIC1","description":"ICD-BFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFD1","description":"ICD-FFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol wipes per box","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4245","description":"Alcohol wipes per box","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tacrol astagraf ex rel oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7508","description":"Tacrol astagraf ex rel oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ prog_ bin_ ite","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5252","description":"Hearing aid_ prog_ bin_ ite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Os pch urine w bar/fange/tap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4432","description":"Os pch urine w bar/fange/tap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWC1","description":"ICD-HHWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHMU","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHFE0","description":"ICD-GHFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric speech aid","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5952","description":"Pediatric speech aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGEA1","description":"ICD-IGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGGA1","description":"ICD-JGGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTA1","description":"ICD-MFTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJCF1","description":"ICD-OJCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Albuterol comp unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7609","description":"Albuterol comp unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso flexion control custom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0634","description":"Lso flexion control custom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAC0","description":"ICD-KBAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise kneecap","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27437","description":"Revise kneecap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBTC1","description":"ICD-CBTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00870","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","description":"CPT-00870","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ amivantamab-vmjw_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9061","description":"Injection_ amivantamab-vmjw_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0846T","description":"Digitization of glass microscope slides for immunofluorescence_ per specimen; each additional single antibody stain procedure (List separately in addition to code for primary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spin&cord 2 stgs thrc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63199","description":"Incise spin&cord 2 stgs thrc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA22D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECMF0","description":"ICD-ECMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC240","description":"Special Care Low _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFA1","description":"ICD-KCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSB1","description":"ICD-GCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHHD1","description":"ICD-CHHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMD0","description":"ICD-NDMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWA0","description":"ICD-LBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intercep dental tx transitn","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8060","description":"Intercep dental tx transitn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDKB1","description":"ICD-JDKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEVF0","description":"ICD-CEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGE1","description":"ICD-CGGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIKD1","description":"ICD-OIKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB130","description":"Reduced Physical Function _ ADL Index 2-5/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGDE1","description":"ICD-EGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA20C","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply forearm splint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29125","description":"Apply forearm splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1LB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1LB21","description":"ICD-1LB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEE0","description":"ICD-BEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB0","description":"ICD-OFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add us imag","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19286","description":"Perq dev breast add us imag","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB3B","description":"Low Rehab_ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01472","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","description":"CPT-01472","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFB0","description":"ICD-CEFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home mgmt pprom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9209","description":"Home mgmt pprom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mh partial hosp tx under 24h","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0035","description":"Mh partial hosp tx under 24h","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelet pheres leukoreduced","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9035","description":"Platelet pheres leukoreduced","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODNC1","description":"ICD-ODNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0684U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684U","description":"CPT-0684U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAUB0","description":"ICD-FAUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Indium in-111 auto wbc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9570","description":"Indium in-111 auto wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECE0","description":"ICD-BECE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1005T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","description":"CPT-1005T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC1","description":"ICD-HFQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis w/discectomy lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22224","description":"Incis w/discectomy lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBE1","description":"ICD-IFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated reticulocyte count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85045","description":"Automated reticulocyte count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF0","description":"ICD-MHLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE224","description":"Clinically Complex _ ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMB0","description":"ICD-IGMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81521","description":"Oncology (breast)_ mRNA_ microarray gene expression profiling of 70 content genes and 465 housekeeping genes_ utilizing fresh frozen or formalin-fixed paraffin-embedded tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHCE0","description":"ICD-KHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFRB0","description":"ICD-KFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 iodide cap_ rx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9517","description":"I131 iodide cap_ rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHA1","description":"ICD-ABHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelet deplete of harvest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38213","description":"Platelet deplete of harvest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKUF1","description":"ICD-NKUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1096","description":"Radiation Therapy For Lymphoma Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asth controlled","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9432","description":"Asth controlled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Integra meshed bil wound mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9363","description":"Integra meshed bil wound mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIQF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIQF1","description":"ICD-GIQF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Habil ed waiver_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2012","description":"Habil ed waiver_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCLC0","description":"ICD-NCLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDA1","description":"ICD-NEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gradient pressure wrap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S8429","description":"Gradient pressure wrap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKA1","description":"ICD-JEKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4295","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","description":"HCPCS-A4295","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOD1","description":"ICD-CBOD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCGA0","description":"ICD-OCGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of myoglobin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83874","description":"Assay of myoglobin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUE1","description":"ICD-NEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBE1","description":"ICD-FGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPD0","description":"ICD-JBPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF1","description":"ICD-IBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9563","description":"Home injectable therapy_ immunotherapy_ including administrative services_ professional pharmacy services_ care coordination_ and all necessary supplies and equipment (drugs a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood/lymph nuclear exam","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78199","description":"Blood/lymph nuclear exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv4 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90687","description":"Iiv4 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDRC0","description":"ICD-LDRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHB0","description":"ICD-JGHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHBB0","description":"ICD-EHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFF0","description":"ICD-OJFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE101","description":"Special Care High _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4593","description":"Neuromodulation stimulator system_ adjunct to rehabilitation therapy regime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J9191","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9191","description":"HCPCS-J9191","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of rectal lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45160","description":"Excision of rectal lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound pouch each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6154","description":"Wound pouch each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA44","description":"Very High Rehab _ ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGGC0","description":"ICD-CGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0164U","description":"Gastroenterology (irritable bowel syndrome [IBS])_ immunoassay for anti-CdtB and anti-vinculin antibodies_ utilizing plasma_ algorithm for elevated or not elevated qualitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX30","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF1","description":"ICD-JIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJHC1","description":"ICD-MJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Porcelain/ceramic retainer","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6548","description":"Porcelain/ceramic retainer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPD1","description":"ICD-JGPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part maxil lab","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5760","description":"Denture reln part maxil lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCPF1","description":"ICD-CCPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICF1","description":"ICD-EICF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIAF0","description":"ICD-NIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA36","description":"Ultra High Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGLS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCAC1","description":"ICD-MCAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovas aaa repr w/long tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34805","description":"Endovas aaa repr w/long tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Finger splint_ static","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4049","description":"Finger splint_ static","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAHE0","description":"ICD-FAHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABTD0","description":"ICD-ABTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cover eye w/membrane suture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65779","description":"Cover eye w/membrane suture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFVE1","description":"ICD-GFVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDB1","description":"ICD-GCDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGNA0","description":"ICD-OGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17107","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFYF0","description":"ICD-LFYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esrd home pt srv p day 12-19","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90969","description":"Esrd home pt srv p day 12-19","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Protein western blot test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84182","description":"Protein western blot test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1028T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1028T","description":"CPT-1028T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFND0","description":"ICD-CFND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACF0","description":"ICD-GACF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFTD1","description":"ICD-JFTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adhesive bandage_ first-aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6413","description":"Adhesive bandage_ first-aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove muti-comp penis pros","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54406","description":"Remove muti-comp penis pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWF1","description":"ICD-HBWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo removal donor kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50547","description":"Laparo removal donor kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGB0","description":"ICD-KDGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove iris and lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66600","description":"Remove iris and lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC260","description":"Reduced Physical Function _ ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization admin by intramuscular injection of s (SARS-CoV-2) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0051A","description":"Immunization admin by intramuscular injection of s (SARS-CoV-2) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3 mL dosage_ tris-sucrose form first dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELC0","description":"ICD-FELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIYF0","description":"ICD-GIYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC25","description":"Very High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC31","description":"Ultra High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES212","description":"Extensive Services _ ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIC1","description":"ICD-KFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise spine&cord 2 trx crvl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63196","description":"Incise spine&cord 2 trx crvl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial prenatal care visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0500F","description":"Initial prenatal care visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHVE1","description":"ICD-CHVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTF0","description":"ICD-ECTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography screening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74263","description":"Ct colonography screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1389","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1389","description":"HCPCS-M1389","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIXF0","description":"ICD-GIXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LC11","description":"ICD-3LC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta blckr admin w/in 24 hrs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4115F","description":"Beta blckr admin w/in 24 hrs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPC1","description":"ICD-NEPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of major vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37660","description":"Revision of major vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAE1","description":"ICD-FBAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDGE1","description":"ICD-NDGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJF1","description":"ICD-NFJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBC1","description":"ICD-BBBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDNA0","description":"ICD-FDNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8531","description":"Clinician Documented That Patient Was Not An Eligible Candidate For Autogenous AV Fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD0","description":"ICD-JEKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC244","description":"Special Care High _ ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACMC1","description":"ICD-ACMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sirolimus protein-bound particles_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9091","description":"Injection_ sirolimus protein-bound particles_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine fusion combined","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22633","description":"Lumbar spine fusion combined","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4D","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMA0","description":"ICD-BIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0641T","description":"Noncontact near-infrared spectroscopy studies of flap or wound (eg_ for measurement of deoxyhemoglobin_ oxyhemoglobin_ and ratio of tissue oxygenation [StO2]); image acquisiti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC1","description":"ICD-IHLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIFB1","description":"ICD-FIFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBF1","description":"ICD-OGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPA0","description":"ICD-NJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBND0","description":"ICD-CBND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0606","description":"Room and Board Rate - A flat per diem rate before area wage adjustment for patients whose home is a nursing home.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGA1","description":"ICD-OFGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAFC0","description":"ICD-FAFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onlay porc/crmc >=3 surfaces","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6609","description":"Onlay porc/crmc >=3 surfaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDND1","description":"ICD-KDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBB1","description":"ICD-EGBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFDE1","description":"ICD-FFDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise max/zygoma mal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21034","description":"Excise max/zygoma mal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIRE1","description":"ICD-KIRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDFA0","description":"ICD-NDFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1401","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1401","description":"CDT-D1401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECTE0","description":"ICD-ECTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0048","description":"Patients Who Receive Palliative Care Services Any Time During The Intake Period Through The End Of The Measurement Year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCC0","description":"ICD-OGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision Of Chest Wall Tumor Including Rib(S)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21601","description":"Excision Of Chest Wall Tumor Including Rib(S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1803","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1803","description":"HCPCS-A1803","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQD1","description":"ICD-OJQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCB0","description":"ICD-AGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0290U","description":"Pain Management_ Mrna_ Gene Expression Profiling By Rna Sequencing Of 36 Genes_ Whole Blood_ Algorithm Reported As Predictive Risk Score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam l-s spine 2/3 vws","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72100","description":"X-ray exam l-s spine 2/3 vws","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retrieval of oocyte","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58970","description":"Retrieval of oocyte","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEFA1","description":"ICD-JEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral device/appliance cusfab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0486","description":"Oral device/appliance cusfab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal chrmoml aneuploidy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81420","description":"Fetal chrmoml aneuploidy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC21","description":"ICD-1FC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rem endovas vena cava filter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37193","description":"Rem endovas vena cava filter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGEB1","description":"ICD-KGEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQD0","description":"ICD-LEQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEKE0","description":"ICD-FEKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC205","description":"Reduced Physical Function _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx esophag t1-t3 noprog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9096","description":"Onc dx esophag t1-t3 noprog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCTA1","description":"ICD-JCTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thigh fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27248","description":"Treat thigh fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parathyrd planar w/spect&ct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78072","description":"Parathyrd planar w/spect&ct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove in/ex hem grp & fiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46257","description":"Remove in/ex hem grp & fiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHN1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEIC0","description":"ICD-OEIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJHC1","description":"ICD-NJHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemolysins/agglutinins auto","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86940","description":"Hemolysins/agglutinins auto","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture type pulse field gel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87152","description":"Culture type pulse field gel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWB0","description":"ICD-HAWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAIC1","description":"ICD-JAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25A","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGSD0","description":"ICD-OGSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB3B","description":"Medium Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation follow-up surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27886","description":"Amputation follow-up surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77091","description":"Trabecular Bone Score (Tbs)_ Structural Condition Of The Bone Microarchitecture; Technical Calculation Only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risperidone_ (perseris)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2798","description":"Injection_ risperidone_ (perseris)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9138","description":"Injection_ Factor VIII (antihemophiliac factor_ recombinant) (Nuwiq)_ 1 I.U.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHAE1","description":"ICD-BHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic band & belt thigh fla","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2192","description":"Pelvic band & belt thigh fla","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiofq trsmtr for implt neu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8683","description":"Radiofq trsmtr for implt neu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4425","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","description":"HCPCS-Q4425","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECA0","description":"ICD-GECA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB14B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replantation hand complete","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20808","description":"Replantation hand complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEUE1","description":"ICD-GEUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Njx platelet plasma","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0232T","description":"Njx platelet plasma","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB134","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CC","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBXA0","description":"ICD-NBXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wrst mold sock w/exp interfa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6055","description":"Wrst mold sock w/exp interfa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCD1","description":"ICD-KGCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEXF0","description":"ICD-OEXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64804","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAE1","description":"ICD-EFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-skin fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44640","description":"Repair bowel-skin fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGGC0","description":"ICD-BGGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dyspnea scrnd mod-high dysp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3451F","description":"Dyspnea scrnd mod-high dysp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCLD0","description":"ICD-CCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAB0","description":"ICD-GDAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCUB1","description":"ICD-BCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMB0","description":"ICD-JHMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leucovorin calcium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0640","description":"Leucovorin calcium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES34B","description":"Extensive Services _ ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8718","description":"Total kt/v greater than or equal to 1. 7 per week (total clearance of urea [kt] / volume [v])","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGA1","description":"ICD-OLGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vasopneumatic device therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97016","description":"Vasopneumatic device therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFXE1","description":"ICD-OFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLB1","description":"ICD-IFLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD246","description":"Reduced Physical Function _ ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAD0","description":"ICD-EFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCA1","description":"ICD-FGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brst prsths adhsv attchmnt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4280","description":"Brst prsths adhsv attchmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIXA1","description":"ICD-BIXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWB1","description":"ICD-LDWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Postsurgical obturator","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5932","description":"Postsurgical obturator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl graft or axolotl dualgraft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4210","description":"Axolotl graft or axolotl dualgraft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDXB0","description":"ICD-CDXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOA0","description":"ICD-KHOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCED1","description":"ICD-JCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amb infusion pump mechanical","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0779","description":"Amb infusion pump mechanical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KETE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KETE0","description":"ICD-KETE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95251","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis_ interpretation and report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQC1","description":"ICD-LHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot longitud/metatarsal sup","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3020","description":"Foot longitud/metatarsal sup","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBJF0","description":"ICD-BBJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levalbuterol comp con","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7607","description":"Levalbuterol comp con","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00322","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","description":"CPT-00322","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWD0","description":"ICD-DDWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHF1","description":"ICD-CEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Head control nonproportional","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2329","description":"Head control nonproportional","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatic function panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80076","description":"Hepatic function panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFEC0","description":"ICD-JFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1340","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECDC0","description":"ICD-ECDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of gonadotropin (fsh)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83001","description":"Assay of gonadotropin (fsh)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANB0","description":"ICD-KANB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2EA31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2EA31","description":"ICD-2EA31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQE0","description":"ICD-HHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0203","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0203","description":"HCPCS-C0203","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Virus antibody nos","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86790","description":"Virus antibody nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microscopic exam of urine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81015","description":"Microscopic exam of urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJLB1","description":"ICD-OJLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVC1","description":"ICD-OAVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBUF0","description":"ICD-IBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCC0","description":"ICD-OBCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00532","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","description":"CPT-00532","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ avacincaptad pegol_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2782","description":"Injection_ avacincaptad pegol_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBA0","description":"ICD-NGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25150","description":"Partial removal of ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFKS","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGA0","description":"ICD-BEGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50340","description":"Removal of kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26215","description":"Remove/graft finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHDC1","description":"ICD-GHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78832","description":"Radiopharmaceutical Localization Of Tumor_ Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging_ When Performed)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acne surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10040","description":"Acne surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDBF1","description":"ICD-EDBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB13B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1375","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","description":"HCPCS-M1375","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0205","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0205","description":"HCPCS-C0205","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive chemotherapy in the last 14 days of life","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9848","description":"Patient did not receive chemotherapy in the last 14 days of life","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLA0","description":"ICD-CBLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC24C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF1","description":"ICD-FDCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD236","description":"Special Care High _ ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSE1","description":"ICD-PDSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj estrogen conjugate 25 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1410","description":"Inj estrogen conjugate 25 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OINF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OINF1","description":"ICD-OINF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRF1","description":"ICD-LHRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABA1","description":"ICD-NABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD21A","description":"Special Care High _ ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50394","description":"Injection procedure for pyelography (as nephrostogram_ pyelostogram_ antegrade pyeloureterograms) through nephrostomy or pyelostomy tube_ or indwelling ureteral c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDDF1","description":"ICD-EDDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHRD1","description":"ICD-KHRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct lumbar spine w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72132","description":"Ct lumbar spine w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODLA0","description":"ICD-ODLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBBD1","description":"ICD-BBBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAB0","description":"ICD-NEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEE1","description":"ICD-NKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEFC1","description":"ICD-KEFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARD0","description":"ICD-KARD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1904","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1904","description":"HCPCS-B1904","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pin hand dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26676","description":"Pin hand dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44346","description":"Revision of colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIMD0","description":"ICD-GIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAE1","description":"ICD-GFAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPF1","description":"ICD-KFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of lrh hormone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83727","description":"Assay of lrh hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pos air press adhere no perf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8855","description":"Pos air press adhere no perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2136","description":"Back Pain Measured By The Visual Analog Scale (Vas) At Three Months (6 ? 20 Weeks) Postoperatively Was Less Than Or Equal To 3.0 Or Back Pain Measured By The Visual Analog Sca","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1704","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1704","description":"HCPCS-A1704","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Set radiation therapy field","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77290","description":"Set radiation therapy field","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVE0","description":"ICD-OHVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anl sp inf pmp w/mdreprg&fil","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62370","description":"Anl sp inf pmp w/mdreprg&fil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Procarbazine_ oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0182","description":"Procarbazine_ oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDWE1","description":"ICD-LDWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJBE0","description":"ICD-OJBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIVB1","description":"ICD-KIVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26608","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Family psytx w/patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90847","description":"Family psytx w/patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFKD0","description":"ICD-FFKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGD0","description":"ICD-NLGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ocular implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65125","description":"Revise ocular implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA36","description":"Medium Rehab _ ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFUC0","description":"ICD-FFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNF1","description":"ICD-BDNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCIF0","description":"ICD-KCIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDOD0","description":"ICD-LDOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBIC1","description":"ICD-FBIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCVD0","description":"ICD-FCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELE0","description":"ICD-IELE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWD1","description":"ICD-PLWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFB1","description":"ICD-NLFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXC0","description":"ICD-KDXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc arm/elbow les sc 3 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24071","description":"Exc arm/elbow les sc 3 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFUD0","description":"ICD-IFUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytp urne 3-5 probes ea spec","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88120","description":"Cytp urne 3-5 probes ea spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLC1","description":"ICD-BDLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIF0","description":"ICD-IBIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEOD0","description":"ICD-PEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLB0","description":"ICD-GFLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC114","description":"Clinically Complex _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB45","description":"Medium Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1094","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Professional Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHDA0","description":"ICD-CHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous catheter anchor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A5200","description":"Percutaneous catheter anchor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCED1","description":"ICD-CCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pump uninterrupted infusion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0455","description":"Pump uninterrupted infusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/treat lung lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32141","description":"Remove/treat lung lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHMC0","description":"ICD-MHMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved oral anticoagulant is prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8967","description":"Warfarin or another FDA-approved oral anticoagulant is prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5125","description":"Injection_ filgrastim-ayow_ biosimilar_ (Releuko)_ 1 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom sleep apnea appliance fabrication and placement","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9947","description":"Custom sleep apnea appliance fabrication and placement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44312","description":"Revision of ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Omental flap intra-abdom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49905","description":"Omental flap intra-abdom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJC1","description":"ICD-BAJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted case management","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1017","description":"Targeted case management","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFGD0","description":"ICD-FFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of spine 1 view","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72020","description":"X-ray exam of spine 1 view","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCRF1","description":"ICD-LCRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hip arthro w/labral repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29916","description":"Hip arthro w/labral repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PARA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PARA1","description":"ICD-PARA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNB0","description":"ICD-FHNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9808","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9808","description":"HCPCS-C9808","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep ak ischial thermo mold","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5580","description":"Prep ak ischial thermo mold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55869","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","description":"CPT-55869","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXE1","description":"ICD-NGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone biopsy trocar/needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20220","description":"Bone biopsy trocar/needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec rpt no doc class histo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9425","description":"Spec rpt no doc class histo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRB1","description":"ICD-PDRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0524U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","description":"CPT-0524U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIYD0","description":"ICD-OIYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0577","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0577","description":"HCPCS-G0577","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFA1","description":"ICD-KFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of large breast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19318","description":"Reduction of large breast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/replace ur sphincter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53447","description":"Remove/replace ur sphincter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25265","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complement fixation each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86171","description":"Complement fixation each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00910","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","description":"CPT-00910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGD0","description":"ICD-FCGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8X","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAAA0","description":"ICD-NAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01710","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","description":"CPT-01710","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excise sublingual gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42450","description":"Excise sublingual gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJHB1","description":"ICD-OJHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8H","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIA0","description":"ICD-ICIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSE0","description":"ICD-KHSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11311","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Voice d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9173","description":"Voice d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cd4+ cell percentage <15%","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3497F","description":"Cd4+ cell percentage <15%","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD11C","description":"Special Care Low _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ear microscopy examination","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92504","description":"Ear microscopy examination","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20932","description":"Allograft_ includes templating_ cutting_ placement and internal fixation_ when performed; osteoarticular_ including articular surface and contiguous bone (List separately in a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFCF0","description":"ICD-FFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYA1","description":"ICD-DAYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB0","description":"ICD-OLDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C8007","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8007","description":"HCPCS-C8007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TB screening not performed or results not interpreted_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1005","description":"TB screening not performed or results not interpreted_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHF0","description":"ICD-IDHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX0C","description":"Low Rehab plus Extensive _ ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9998","description":"Documentation Of Medical Reason(S) For An Interval Of Less Than 3 Years Since The Last Colonoscopy (E.G._ Last Colonoscopy Incomplete_ Last Colonoscopy Had Inadequate Prep_ Pi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWB1","description":"ICD-OFWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cvd risk assessment performed_ have a documented calculated risk score","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1258","description":"Cvd risk assessment performed_ have a documented calculated risk score","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGTA1","description":"ICD-NGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB0","description":"ICD-JDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0078U","description":"Pain management (opioid-use disorder) genotyping panel_ 16 common variants (ie_ ABCB1_ COMT_ DAT1_ DBH_ DOR_ DRD1_ DRD2_ DRD4_ GABA_ GAL_ HTR2A_ HTTLPR_ MTHFR_ MUOR_ OPRK1_ OP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remv/replc penis pros compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54417","description":"Remv/replc penis pros compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE1","description":"ICD-NFHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair lead pace-defib dual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33220","description":"Repair lead pace-defib dual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc daily aspirin or contra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9277","description":"Doc daily aspirin or contra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES241","description":"Extensive Services _ ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHE0","description":"ICD-GEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride genitalia & perineum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11004","description":"Debride genitalia & perineum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1134","description":"Ongoing Care Not Indicated_ Patient Self-Discharged Early And Seen Only 1-2 Visits (E.G._ Financial Or Insurance Reasons_ Transportation Problems_ Or Reason Unknown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BILA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BILA0","description":"ICD-BILA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMA0","description":"ICD-IBMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGF1","description":"ICD-KFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0305","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0305","description":"HCPCS-C0305","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD24A","description":"Special Care Low _ ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWF1","description":"ICD-KGWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patch_ lidocaine/tetracaine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9285","description":"Patch_ lidocaine/tetracaine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAID1","description":"ICD-CAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLHD1","description":"ICD-MLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28H","description":"Clinically Complex _ ADL Index 6-10/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 3 vhd cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0853","description":"Pwc gp 3 vhd cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hh respiratory thrpy in eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5180","description":"Hh respiratory thrpy in eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor intestine/venous","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44720","description":"Prep donor intestine/venous","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIFF0","description":"ICD-JIFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDEB1","description":"ICD-JDEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXE0","description":"ICD-JHXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA14A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pancreas surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48999","description":"Pancreas surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASE1","description":"ICD-HASE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEHC1","description":"ICD-CEHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0504","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0504","description":"HCPCS-A0504","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ blinatumomab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9039","description":"Injection_ blinatumomab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat clavicle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23515","description":"Treat clavicle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBBD0","description":"ICD-NBBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB0","description":"ICD-GIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIHF0","description":"ICD-EIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx nose/jaw fx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21345","description":"Closed tx nose/jaw fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTA1","description":"ICD-BHTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE10B","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hand restoration replacmnt g","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6915","description":"Hand restoration replacmnt g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFKE0","description":"ICD-BFKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIA1","description":"ICD-OFIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OANB1","description":"ICD-OANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orbitocranial approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61585","description":"Orbitocranial approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFLC1","description":"ICD-CFLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GELC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GELC0","description":"ICD-GELC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEBF1","description":"ICD-BEBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDQD0","description":"ICD-CDQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVF0","description":"ICD-JBVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC23","description":"High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Braf gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81210","description":"Braf gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerv collar supp adj cerv ba","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0190","description":"Cerv collar supp adj cerv ba","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA0","description":"ICD-CAOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFFA1","description":"ICD-FFFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFB1","description":"ICD-OJFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26641","description":"Treat thumb dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE0","description":"ICD-KFSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWE1","description":"ICD-DFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVD0","description":"ICD-NCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424U","description":"Oncology (prostate)_ exosome-based analysis of 53 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal abdomen lymph nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38564","description":"Removal abdomen lymph nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF0","description":"ICD-KFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Srs spinal lesion addl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63621","description":"Srs spinal lesion addl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGKC1","description":"ICD-NGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Counseling_ group_ by department of veterans affairs chaplain services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9003","description":"Counseling_ group_ by department of veterans affairs chaplain services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Red cell survival study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78130","description":"Red cell survival study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01212","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","description":"CPT-01212","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair vessel defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33802","description":"Repair vessel defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBJA0","description":"ICD-CBJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"reline custom sleep apnea appliance (indirect)","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9953","description":"reline custom sleep apnea appliance (indirect)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28D","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKD0","description":"ICD-GGKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transpetrosal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61598","description":"Transpetrosal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sed rate automated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85652","description":"Rbc sed rate automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper ext fx orthosis wrist","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3984","description":"Upper ext fx orthosis wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE0","description":"ICD-JHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEVB0","description":"ICD-FEVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDSB0","description":"ICD-KDSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDEE0","description":"ICD-EDEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFB1","description":"ICD-OBFB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGMW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBJE1","description":"ICD-OBJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IECC0","description":"ICD-IECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90686","description":"Influenza virus vaccine_ quadrivalent (IIV4)_ split virus_ preservative free_ 0.5 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGPF1","description":"ICD-BGPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCB0","description":"ICD-NKCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of ureter stone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50610","description":"Removal of ureter stone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYA0","description":"ICD-GFYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIA1","description":"ICD-BGIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0926T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","description":"CPT-0926T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMF1","description":"ICD-OBMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0389U","description":"Pediatric febrile illness (Kawasaki disease [KD])_ interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1)_ RNA_ using reverse transc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVD1","description":"ICD-NHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Idarubicin hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9211","description":"Idarubicin hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove by ligat int hem grp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46945","description":"Remove by ligat int hem grp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKD0","description":"ICD-CBKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGMA0","description":"ICD-MGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIHA1","description":"ICD-FIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEE1","description":"ICD-KIEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mast mod rad","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19307","description":"Mast mod rad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01464","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","description":"CPT-01464","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGVE0","description":"ICD-OGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7508","description":"Percutaneous vertebral augmentations_ first lumbar and any additional thoracic or lumbar vertebral bodies_ including cavity creations (fracture reductions and bone biopsies in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove shoulder blade lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23172","description":"Remove shoulder blade lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MAID0","description":"ICD-MAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dil macula/fundus exam/w doc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8397","description":"Dil macula/fundus exam/w doc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHED0","description":"ICD-MHED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial remolding orthosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1040","description":"Cranial remolding orthosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2199","description":"Patient not screened for unhealthy alcohol use using a systematic screening method_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRE1","description":"ICD-LHRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEKA0","description":"ICD-OEKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWD1","description":"ICD-DIWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQA0","description":"ICD-HBQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for shoulder x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23350","description":"Injection for shoulder x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC2A","description":"Very High Rehab _ ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEQB1","description":"ICD-LEQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ imm glob bivigam_ 500mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1556","description":"Inj_ imm glob bivigam_ 500mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJIB0","description":"ICD-MJIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic ftwear ladies oxf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3215","description":"Orthopedic ftwear ladies oxf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADC1","description":"ICD-MADC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein three","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33512","description":"Cabg vein three","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE1","description":"ICD-KIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Macroscopic exam arthropod","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87168","description":"Macroscopic exam arthropod","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External beam to prost only","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4200F","description":"External beam to prost only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eptinezumab-jjmr_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3032","description":"Injection_ eptinezumab-jjmr_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair gum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41872","description":"Repair gum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sugars single quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84378","description":"Sugars single quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA31","description":"Low Rehab_ ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"A/d halfway house_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2034","description":"A/d halfway house_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWF0","description":"ICD-DDWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1097T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1097T","description":"CPT-1097T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE1","description":"ICD-MCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJD1","description":"ICD-FEJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ clindamycin phosphate_ 300 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0736","description":"Injection_ clindamycin phosphate_ 300 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGKX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision/fixation of femur","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27165","description":"Incision/fixation of femur","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJTB1","description":"ICD-OJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFXE0","description":"ICD-BFXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Congenital Neutropenia Panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0271U","description":"Hematology (congenital neutropenia)_ genomic sequence analysis of 23 genes_ blood_ buccal swab_ or amniotic fluid (Versiti™ Congenital Neutropenia Panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pros_ urinary sph_ imp","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1815","description":"Pros_ urinary sph_ imp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening performed and positive and provision of recommendations","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9919","description":"Screening performed and positive and provision of recommendations","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8951","description":"Pre-hypertensive or hypertensive blood pressure reading documented_ indicated follow-up not documented_ Patient not eligible/ not appropriate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHDD0","description":"ICD-KHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMA1","description":"ICD-FGMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1412","description":"Injection_ valoctocogene roxaparvovec-rvox_ per ml_ containing nominal 2 x 10^13 vector genomes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20701","description":"Removal Of Drug-Delivery Device(S)_ Deep (Eg_ Subfascial) (List Separately In Addition To Code For Primary Procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of head","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76506","description":"Echo exam of head","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4223","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4223","description":"HCPCS-Q4223","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excis uppr jaw cyst w/repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21049","description":"Excis uppr jaw cyst w/repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2252","description":"Brief communication technology-based service_ e.g. virtual check-in_ by a physician or other qualified health care professional who can report evaluation and management servic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81552","description":"Oncology (Uveal Melanoma)_ Mrna_ Gene Expression Profiling By Real-Time Rt-Pcr Of 15 Genes (12 Content And 3 Housekeeping)_ Utilizing Fine Needle Aspirate Or Formalin-Fixed Pa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGMV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGE0","description":"ICD-KIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCAE0","description":"ICD-FCAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJAB1","description":"ICD-MJAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAB0","description":"ICD-CEAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE25D","description":"Reduced Physical Function _ ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDWA0","description":"ICD-GDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHHC1","description":"ICD-BHHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIHD0","description":"ICD-MIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIE0","description":"ICD-GIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No admit req surg rev","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9413","description":"No admit req surg rev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESA0","description":"ICD-CESA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A0105","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0105","description":"HCPCS-A0105","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIXD1","description":"ICD-JIXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIVF0","description":"ICD-OIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRE1","description":"ICD-GDRE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise skull/brain surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61720","description":"Incise skull/brain surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoplasty_ medialization_ unilateral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31591","description":"Laryngoplasty_ medialization_ unilateral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD0","description":"ICD-BFDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDCA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDCA0","description":"ICD-CDCA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2FC31","description":"ICD-2FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCRD0","description":"ICD-PCRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGUD0","description":"ICD-OGUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPC0","description":"ICD-NFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA28H","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQA1","description":"ICD-LDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj dupuytren cord w/enzyme","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20527","description":"Inj dupuytren cord w/enzyme","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL8A","description":"High Rehab plus Extensive _ ADL Index 2-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Als defibrillation supplies","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0392","description":"Als defibrillation supplies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLWA0","description":"ICD-PLWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJB1","description":"ICD-OIJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACHB0","description":"ICD-ACHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contour of face bone lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21029","description":"Contour of face bone lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hypoxia response curve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94450","description":"Hypoxia response curve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBC0","description":"ICD-IGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absorpt drg <=16 sq in w/bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6254","description":"Absorpt drg <=16 sq in w/bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFUC0","description":"ICD-AFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIIA0","description":"ICD-GIIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81179","description":"ATXN2 (ataxin 2) (eg_ spinocerebellar ataxia) gene analysis_ evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKOA1","description":"ICD-OKOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MALC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MALC0","description":"ICD-MALC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hematoma/fluid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10140","description":"Drainage of hematoma/fluid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIC0","description":"ICD-BIIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAKD1","description":"ICD-OAKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interstitial radiation source application; intermediate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77777","description":"Interstitial radiation source application; intermediate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amantadine hcl 100mg oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9017","description":"Amantadine hcl 100mg oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Newborn metabolic screening","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3620","description":"Newborn metabolic screening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hkafo torsion cable hip pelv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2050","description":"Hkafo torsion cable hip pelv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA28F","description":"Clinically Complex _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCMB0","description":"ICD-MCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHC1","description":"ICD-NFHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBQC1","description":"ICD-CBQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eyelashes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67820","description":"Revise eyelashes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cannabinoids natural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80349","description":"Cannabinoids natural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NATB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NATB0","description":"ICD-NATB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDHC0","description":"ICD-FDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQE0","description":"ICD-OJQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDSC1","description":"ICD-GDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA25B","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1095","description":"Radiation Therapy For Lung Cancer Under The Radiation Oncology Model_ 90 Day Episode_ Technical Component","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXE1","description":"ICD-GCXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Telecare equipment installation and removal with training","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W2025","description":"Telecare equipment installation and removal with training","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7354","description":"Cantharidin for topical administration_ 0.7%_ single unit dose applicator (3.2 mg)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA26","description":"Medium Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy abdom complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58146","description":"Myomectomy abdom complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIIE0","description":"ICD-AIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDID1","description":"ICD-IDID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lpn/lvn services up to 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1003","description":"Lpn/lvn services up to 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc neg elder mal no plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8734","description":"Doc neg elder mal no plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGKT","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Primatrix","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4110","description":"Primatrix","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Allgrft implnt knee w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29867","description":"Allgrft implnt knee w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of sinuses","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31090","description":"Exploration of sinuses","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCKA1","description":"ICD-BCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDGF0","description":"ICD-GDGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk thigh lacer glut/ischia m","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5682","description":"Bk thigh lacer glut/ischia m","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBA1","description":"ICD-KEBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE1","description":"ICD-KBLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFVA1","description":"ICD-NFVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETC1","description":"ICD-OETC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBEC1","description":"ICD-NBEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytarabine hcl 100 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9100","description":"Cytarabine hcl 100 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rehabilitation program 1/2 d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2001","description":"Rehabilitation program 1/2 d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0742T","description":"Absolute quantitation of myocardial blood flow (AQMBF)_ single-photon emission computed tomography (SPECT)_ with exercise or pharmacologic stress_ and at rest_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFBD0","description":"ICD-GFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J0138","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","description":"HCPCS-J0138","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytarabine liposome inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9098","description":"Cytarabine liposome inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovasc taa repr w/o subcl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33881","description":"Endovasc taa repr w/o subcl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA45","description":"High Rehab _ ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCD1","description":"ICD-IBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB3B","description":"High Rehab _ ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrotherapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97036","description":"Hydrotherapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neck spine disk surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63020","description":"Neck spine disk surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB17","description":"Medium Rehab _ ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXD0","description":"ICD-CGXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc cath >90d for maint dia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9265","description":"Doc cath >90d for maint dia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFQD1","description":"ICD-LFQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2208","description":"Patient did not receive adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDND1","description":"ICD-NDND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0100U","description":"Respiratory pathogen_ multiplex reverse transcription and multiplex amplified probe technique_ multiple types or subtypes_ 21 targets (adenovirus_ coronavirus 229E_ coronaviru","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gefitinib oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8565","description":"Gefitinib oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEUA1","description":"ICD-NEUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA05","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of aortic valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33406","description":"Replacement of aortic valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAIC1","description":"ICD-FAIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMC1","description":"ICD-OFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA13","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insulin antibodies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86337","description":"Insulin antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDVB1","description":"ICD-JDVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No antibio w in 10d of sympt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9287","description":"No antibio w in 10d of sympt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of nasal septum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30520","description":"Repair of nasal septum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSB1","description":"ICD-OLSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB116","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Med","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair spec size w/ leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1224","description":"Wheelchair spec size w/ leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGKD1","description":"ICD-BGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dementia severity classified_ moderate (DEM)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2033F","description":"Dementia severity classified_ moderate (DEM)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLD1","description":"ICD-ACLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of spleen partial","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38101","description":"Removal of spleen partial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGMV","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHBD0","description":"ICD-OHBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diazepam injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3360","description":"Diazepam injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26140","description":"Revise finger joint each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1042","description":"Functional status measurement with score was obtained utilizing the Oswestry Disability Index (ODI version 2.1a) patient report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQA1","description":"ICD-HHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE151","description":"Special Care High _ ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aflibercept hd_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9161","description":"Injection_ aflibercept hd_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9977","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoassay dipstick","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83518","description":"Immunoassay dipstick","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAIE1","description":"ICD-EAIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl draw <3 yrs scalp vein","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36405","description":"Bl draw <3 yrs scalp vein","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3B","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01758","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","description":"CPT-01758","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQB0","description":"ICD-HHQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGPC1","description":"ICD-CGPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B2101","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B2101","description":"HCPCS-B2101","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBAE0","description":"ICD-OBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular reconst transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65781","description":"Ocular reconst transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath mtral vlve repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0345T","description":"Transcath mtral vlve repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGOA1","description":"ICD-LGOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient discharged alive following endovascular AAA repair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9263","description":"Documentation of patient discharged alive following endovascular AAA repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long chain fatty acids","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82726","description":"Long chain fatty acids","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAIE0","description":"ICD-NAIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHD0","description":"ICD-ADHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ plazomicin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0291","description":"Injection_ plazomicin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNA1","description":"ICD-FHNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDME1","description":"ICD-FDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza imm status assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1030F","description":"Influenza imm status assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69637","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGL2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0924T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","description":"CPT-0924T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEXE1","description":"ICD-CEXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduction of skull defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62117","description":"Reduction of skull defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC1","description":"ICD-MFDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMB0","description":"ICD-FCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEMF0","description":"ICD-OEMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIB0","description":"ICD-BCIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung transplant double","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32853","description":"Lung transplant double","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLMB0","description":"ICD-NLMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHME0","description":"ICD-JHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pm/icd remote tech serv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93296","description":"Pm/icd remote tech serv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTC0","description":"ICD-JBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CADC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CADC0","description":"ICD-CADC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCMF1","description":"ICD-FCMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg >4 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11606","description":"Exc tr-ext mal+marg >4 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ethylene glycol","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82693","description":"Assay of ethylene glycol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCF0","description":"ICD-JGCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAVC0","description":"ICD-NAVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mammo result com to pt 5 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"5062F","description":"Mammo result com to pt 5 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert mesh/pelvic flr addon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57267","description":"Insert mesh/pelvic flr addon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFED0","description":"ICD-EFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFMF0","description":"ICD-JFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gen w/c cushion wdth >=22 in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2602","description":"Gen w/c cushion wdth >=22 in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJC0","description":"ICD-FEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF0","description":"ICD-BFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWC0","description":"ICD-PIWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFLE1","description":"ICD-IFLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cabg vein five","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33514","description":"Cabg vein five","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"I131 tositumomab_ dx","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9544","description":"I131 tositumomab_ dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair anorectal fist w/plug","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46707","description":"Repair anorectal fist w/plug","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4398","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","description":"HCPCS-Q4398","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tocilizumab injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3262","description":"Tocilizumab injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 6/> vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72084","description":"X-ray exam entire spi 6/> vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surg dx exam anorectal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45990","description":"Surg dx exam anorectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wound warming device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0231","description":"Wound warming device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dopamine injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1265","description":"Dopamine injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMT","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2AB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2AB21","description":"ICD-2AB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICBB1","description":"ICD-ICBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0674U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674U","description":"CPT-0674U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ppps_ subseq visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0439","description":"Ppps_ subseq visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abortion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59856","description":"Abortion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice care supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99378","description":"Hospice care supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of tibia","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27705","description":"Incision of tibia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ecmo/ecls insj prph cannula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33952","description":"Ecmo/ecls insj prph cannula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bp scrn no perf at interval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8785","description":"Bp scrn no perf at interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychia interven order","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4525F","description":"Neuropsychia interven order","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFM5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA23D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABC0","description":"ICD-OABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Custom shape cover ak","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5705","description":"Custom shape cover ak","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Collagen crosslinks","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82523","description":"Collagen crosslinks","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj pembrolizumab","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9271","description":"Inj pembrolizumab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIPF0","description":"ICD-BIPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD1","description":"ICD-NJTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Admit w/in 180d req remov","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9410","description":"Admit w/in 180d req remov","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGAF1","description":"ICD-NGAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9800","description":"Gallium Ga-68 gozetotide_ diagnostic_ (Locametz)_1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEIA0","description":"ICD-NEIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0864T","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum_ low energy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 5","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88261","description":"Chromosome analysis 5","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex arm/elbow tum deep 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24073","description":"Ex arm/elbow tum deep 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIRC0","description":"ICD-HIRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special reports or forms","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99080","description":"Special reports or forms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBVC1","description":"ICD-GBVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYB1","description":"ICD-HDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDYF0","description":"ICD-HDYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTA1","description":"ICD-NDTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES334","description":"Extensive Services _ ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHDD1","description":"ICD-FHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEHB1","description":"ICD-AEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove cva device obstruct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75901","description":"Remove cva device obstruct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCHB0","description":"ICD-GCHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBE0","description":"ICD-ADBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDTC0","description":"ICD-GDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGD0","description":"ICD-GFGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX32","description":"Medium Rehab plus Extensive_ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGRC1","description":"ICD-GGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lev 5 hosp type b ed visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0384","description":"Lev 5 hosp type b ed visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAB0","description":"ICD-MFAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF0","description":"ICD-CIHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC134","description":"Special Care Low _ ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGWB0","description":"ICD-KGWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is not dysarthric","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3763F","description":"Patient is not dysarthric","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20A","description":"Clinically Complex _ ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61736","description":"Laser Interstitial Thermal Therapy (Litt) Of Lesion_ Intracranial_ Including Burr Hole(S)_ With Magnetic Resonance Imaging Guidance_ When Performed; Single Trajectory For 1 Si","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Performance Not Met: Multimodal Pain Management Was Not Used","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2150","description":"Performance Not Met: Multimodal Pain Management Was Not Used","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Services performed by birth a doula birth workers_ per 15 minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1032","description":"Services performed by birth a doula birth workers_ per 15 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEID0","description":"ICD-NEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G1002","description":"Clinical Decision Support Mechanism Medcurrent_ As Defined By The Medicare Appropriate Use Criteria Program","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFMC1","description":"ICD-GFMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBUF0","description":"ICD-OBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSD1","description":"ICD-GCSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PLOF1","description":"ICD-PLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-64466","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","description":"CPT-64466","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maint drug infus cath per wk","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4221","description":"Maint drug infus cath per wk","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOA0","description":"ICD-PDOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD214","description":"Special Care Low _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ped home apnea rec hk-up","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94775","description":"Ped home apnea rec hk-up","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFRB1","description":"ICD-CFRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic caster tire each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2214","description":"Pneumatic caster tire each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHLA1","description":"ICD-BHLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE1","description":"ICD-FIGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGND0","description":"ICD-GGND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC11C","description":"Special Care High _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2014","description":"Limited (30 minutes) care plan oversight. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary’s home_ domiciliary_ rest home_ assi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHLU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHOB0","description":"ICD-CHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBMD0","description":"ICD-MBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28I","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj iris prosth w/rmvl&insj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0617T","description":"Insj iris prosth w/rmvl&insj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAEB0","description":"ICD-FAEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KA21","description":"ICD-4KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ efgartigimod alfa-fcab_ 2 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9332","description":"Injection_ efgartigimod alfa-fcab_ 2 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect heart sac lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33050","description":"Resect heart sac lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHC1","description":"ICD-MGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heart symp image plnr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0331T","description":"Heart symp image plnr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX33","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDNB0","description":"ICD-NDNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYD0","description":"ICD-PEYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc med reas no pt cat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9429","description":"Doc med reas no pt cat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace lithium battery 1.5v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4602","description":"Replace lithium battery 1.5v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCC0","description":"ICD-AGCC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYA0","description":"ICD-DHYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Coombs test indirect titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86886","description":"Coombs test indirect titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE24D","description":"Special Care Low _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDF0","description":"ICD-IGDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEBB1","description":"ICD-JEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic exercises","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97110","description":"Therapeutic exercises","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc cardiac modulj sys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0408T","description":"Insj/rplc cardiac modulj sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIEE0","description":"ICD-OIEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low rsk thromboembolism","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3550F","description":"Low rsk thromboembolism","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABBA1","description":"ICD-ABBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHPE0","description":"ICD-FHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCWE0","description":"ICD-KCWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt notrcvng1st antitnf txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6150F","description":"Pt notrcvng1st antitnf txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt disch home day #2 evar","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8826","description":"Pt disch home day #2 evar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoskel knee-shin mnl lock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5810","description":"Endoskel knee-shin mnl lock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5644","description":"Above knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFGF0","description":"ICD-OFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC0","description":"ICD-HCSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODKB0","description":"ICD-ODKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor viii fc fusion recomb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7205","description":"Factor viii fc fusion recomb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0953","description":"Wheelchair accessory_ lateral thigh or knee support_ any type including fixed mounting hardware_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dstrj neurofibromata xtnsv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0420T","description":"Dstrj neurofibromata xtnsv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3EC31","description":"ICD-3EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot plate molded stirrup at","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2250","description":"Foot plate molded stirrup at","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breath tst attain/anal c-14","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78267","description":"Breath tst attain/anal c-14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spherocylinder 4.00d/>6.00d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2106","description":"Spherocylinder 4.00d/>6.00d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCHD0","description":"ICD-MCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODYE1","description":"ICD-ODYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIXD0","description":"ICD-CIXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF0","description":"ICD-NJGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFF1","description":"ICD-BEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAXE0","description":"ICD-OAXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGBF1","description":"ICD-MGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ teclistamab-cqyv_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9380","description":"Injection_ teclistamab-cqyv_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0482U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","description":"CPT-0482U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bile duct tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47711","description":"Excision of bile duct tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEWA1","description":"ICD-PEWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHC1","description":"ICD-AIHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4436","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","description":"HCPCS-Q4436","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9907","description":"Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g._ limited life expectancy_ other medical reason)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDFE0","description":"ICD-GDFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIWC1","description":"ICD-CIWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bp sys <140 and dias <90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8476","description":"Bp sys <140 and dias <90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNA0","description":"ICD-GCNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHD1","description":"ICD-OLHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9799","description":"Patients with a medication dispensing event indicator of a history of asthma any time during the patient_s history through the end of the measure period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD0","description":"ICD-EELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHOA1","description":"ICD-PHOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEXA1","description":"ICD-GEXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHIB0","description":"ICD-KHIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC01","description":"High Rehab _ ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tetanus ig im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90389","description":"Tetanus ig im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOST_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4328","description":"MOST_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBD1","description":"ICD-MLBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Crutch underarm pair no wood","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0114","description":"Crutch underarm pair no wood","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMD1","description":"ICD-NGMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNB1","description":"ICD-BDNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBF1","description":"ICD-KFBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBD1","description":"ICD-KDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88239","description":"Tissue culture tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast exam thoracic aorta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75605","description":"Contrast exam thoracic aorta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3502","description":"Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of knee ligaments","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27409","description":"Repair of knee ligaments","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVA06","description":"Very High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWC0","description":"ICD-KEWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD10B","description":"Clinically Complex _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 1 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0814","description":"Pwc gp 1 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2LC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2LC31","description":"ICD-2LC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKF0","description":"ICD-NKKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcvng ace/arb b-blockertx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4480F","description":"Pt rcvng ace/arb b-blockertx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHA0","description":"ICD-NKHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCV2 10MCG TRS-SUCR 1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0071A","description":"ADM SARSCV2 10MCG TRS-SUCR 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYA1","description":"ICD-PEYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFQC0","description":"ICD-HFQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLF0","description":"ICD-EFLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dsm-5 info mdd docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1040F","description":"Dsm-5 info mdd docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Head/extremity control inter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2328","description":"Head/extremity control inter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCJF0","description":"ICD-GCJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27455","description":"Realignment of knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel-bladder fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44660","description":"Repair bowel-bladder fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for exploration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61304","description":"Open skull for exploration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of circulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37160","description":"Revision of circulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hospice evaluation preelecti","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0337","description":"Hospice evaluation preelecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD213","description":"Clinically Complex _ ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare shor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIJA0","description":"ICD-BIJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFF0","description":"ICD-BDFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVA1","description":"ICD-BHVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HDRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HDRD0","description":"ICD-HDRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTD1","description":"ICD-GHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEAE0","description":"ICD-BEAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afo sing bar clasp attach sh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1910","description":"Afo sing bar clasp attach sh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVB0","description":"ICD-KHVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fuse bile ducts and bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47760","description":"Fuse bile ducts and bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GALF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GALF0","description":"ICD-GALF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA41","description":"High Rehab _ ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LASA0","description":"ICD-LASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1103","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1103","description":"CDT-D1103","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTD0","description":"ICD-MBTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6031","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","description":"HCPCS-L6031","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC236","description":"Special Care Low _ ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQB1","description":"ICD-DCQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pelvic control pelvic sling","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2580","description":"Pelvic control pelvic sling","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHHA0","description":"ICD-AHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE12D","description":"Special Care High _ ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHNC1","description":"ICD-FHNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFVB0","description":"ICD-KFVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with dementia any time during the patient_s history through the end of the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1164","description":"Patients with dementia any time during the patient_s history through the end of the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ eravacycline_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0122","description":"Injection_ eravacycline_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBOA1","description":"ICD-CBOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhv-6 dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87531","description":"Hhv-6 dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1603","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1603","description":"CDT-D1603","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKD0","description":"ICD-JCKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFCB0","description":"ICD-GFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0711","description":"Upper extremity medical tubing/lines enclosure or covering device_ restricts elbow range of motion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD126","description":"Special Care Low _ ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFNA1","description":"ICD-FFNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Restraints any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0710","description":"Restraints any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CHKW","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-emer transport wait time","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2007","description":"Non-emer transport wait time","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLKF0","description":"ICD-NLKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rolapitant_ oral_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8670","description":"Rolapitant_ oral_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Correction of bladder defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51940","description":"Correction of bladder defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct angiography neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70498","description":"Ct angiography neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc face les sc <2 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21011","description":"Exc face les sc <2 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91309","description":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 50 mcg/0.5 mL dosage_ for int","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of esophagus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43100","description":"Excision of esophagus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0447U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 11 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GATB1","description":"ICD-GATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbiology procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87999","description":"Microbiology procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FALC1","description":"ICD-FALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B0107","description":"Stroke with Motor >26.15 & Motor <30.05._comorbidity in tier 1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJE0","description":"ICD-CGJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0312U","description":"Autoimmune diseases (eg_ systemic lupus erythematosus [SLE])_ analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorben","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81231","description":"CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg_ drug metabolism)_ gene analysis_ common variants (eg_ *2_ *3_ *4_ *5_ *6_ *7)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"remove broken implant retaining screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6096","description":"remove broken implant retaining screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGBD0","description":"ICD-JGBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rezafungin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0349","description":"Injection_ rezafungin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHF0","description":"ICD-KCHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unclassified biologics","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3590","description":"Unclassified biologics","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGMD0","description":"ICD-GGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mdd mild","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3088F","description":"Mdd mild","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES18I","description":"Extensive Services _ ADL Index 2-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIBA0","description":"ICD-CIBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHE1","description":"ICD-NAHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01963","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","description":"CPT-01963","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0564","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0564","description":"HCPCS-G0564","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Denture reln part mand chr","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5741","description":"Denture reln part mand chr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB2C","description":"Ultra High Rehab _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC60","description":"Ultra High Rehab _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFUB0","description":"ICD-BFUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81560","description":"Transplantation Medicine (Allograft Rejection_ Pediatric Liver And Small Bowel)_ Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells_ Utilizing Whole P","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA11","description":"Ultra High Rehab _ ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAUA1","description":"ICD-KAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF1","description":"ICD-NDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLRF0","description":"ICD-OLRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0653T","description":"Esophagogastroduodenoscopy_ flexible_ transnasal; with biopsy_ single or multiple","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB212","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAC0","description":"ICD-OLAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEIB0","description":"ICD-CEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OARB1","description":"ICD-OARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFIE0","description":"ICD-OFIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIWE0","description":"ICD-OIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF0","description":"ICD-CCEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81164","description":"BRCA1 (BRCA1_ DNA repair associated)_ BRCA2 (BRCA2_ DNA repair associated) (eg_ hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie_ de","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0077","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary_s home_ dom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00211","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","description":"CPT-00211","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDEB0","description":"ICD-IDEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKJA1","description":"ICD-NKJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCGC0","description":"ICD-KCGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDC1","description":"ICD-NKDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB1C","description":"Very High Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the followi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJF1","description":"ICD-CIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair lightwt foot rest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1260","description":"Wheelchair lightwt foot rest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDOB1","description":"ICD-KDOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bupren/nal 6.1 to 10mg bupre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0574","description":"Bupren/nal 6.1 to 10mg bupre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0339U","description":"Oncology (prostate)_ mRNA expression profiling of HOXC6 and DLX1_ reverse transcription polymerase chain reaction (RT-PCR)_ first-void urine following digital rectal examinati","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFBF0","description":"ICD-EFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIYB1","description":"ICD-HIYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJGF1","description":"ICD-NJGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bile acids cholylglycine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82240","description":"Bile acids cholylglycine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Afamelanotide implant_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7352","description":"Afamelanotide implant_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKSC0","description":"ICD-OKSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuromuscular junction test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95937","description":"Neuromuscular junction test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML2B","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1471","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","description":"HCPCS-M1471","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGL4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMB1","description":"ICD-ABMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD15D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDTA0","description":"ICD-FDTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHRD0","description":"ICD-OHRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair arterial blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75966","description":"Repair arterial blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKLD1","description":"ICD-OKLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX10","description":"Medium Rehab plus Extensive_ ADL Index 11-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAXF0","description":"ICD-GAXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28476","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPF0","description":"ICD-NFPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Accessing and retorquing loose implant screw - per screw","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6089","description":"Accessing and retorquing loose implant screw - per screw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath occlusion non-cns","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61626","description":"Transcath occlusion non-cns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Arm pad each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0019","description":"Arm pad each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33871","description":"Transverse Aortic Arch Graft_ With Cardiopulmonary Bypass_ With Profound Hypothermia_ Total Circulatory Arrest And Isolated Cerebral Perfusion With Reimplantation Of Arch Vess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB51","description":"Low Rehab_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHE0","description":"ICD-JIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFC0","description":"ICD-KCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc pretx incubatj w/chemicl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86970","description":"Rbc pretx incubatj w/chemicl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWA0","description":"ICD-KHWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endodontic endosseous implan","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D3460","description":"Endodontic endosseous implan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANA0","description":"ICD-JANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDIB0","description":"ICD-EDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Camp day waiver/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2037","description":"Camp day waiver/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACDF0","description":"ICD-ACDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMF0","description":"ICD-NGMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD0","description":"ICD-MBCD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHE0","description":"ICD-NLHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCVD0","description":"ICD-CCVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDSF1","description":"ICD-PDSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Plmt post facet implt thor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0220T","description":"Plmt post facet implt thor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr umbil hern reduc > 5 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49585","description":"Rpr umbil hern reduc > 5 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thiotepa injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9340","description":"Thiotepa injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHSD0","description":"ICD-LHSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDCB1","description":"ICD-JDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj levocarnitine per 1 gm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1955","description":"Inj levocarnitine per 1 gm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCMB0","description":"ICD-GCMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of foot","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28116","description":"Revision of foot","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydration iv infusion init","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96360","description":"Hydration iv infusion init","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2156","description":"Patient Did Not Receive At Least One Td Vaccine Or One Tdap Vaccine Between Nine Years Prior To The Start Of The Measurement Period And The End Of The Measurement Period; Or H","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Angina present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1011F","description":"Angina present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0302T","description":"Icar ischm mntrng sys compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyme disease antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86618","description":"Lyme disease antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGQA0","description":"ICD-CGQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Most recent tobacco status is tobacco free","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9791","description":"Most recent tobacco status is tobacco free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc of tobacco user","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9276","description":"Doc of tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXB0","description":"ICD-KFXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA13A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCOC0","description":"ICD-HCOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shorten radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25390","description":"Shorten radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBA0","description":"ICD-BCBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOA1","description":"ICD-GCOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBMB0","description":"ICD-FBMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUB8D","description":"Ultra High Rehab _ ADL Index 6-10/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRC1","description":"ICD-GFRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB18I","description":"Clinically Complex _ ADL Index 2-5/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGCC1","description":"ICD-KGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAJF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAJF0","description":"ICD-KAJF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIJC1","description":"ICD-KIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress forearm 2 spaces","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25024","description":"Decompress forearm 2 spaces","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4BB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4BB21","description":"ICD-4BB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E3200","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","description":"HCPCS-E3200","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBQF0","description":"ICD-DBQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX54","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OABD0","description":"ICD-OABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9777","description":"Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93594","description":"Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone; Abnormal Native Connecti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft fem-popliteal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35556","description":"Art byp grft fem-popliteal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADBF1","description":"ICD-ADBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX44","description":"Low Rehab plus Extensive _ ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE14C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABA1","description":"ICD-EABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Capillary blood draw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36416","description":"Capillary blood draw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leukocyte assessment fecal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89055","description":"Leukocyte assessment fecal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIAA1","description":"ICD-BIAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Harvest vein for bypass","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35500","description":"Harvest vein for bypass","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81458","description":"Solid organ neoplasm_ genomic sequence analysis panel_ interrogation for sequence variants; DNA analysis_ copy number variants and microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sealant repair per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1353","description":"Sealant repair per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prev visit new age 40-64","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99386","description":"Prev visit new age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electroejaculation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55870","description":"Electroejaculation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcath closure of asd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93580","description":"Transcath closure of asd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEAE1","description":"ICD-CEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBOA0","description":"ICD-GBOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAC0","description":"ICD-FDAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEDF1","description":"ICD-AEDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKCE1","description":"ICD-NKCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adjust finger ext/flex devc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1825","description":"Adjust finger ext/flex devc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incision of stomach nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64755","description":"Incision of stomach nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHND0","description":"ICD-OHND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC31","description":"ICD-4EC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28X","description":"Special Care High _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIWE0","description":"ICD-HIWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"D/c hemo or perit dialysis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9523","description":"D/c hemo or perit dialysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKLB1","description":"ICD-MKLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELD1","description":"ICD-EELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICA0","description":"ICD-FICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0858T","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDE0","description":"ICD-KEDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTB0","description":"ICD-JBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8H","description":"Medium Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHAE0","description":"ICD-KHAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/excise cranial lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61600","description":"Resect/excise cranial lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMF0","description":"ICD-IBMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal sweat gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11463","description":"Removal sweat gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFRD0","description":"ICD-DFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHPE0","description":"ICD-JHPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W0602","description":"Routine Home Care - A flat per diem before area wage adjustment for intermittent services furnished.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCWA1","description":"ICD-CCWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX32","description":"Low Rehab plus Extensive _ ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Upper arm/elbow surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24999","description":"Upper arm/elbow surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCE1","description":"ICD-MBCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETD0","description":"ICD-AETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EABF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EABF0","description":"ICD-EABF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHLD0","description":"ICD-CHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNB1","description":"ICD-NGNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65101","description":"Removal of eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1557","description":"Removal Of Fixed Bilateral Space Maintainer - Maxillary","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0806","description":"Replacement of lower extremity joint with Motor <22.05._comorbidity in tier 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9885","description":"Two Medicare Diabetes Prevention Program (MDPP) ongoing maintenance sess ions (MS) were attended by an MDPP beneficiary in months (mo) 22-24 under the MDPP Expanded Model","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF1","description":"ICD-OHIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBNF0","description":"ICD-NBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv adjuvant vaccine im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90653","description":"Iiv adjuvant vaccine im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0481T","description":"Injection(s)_ autologous white blood cell concentrate (autologous protein solution)_ any site_ including image guidance_ harvesting and preparation_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC0","description":"ICD-FIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUD1","description":"ICD-FDUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal shunt placement w/us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59076","description":"Fetal shunt placement w/us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGWF0","description":"ICD-LGWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE0","description":"ICD-EADE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC22","description":"Ultra High Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCAA0","description":"ICD-KCAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA28E","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGGD1","description":"ICD-FGGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL07","description":"High Rehab plus Extensive _ ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHD0","description":"ICD-AIHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rvw meds by rx/dr in rcrd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1160F","description":"Rvw meds by rx/dr in rcrd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHVD1","description":"ICD-OHVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ther behav svc_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2020","description":"Ther behav svc_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIEB0","description":"ICD-IIEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neuropsychi sympt 1+present","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1182F","description":"Neuropsychi sympt 1+present","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90759","description":"Hepatitis B Vaccine (Hepb)_ 3-Antigen (S_ Pre-S1_ Pre-S2)_ 10 Mcg Dosage_ 3 Dose Schedule_ For Intramuscular Use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIWF1","description":"ICD-PIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGOB1","description":"ICD-HGOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed total elect w/o mat","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0297","description":"Hosp bed total elect w/o mat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB24D","description":"Clinically Complex _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ptnot rcvng anti-rhm thxpyra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4196F","description":"Ptnot rcvng anti-rhm thxpyra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBLC1","description":"ICD-CBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Humidifier for use w/ regula","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0555","description":"Humidifier for use w/ regula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFCB0","description":"ICD-NFCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHME0","description":"ICD-MHME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOA0","description":"ICD-HEOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHB0","description":"ICD-CIHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FELD1","description":"ICD-FELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBAA1","description":"ICD-KBAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nash fibrosure(tm)_ labcorp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0003M","description":"Nash fibrosure(tm)_ labcorp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of kidney/ureter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50400","description":"Revision of kidney/ureter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NILF1","description":"ICD-NILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acupunct w/o stimul 15 min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97810","description":"Acupunct w/o stimul 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCGB0","description":"ICD-GCGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDRE0","description":"ICD-PDRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYC0","description":"ICD-PJYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE244","description":"Special Care Low _ ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ef ped specmetabolic inherit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"B4162","description":"Ef ped specmetabolic inherit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5172","description":"Hearing aid_ contralateral routing device_ monaural_ in the canal (ITC)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5165","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5165","description":"HCPCS-Q5165","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRD0","description":"ICD-OIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of brain tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61538","description":"Removal of brain tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDXB1","description":"ICD-NDXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAC1","description":"ICD-IHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCOF1","description":"ICD-GCOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place catheter in artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36014","description":"Place catheter in artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB0","description":"ICD-LCSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIEA0","description":"ICD-CIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical home_ initial plan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0280","description":"Medical home_ initial plan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of windpipe defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31825","description":"Repair of windpipe defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBB0","description":"ICD-JHBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC1","description":"ICD-GFEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMB0","description":"ICD-FIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore wound extremity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20103","description":"Explore wound extremity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hearing loss dup/del analys","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81431","description":"Hearing loss dup/del analys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBAB1","description":"ICD-MBAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHKF0","description":"ICD-KHKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9534","description":"Advanced brain imaging (CTA_ CT_ MRA or MRI) was not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRA0","description":"ICD-CCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Romiplostim injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2796","description":"Romiplostim injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11306","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDUE0","description":"ICD-MDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAE0","description":"ICD-BFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHNE0","description":"ICD-GHNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBEE1","description":"ICD-GBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDA0","description":"ICD-KBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOA0","description":"ICD-DCOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31255","description":"Nasal/sinus endoscopy_ surgical with ethmoidectomy; total (anterior and posterior)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Olanzapine long-acting inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2358","description":"Olanzapine long-acting inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFKF1","description":"ICD-GFKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCGF0","description":"ICD-FCGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATC1","description":"ICD-MATC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDRF1","description":"ICD-GDRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF0","description":"ICD-MLMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA55","description":"Ultra High Rehab _ ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trans shoe solid stirrup exi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3620","description":"Trans shoe solid stirrup exi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHMD0","description":"ICD-AHMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15D","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDQA1","description":"ICD-KDQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISF1","description":"ICD-PISF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fibrinolytic plasmin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85400","description":"Fibrinolytic plasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert picvad cath","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36571","description":"Insert picvad cath","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrophysiology evaluation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93620","description":"Electrophysiology evaluation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9900","description":"Screening_ diagnostic_ film_ digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYA0","description":"ICD-KBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFMF0","description":"ICD-BFMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Retrograde ejaculation anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89331","description":"Retrograde ejaculation anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVD1","description":"ICD-NKVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc sed rate nonautomated","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85651","description":"Rbc sed rate nonautomated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC106","description":"Special Care Low _ ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1043T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1043T","description":"CPT-1043T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pharmacologic mgmt w/psytx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90863","description":"Pharmacologic mgmt w/psytx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch for bar w flange/flt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4419","description":"Ost pch for bar w flange/flt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx brst stg3-hr_ no pro","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9073","description":"Onc dx brst stg3-hr_ no pro","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJSA0","description":"ICD-OJSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAAA0","description":"ICD-FAAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCOE1","description":"ICD-DCOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81405","description":"MOLECULAR PATHOLOGY PROCEDURE LEVEL 6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARE1","description":"ICD-LARE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHYD0","description":"ICD-LHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBFA1","description":"ICD-GBFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AETF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AETF1","description":"ICD-AETF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0567U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","description":"CPT-0567U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDPA0","description":"ICD-JDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGDB1","description":"ICD-MGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Employment - Employment Skills Development (1:2 to 1:3)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W1729","description":"Employment - Employment Skills Development (1:2 to 1:3)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Division of fallopian tube","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58605","description":"Division of fallopian tube","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55060","description":"Repair of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace quadlat socket brim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L4020","description":"Replace quadlat socket brim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC115","description":"Reduced Physical Function _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATE1","description":"ICD-JATE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung function test (mbc/mvv)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94200","description":"Lung function test (mbc/mvv)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEVA0","description":"ICD-BEVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01952","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","description":"CPT-01952","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHIF0","description":"ICD-OHIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4100","description":"Skin substitute_ FDA-cleared as a device_ not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Addl neck spine fusion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22552","description":"Addl neck spine fusion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANC1","description":"ICD-KANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGB0","description":"ICD-GBGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9943","description":"Back pain was not measured by the visual analog scale (VAS) within three months preoperatively and at three months (6 - 20 weeks) postoperatively","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical splint","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5988","description":"Surgical splint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACF1","description":"ICD-IACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Position seat spec orth need","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T5001","description":"Position seat spec orth need","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEE1","description":"ICD-ECEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGKX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Death did not occur after discharge from the hospital within 30 days post procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9817","description":"Death did not occur after discharge from the hospital within 30 days post procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathogen reduced plasma pool","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9070","description":"Pathogen reduced plasma pool","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ko single upright pre cst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L1843","description":"Ko single upright pre cst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDE0","description":"ICD-GCDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Busulfan injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0594","description":"Busulfan injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Epidural lysis mult sessions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62263","description":"Epidural lysis mult sessions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAED0","description":"ICD-KAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE21B","description":"Reduced Physical Function _ ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision lesion mouth roof","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42106","description":"Excision lesion mouth roof","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strep a dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87652","description":"Strep a dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRD0","description":"ICD-CIRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOD0","description":"ICD-PKOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA250","description":"Reduced Physical Function _ ADL Index 0-1/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDME0","description":"ICD-KDME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE21C","description":"Special Care Low _ ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post and core cast + crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2952","description":"Post and core cast + crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPB0","description":"ICD-FGPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJOE1","description":"ICD-OJOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cstm manual wheelchair/base","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0008","description":"Cstm manual wheelchair/base","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nerve palsy fascial graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15840","description":"Nerve palsy fascial graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABAB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABAB0","description":"ICD-ABAB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28G","description":"Special Care Low _ ADL Index 6-10/TRICARE 300-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAA1","description":"ICD-OLAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Myomectomy abdom method","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58140","description":"Myomectomy abdom method","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD231","description":"Special Care Low _ ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC1","description":"ICD-JFIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBMA1","description":"ICD-EBMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip foreign body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27087","description":"Remove hip foreign body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFMF1","description":"ICD-FFMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGTC0","description":"ICD-BGTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96101","description":"Psychological testing (includes psychodiagnostic assessment of emotionality_ intellectual abilities_ personality and psychopathology_ eg_ MMPI_ Rorschach_ WAIS)_ per hour of t","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tongue jaw & neck surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41155","description":"Tongue jaw & neck surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEA0","description":"ICD-FBEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vte prophylaxis rcvd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4069F","description":"Vte prophylaxis rcvd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chest x-ray frnt lat oblique","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71022","description":"Chest x-ray frnt lat oblique","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAF1","description":"ICD-GFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGRA1","description":"ICD-PGRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration of hip joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27033","description":"Exploration of hip joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCED0","description":"ICD-GCED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTF1","description":"ICD-GBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0446U","description":"Autoimmune diseases (systemic lupus erythematosus [SLE])_ analysis of 10 cytokine soluble mediator biomarkers by immunoassay_ plasma_ individual components reported with an al","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Embolization protect syst","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1884","description":"Embolization protect syst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JB11","description":"ICD-3JB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVF0","description":"ICD-JIVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGCB0","description":"ICD-FGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBXD0","description":"ICD-GBXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE110","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIPE0","description":"ICD-OIPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGKF0","description":"ICD-GGKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFLX","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASD1","description":"ICD-OASD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHGD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHGD1","description":"ICD-NHGD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-invasive vagus nerve stimulator (GammaCore-S)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1020","description":"Non-invasive vagus nerve stimulator (GammaCore-S)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBMD0","description":"ICD-JBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIHF1","description":"ICD-CIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWD0","description":"ICD-GIWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEHB1","description":"ICD-NEHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 4 vhd seat/back","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0871","description":"Pwc gp 4 vhd seat/back","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE1","description":"ICD-KCNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBTB0","description":"ICD-GBTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply finger cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29086","description":"Apply finger cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0564T","description":"Oncology_ Chemotherapeutic Drug Cytotoxicity Assay Of Cancer Stem Cells (Cscs)_ From Cultured Cscs And Primary Tumor Cells_ Categorical Drug Response Reported Based On Percent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87635","description":"Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])_ amplified probe techniq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAID0","description":"ICD-FAID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHJE1","description":"ICD-JHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEEA0","description":"ICD-FEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLAC1","description":"ICD-MLAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69726","description":"Removal_ Osseointegrated Implant_ Skull; With Percutaneous Attachment To External Speech Processor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBMC0","description":"ICD-IBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft aortbifemoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35540","description":"Art byp grft aortbifemoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPD1","description":"ICD-OAPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFDD1","description":"ICD-BFDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCXB1","description":"ICD-GCXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOB1","description":"ICD-CAOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRB0","description":"ICD-KBRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystoscopy and treatment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"52330","description":"Cystoscopy and treatment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin protect wc cus wd <22in","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2603","description":"Skin protect wc cus wd <22in","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4403","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","description":"HCPCS-Q4403","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49593","description":"Repair of anterior abdominal hernia(s) (ie_ epigastric_ incisional_ ventral_ umbilical_ spigelian)_ any approach (ie_ open_ laparoscopic_ robotic)_ initial_ including implanta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No med visit in 24mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9246","description":"No med visit in 24mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCE1","description":"ICD-OGCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF0","description":"ICD-JBFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIC1","description":"ICD-ECIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA11A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ uns","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat thumb fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26665","description":"Treat thumb fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Change g-tube to g-j perc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49446","description":"Change g-tube to g-j perc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDCF0","description":"ICD-FDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLA0","description":"ICD-CDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAHB1","description":"ICD-BAHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0782T","description":"Bronchoscopy_ rigid or flexible_ with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves_ including fluoroscopic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHDF0","description":"ICD-AHDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOC1","description":"ICD-KCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0524T","description":"Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein_ open or percutaneous_ including all vascular access_ catheter manipulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBLC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBLC1","description":"ICD-IBLC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCTB1","description":"ICD-NCTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDAC1","description":"ICD-IDAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDWA0","description":"ICD-CDWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYB1","description":"ICD-DBYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDTE1","description":"ICD-EDTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEDA1","description":"ICD-OEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skn sub grft f/n/hf/g child","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15277","description":"Skn sub grft f/n/hf/g child","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNF0","description":"ICD-JBNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0830T","description":"Digitization of glass microscope slides for cytopathology_ selective-cellular enhancement technique with interpretation (eg_ liquid-based slide preparation method)_ except cer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHCD1","description":"ICD-FHCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein access cutdown < 1 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36420","description":"Vein access cutdown < 1 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA1","description":"ICD-BEEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1217","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g._ spirometry equipment not available at the time of the encounter)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUF0","description":"ICD-OHUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Air fluidized bed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0194","description":"Air fluidized bed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy remov fb/fibrin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32653","description":"Thoracoscopy remov fb/fibrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOD0","description":"ICD-GGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Declot vascular device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36593","description":"Declot vascular device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intmd rpr s/a/t/ext 12.6-20","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"12035","description":"Intmd rpr s/a/t/ext 12.6-20","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFYD1","description":"ICD-KFYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBVD1","description":"ICD-FBVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"vaccine administration-human papillomavirus - Dose 3","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1783","description":"vaccine administration-human papillomavirus - Dose 3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIB0","description":"ICD-ABIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bronchus add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32501","description":"Repair bronchus add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t4_ n0 w/o prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9085","description":"Onc dx colon t4_ n0 w/o prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIBE0","description":"ICD-IIBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Detect agnt mult dna direc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87800","description":"Detect agnt mult dna direc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast stacked diep/gap","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2067","description":"Breast stacked diep/gap","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFD1","description":"ICD-CBFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of ferritin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82728","description":"Assay of ferritin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBB0","description":"ICD-BIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFL5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CACB1","description":"ICD-CACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPD0","description":"ICD-CAPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0601","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0601","description":"HCPCS-C0601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCAF0","description":"ICD-JCAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of bladder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51550","description":"Partial removal of bladder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mnpj of tmj w/anesth","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21073","description":"Mnpj of tmj w/anesth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hdr elctr ntrst/ntrcv brchtx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0395T","description":"Hdr elctr ntrst/ntrcv brchtx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colon ca screen;barium enema","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0106","description":"Colon ca screen;barium enema","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC8B","description":"Very High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJPE1","description":"ICD-NJPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFLA1","description":"ICD-EFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIMD0","description":"ICD-FIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEBD1","description":"ICD-CEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAPE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAPE0","description":"ICD-CAPE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFED0","description":"ICD-AFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHCA1","description":"ICD-IHCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assessment for hearing aid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5010","description":"Assessment for hearing aid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLAF1","description":"ICD-OLAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAB1","description":"ICD-JGAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BHK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cerebrospinal fluid scan","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78647","description":"Cerebrospinal fluid scan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Analysis skeletal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88355","description":"Analysis skeletal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wireless pressure sensor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C2624","description":"Wireless pressure sensor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDTC0","description":"ICD-KDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MICC1","description":"ICD-MICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSD1","description":"ICD-LBSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EALC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EALC1","description":"ICD-EALC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAQD0","description":"ICD-HAQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0305U","description":"Hematology_ Red Blood Cell (Rbc) Functionality And Deformity As A Function Of Shear Stress_ Whole Blood_ Reported As A Maximum Elongation Index","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGL2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGEC0","description":"ICD-GGEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reremove wrist tendon lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25112","description":"Reremove wrist tendon lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair forearm tendon/muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25260","description":"Repair forearm tendon/muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL55","description":"Very High Rehab plus Extensive _ ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOA0","description":"ICD-PIOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M.avium-intra dna quant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87562","description":"M.avium-intra dna quant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc cln cncr stage 2 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3386F","description":"Ajcc cln cncr stage 2 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGMC1","description":"ICD-FGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replace pump_ alt press pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0182","description":"Replace pump_ alt press pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-98003","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","description":"CPT-98003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB136","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short st","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFSE1","description":"ICD-KFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OADF1","description":"ICD-OADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUB1","description":"ICD-JBUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of magnesium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83735","description":"Assay of magnesium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIKB1","description":"ICD-BIKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNE0","description":"ICD-FBNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81188","description":"CSTB (cystatin B) (eg_ Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg_ expanded) alleles","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKE1","description":"ICD-OGKE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abd imag w/o liv/kid/adr les","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9551","description":"Abd imag w/o liv/kid/adr les","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7510","description":"Bronchoscopy_ rigid or flexible_ with bronchial alveolar lavage(s)_ with computer-assisted image-guided navigation_ including fluoroscopic guidance when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGA0","description":"ICD-GFGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OETB0","description":"ICD-OETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of salivary gland","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42320","description":"Drainage of salivary gland","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANC0","description":"ICD-JANC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGB1","description":"ICD-KEGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit cath maintain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99507","description":"Home visit cath maintain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES32B","description":"Extensive Services _ ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDEF0","description":"ICD-NDEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5119","description":"Injection_ rituximab-pvvr_ biosimilar_ (ruxience)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFGC0","description":"ICD-CFGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete ft_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4271","description":"Complete ft_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJTD0","description":"ICD-NJTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastrointestinal fat absorpt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3708","description":"Gastrointestinal fat absorpt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFJA1","description":"ICD-GFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert endovasc prosth taa","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33883","description":"Insert endovasc prosth taa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRB0","description":"ICD-HFRB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLSA1","description":"ICD-OLSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Contrast x-ray of knee joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73580","description":"Contrast x-ray of knee joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoulder arthroscopy/surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29824","description":"Shoulder arthroscopy/surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGP4","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWB1","description":"ICD-GAWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KALF1","description":"ICD-KALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A4545","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","description":"HCPCS-A4545","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of tonsil abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42700","description":"Drainage of tonsil abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abduction rotation bar shoe","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3140","description":"Abduction rotation bar shoe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0594U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","description":"CPT-0594U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of angiotensin ii","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82163","description":"Assay of angiotensin ii","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of arm tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24320","description":"Repair of arm tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term device_ multi art digit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6715","description":"Term device_ multi art digit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFPD0","description":"ICD-BFPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJUC1","description":"ICD-NJUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD20D","description":"Clinically Complex _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBF0","description":"ICD-KGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGMA0","description":"ICD-BGMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEWE0","description":"ICD-KEWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Surgical trays","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4550","description":"Surgical trays","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBIA0","description":"ICD-JBIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCF1","description":"ICD-IBCF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC140","description":"Reduced Physical Function _ ADL Index 6-10/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2GB11","description":"ICD-2GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4387","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","description":"HCPCS-Q4387","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSC1","description":"ICD-GCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC18X","description":"Clinically Complex _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAF0","description":"ICD-FFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWF1","description":"ICD-DFWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01214","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","description":"CPT-01214","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FATB1","description":"ICD-FATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Venous sampling by catheter","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75893","description":"Venous sampling by catheter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic compression controller without calibrated gradient pressure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0681","description":"Non-pneumatic compression controller without calibrated gradient pressure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI lower extremity w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73719","description":"MRI lower extremity w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKA0","description":"ICD-BHKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAED0","description":"ICD-OAED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLIB0","description":"ICD-MLIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX55","description":"Low Rehab plus Extensive _ ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trach/laryn tube plug/stop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7527","description":"Trach/laryn tube plug/stop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrical stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97032","description":"Electrical stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE211","description":"Special Care High _ ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of androstenedione","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82157","description":"Assay of androstenedione","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB22A","description":"Special Care Low _ ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove for body","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46608","description":"Anoscopy remove for body","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCTA0","description":"ICD-KCTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI brain w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70558","description":"MRI brain w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elosulfase alfa_ injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1322","description":"Elosulfase alfa_ injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N-et; patient attend/escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2001","description":"N-et; patient attend/escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0708T","description":"Intradermal Cancer Immunotherapy; Preparation And Initial Injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove intestinal allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44137","description":"Remove intestinal allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSF1","description":"ICD-LGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHD1","description":"ICD-ABHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA HEPATITIS B SURFACE ANTIGEN","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87340","description":"IAAD IA HEPATITIS B SURFACE ANTIGEN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stationary o2 contents_ liq","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0442","description":"Stationary o2 contents_ liq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXB1","description":"ICD-NEXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0675T","description":"Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBB0","description":"ICD-FFBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OICF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OICF0","description":"ICD-OICF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0523T","description":"Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree_ derived from coronary angiogram data_ for re","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBDD1","description":"ICD-MBDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDC1","description":"ICD-IHDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CFMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65270","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLBE0","description":"ICD-NLBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enterectomy cong add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44128","description":"Enterectomy cong add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCTD0","description":"ICD-MCTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHDD0","description":"ICD-BHDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUC1","description":"ICD-EBUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEF1","description":"ICD-AHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inhibitor","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7198","description":"Anti-inhibitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens aniseikonic trifocal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2318","description":"Lens aniseikonic trifocal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct soft tissue neck w/dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70491","description":"Ct soft tissue neck w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD20D","description":"Special Care Low _ ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFF1","description":"ICD-FCFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD28A","description":"Reduced Physical Function _ ADL Index 11-14/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of bladder/urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"51800","description":"Revision of bladder/urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17108","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEDD0","description":"ICD-BEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spec coll non-blood:a/d test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0048","description":"Spec coll non-blood:a/d test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/wedge resect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32666","description":"Thoracoscopy w/wedge resect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01844","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","description":"CPT-01844","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AADF1","description":"ICD-AADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea compl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0424T","description":"Insj/rplc nstim apnea compl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCFE1","description":"ICD-FCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWF1","description":"ICD-KIWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anti-inflm/anlgsc otc assess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1007F","description":"Anti-inflm/anlgsc otc assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MATB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MATB1","description":"ICD-MATB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLOF1","description":"ICD-OLOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Kidney function study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78725","description":"Kidney function study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCBD0","description":"ICD-FCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryopreservation ovary tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0058T","description":"Cryopreservation ovary tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Specimen infect agnt concntj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87015","description":"Specimen infect agnt concntj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUF1","description":"ICD-MCUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLXE1","description":"ICD-OLXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Knee-shin exo mech stance ph","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5716","description":"Knee-shin exo mech stance ph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of wrist","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73100","description":"X-ray exam of wrist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EELA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EELA1","description":"ICD-EELA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBYF1","description":"ICD-KBYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAMB1","description":"ICD-AAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Paranasal sinus ultrasound","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9024","description":"Paranasal sinus ultrasound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BELA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BELA0","description":"ICD-BELA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEB0","description":"ICD-AGEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95973","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg_ rate_ pulse amplitude and duration_ configuration of wave form_ battery status_ elect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemipelvectomy canadian sach","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5341","description":"Hemipelvectomy canadian sach","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYE0","description":"ICD-DHYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1825","description":"Generator_ neurostimulator (implantable)_ non-rechargeable with carotid sinus baroreceptor stimulation lead(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"M/phmtrc alys ishquant/semiq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88374","description":"M/phmtrc alys ishquant/semiq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Preventive counseling group","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99411","description":"Preventive counseling group","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBD1","description":"ICD-AIBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microbe suscept mycobacteri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87190","description":"Microbe suscept mycobacteri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEFA1","description":"ICD-NEFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiologic examination_ chest; 4 or more views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"71048","description":"Radiologic examination_ chest; 4 or more views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF0","description":"ICD-ODSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr wc drivewheel gear repl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2369","description":"Pwr wc drivewheel gear repl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAWC0","description":"ICD-DAWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB24D","description":"Reduced Physical Function _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ un","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins/rep subq defibrillator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33270","description":"Ins/rep subq defibrillator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Combo pegintf/rib rx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4153F","description":"Combo pegintf/rib rx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood product/irradiation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86945","description":"Blood product/irradiation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hhc slp ea 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0161","description":"Hhc slp ea 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTE0","description":"ICD-FHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OECC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OECC0","description":"ICD-OECC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDMF0","description":"ICD-NDMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL32","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9610","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9610","description":"HCPCS-C9610","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBF1","description":"ICD-BIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHE0","description":"ICD-NKHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCUE1","description":"ICD-CCUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracranial bilat study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93880","description":"Extracranial bilat study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec lock on manual pw elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6638","description":"Elec lock on manual pw elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERB1","description":"ICD-CERB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Whelchr fxd full length arms","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1050","description":"Whelchr fxd full length arms","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8968","description":"Documentation of medical reason(s) for not prescribing warfarin or another FDA-approved anticoagulant (e.g._ atrial appendage device in place)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64821","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOF0","description":"ICD-OEOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFGB0","description":"ICD-KFGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chap services at hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9473","description":"Chap services at hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAMA0","description":"ICD-NAMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemodialysis repeated eval","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90937","description":"Hemodialysis repeated eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj streptokinase /250000 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2995","description":"Inj streptokinase /250000 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGLB0","description":"ICD-GGLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt not rcvng glucoco thxpy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4192F","description":"Pt not rcvng glucoco thxpy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antigen therapy services","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95149","description":"Antigen therapy services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of salivary duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42665","description":"Ligation of salivary duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX3C","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHK2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDC1","description":"ICD-FBDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA0","description":"ICD-FGNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2327","description":"Injection_ risankizumab-rzaa_ intravenous_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDTC0","description":"ICD-NDTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHPW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CETB0","description":"ICD-CETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit est pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99337","description":"Domicil/r-home visit est pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHPF1","description":"ICD-GHPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exhaled air analysis o2/co2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94681","description":"Exhaled air analysis o2/co2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL22","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37246","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease_ intracranial_ coronary_ pulmonary_ or dialysis circuit)_ open or percutaneous_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFRD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFRD0","description":"ICD-HFRD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAPF0","description":"ICD-KAPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKNB1","description":"ICD-OKNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27822","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGIC1","description":"ICD-NGIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove vad different session","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33992","description":"Remove vad different session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOB1","description":"ICD-KHOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEFF1","description":"ICD-OEFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGB1","description":"ICD-CIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHF1","description":"ICD-GIHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92288","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","description":"CPT-92288","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GASE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GASE0","description":"ICD-GASE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec knee-shin swing only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5857","description":"Elec knee-shin swing only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ nitroglycerin_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2305","description":"Injection_ nitroglycerin_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noninterest escort in non er","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0080","description":"Noninterest escort in non er","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of body section","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76100","description":"X-ray exam of body section","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wash harvest stem cells","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38209","description":"Wash harvest stem cells","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCB1","description":"ICD-BHCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Culture aerobic quant other","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87071","description":"Culture aerobic quant other","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEDD1","description":"ICD-CEDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis a antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86708","description":"Hepatitis a antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj magnesium sulfate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3475","description":"Inj magnesium sulfate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCHD0","description":"ICD-NCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PISC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PISC0","description":"ICD-PISC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHDC0","description":"ICD-OHDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolloid drg filler dry","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6241","description":"Hydrocolloid drg filler dry","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psytx pt&/family 30 minutes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90832","description":"Psytx pt&/family 30 minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7903","description":"Group psychotherapy service for diagnosis_ evaluation_ or treatment of a mental health or substance use disorder provided remotely by hospital staff who are licensed to provid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRA0","description":"ICD-CIRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJYF1","description":"ICD-PJYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove hip pressure sore","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15944","description":"Remove hip pressure sore","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AECD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AECD1","description":"ICD-AECD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGGC1","description":"ICD-GGGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGYB0","description":"ICD-HGYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCHC0","description":"ICD-CCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0701","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0701","description":"HCPCS-B0701","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair dura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61618","description":"Repair dura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Subtalar arthro w/deb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29906","description":"Subtalar arthro w/deb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBCA1","description":"ICD-IBCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCVC0","description":"ICD-OCVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCUB1","description":"ICD-FCUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj follitropin alfa 75 iu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0126","description":"Inj follitropin alfa 75 iu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGRC1","description":"ICD-CGRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete cbc w/auto diff wbc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85025","description":"Complete cbc w/auto diff wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9984","description":"Lvonorgestrl-Rls Iu Coc Sys 19.5 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCQF0","description":"ICD-KCQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC250","description":"Reduced Physical Function _ ADL Index 6-10/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KANE0","description":"ICD-KANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0448U","description":"Oncology (lung and colon cancer)_ DNA_ qualitative_ next-generation sequencing detection of single-nucleotide variants and deletions in EGFR and KRAS genes_ formalin-fixed par","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJPA0","description":"ICD-OJPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGDC0","description":"ICD-AGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEQE0","description":"ICD-KEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHE1","description":"ICD-NDHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepatitis c ab test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86803","description":"Hepatitis c ab test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dias bp > or = 90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8755","description":"Dias bp > or = 90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPD1","description":"ICD-FIPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0157U","description":"APC (APC regulator of WNT signaling pathway)(EG_familial adenomatosis polyposis [FAP] MRNA sequence analysis (list seperately in addition to code for primary procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGTE0","description":"ICD-GGTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post-coital mucous exam","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0115","description":"Post-coital mucous exam","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pelvis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26990","description":"Drainage of pelvis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHAF0","description":"ICD-OHAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxaliplatin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9263","description":"Oxaliplatin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hydrocolld drg <=16 w/o bdr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6234","description":"Hydrocolld drg <=16 w/o bdr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCQC0","description":"ICD-DCQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Factor ix non-recombinant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7193","description":"Factor ix non-recombinant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ald_ tv amplifier_ any type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5270","description":"Ald_ tv amplifier_ any type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat radius fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24666","description":"Treat radius fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit new patient","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99343","description":"Home visit new patient","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lang express d/c status","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9164","description":"Lang express d/c status","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBKE0","description":"ICD-KBKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDSC1","description":"ICD-DDSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy w/tumr remove","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45338","description":"Sigmoidoscopy w/tumr remove","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGXC0","description":"ICD-OGXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFUC0","description":"ICD-CFUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial vessel surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61680","description":"Intracranial vessel surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCBD0","description":"ICD-OCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnio quad-core_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4294","description":"Amnio quad-core_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFPB1","description":"ICD-JFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBUF1","description":"ICD-EBUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEDA1","description":"ICD-GEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of b hexosaminidase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83080","description":"Assay of b hexosaminidase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect/debride pancreas","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"48105","description":"Resect/debride pancreas","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electric heat pad standard","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0210","description":"Electric heat pad standard","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shave skin lesion 0.6-1.0 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11301","description":"Shave skin lesion 0.6-1.0 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEAE1","description":"ICD-FEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medicaid certified community behavioral health clinic services_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1040","description":"Medicaid certified community behavioral health clinic services_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Micafungin sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2248","description":"Micafungin sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin full graft een & lips","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15260","description":"Skin full graft een & lips","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGHF1","description":"ICD-EGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icd counseling provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4470F","description":"Icd counseling provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPB1","description":"ICD-OFPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFWE0","description":"ICD-LFWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUE1","description":"ICD-EAUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tube_ pneum wheel drive tire","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2382","description":"Tube_ pneum wheel drive tire","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDF1","description":"ICD-JGDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0239U","description":"Targeted genomic sequence analysis panel_ solid organ neoplasm_ cell-free DNA_ analysis of 311 or more genes_ interrogation for sequence variants_ including substitutions_ ins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICB0","description":"ICD-NICB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bk pain & fxn assessed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1130F","description":"Bk pain & fxn assessed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC18C","description":"Special Care High _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEC1","description":"ICD-KIEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJDE1","description":"ICD-MJDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCYA1","description":"ICD-LCYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLBC1","description":"ICD-MLBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee total contact","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5637","description":"Below knee total contact","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHNS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJF1","description":"ICD-NIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Streptomycin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3000","description":"Streptomycin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEFC0","description":"ICD-FEFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOB1","description":"ICD-OEOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGHC1","description":"ICD-IGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Edetate calcium disodium inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0600","description":"Edetate calcium disodium inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBXF0","description":"ICD-OBXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBSE0","description":"ICD-OBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASB1","description":"ICD-OASB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Straight knee joint heavy du","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2385","description":"Straight knee joint heavy du","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hosp bed var ht w/o rail w/o","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0292","description":"Hosp bed var ht w/o rail w/o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brentuximab vedotin inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9042","description":"Brentuximab vedotin inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFLF1","description":"ICD-BFLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIGB1","description":"ICD-KIGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"2d tte w or w/o fol w/con_fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8924","description":"2d tte w or w/o fol w/con_fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44405","description":"Colonoscopy w/dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEMB1","description":"ICD-JEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCID1","description":"ICD-NCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block lumbar/thoracic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64520","description":"N block lumbar/thoracic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCNC1","description":"ICD-FCNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTC0","description":"ICD-CCTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBFE0","description":"ICD-OBFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prgrmg eval implantable dfb","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93283","description":"Prgrmg eval implantable dfb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction of urethra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54318","description":"Reconstruction of urethra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLUD1","description":"ICD-MLUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFOC0","description":"ICD-GFOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast adjuvant chemotherapy administered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9829","description":"Breast adjuvant chemotherapy administered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FITF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FITF1","description":"ICD-FITF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBAF0","description":"ICD-FBAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1413","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","description":"HCPCS-M1413","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX51","description":"Medium Rehab plus Extensive_ ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA2A","description":"Low Rehab_ ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDNE0","description":"ICD-KDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB55","description":"Very High Rehab _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWF1","description":"ICD-KDWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BFM4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlh w/t/o uterus over 250 g","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58573","description":"Tlh w/t/o uterus over 250 g","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin tx mdd not comm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8960","description":"Clin tx mdd not comm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHYD0","description":"ICD-GHYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHTD1","description":"ICD-FHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth nose/sinus surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"16051","description":"Anesth nose/sinus surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Local anesthesia","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9215","description":"Local anesthesia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECUC1","description":"ICD-ECUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBID1","description":"ICD-EBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCWB1","description":"ICD-GCWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFIA0","description":"ICD-MFIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Disposable cycler set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4671","description":"Disposable cycler set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA245","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult electric hand","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7007","description":"Adult electric hand","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHHA0","description":"ICD-OHHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA03","description":"High Rehab _ ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ sutimlimab-jome_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9094","description":"Injection_ sutimlimab-jome_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIOC1","description":"ICD-KIOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee flex cover system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5964","description":"Above knee flex cover system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair elevating leg res","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0990","description":"Wheelchair elevating leg res","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Simult panc kidn trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2065","description":"Simult panc kidn trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOB0","description":"ICD-DHOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDAF0","description":"ICD-FDAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CC21","description":"ICD-4CC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9957","description":"Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA3D","description":"Medium Rehab _ ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCAF1","description":"ICD-GCAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of finger lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26210","description":"Removal of finger lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBKD1","description":"ICD-JBKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFF1","description":"ICD-JBFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX8D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1JC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1JC21","description":"ICD-1JC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AGPU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KISE1","description":"ICD-KISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFAA0","description":"ICD-FFAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incise inner eye adhesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65880","description":"Incise inner eye adhesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD1","description":"ICD-FCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prq card stent/ath/angio","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92933","description":"Prq card stent/ath/angio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86710","description":"Influenza virus antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colistimethate inh sol mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0142","description":"Colistimethate inh sol mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGHF0","description":"ICD-JGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUD0","description":"ICD-EAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Urology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4037","description":"Urology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00731","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","description":"CPT-00731","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYB1","description":"ICD-GAYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap enterolysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44180","description":"Lap enterolysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC1","description":"ICD-OKGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGVA0","description":"ICD-KGVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML3D","description":"Medium Rehab plus Extensive_ ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJD0","description":"ICD-NDJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drain/inj joint/bursa w/o us","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20610","description":"Drain/inj joint/bursa w/o us","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr epigastric hern reduce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49570","description":"Rpr epigastric hern reduce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBHC1","description":"ICD-GBHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHEF0","description":"ICD-BHEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect arm/elbow tum 5 cm/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24079","description":"Resect arm/elbow tum 5 cm/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clean out mastoid cavity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69222","description":"Clean out mastoid cavity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDCB0","description":"ICD-GDCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCUD1","description":"ICD-JCUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81109","description":"Human Platelet Antigen 5 genotyping (HPA-5)_ ITGA2 (integrin_ alpha 2 [CD49B_ alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg_ neonatal alloimmune thrombocytopenia [NAIT]_ post","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31242","description":"Nasal/sinus endoscopy_ surgical; with destruction by radiofrequency ablation_ posterior nasal nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCBE0","description":"ICD-BCBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGSC1","description":"ICD-LGSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICME0","description":"ICD-ICME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement nasal cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7032","description":"Replacement nasal cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODFE1","description":"ICD-ODFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAKF1","description":"ICD-JAKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ob us detailed sngl fetus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76811","description":"Ob us detailed sngl fetus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEHE1","description":"ICD-FEHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBPC0","description":"ICD-JBPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9776","description":"Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g._ cystic duct_ common bile duct and common hepatic duct) with intravenous administra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPC1","description":"ICD-FCPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIBC1","description":"ICD-BIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHMT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLVD1","description":"ICD-NLVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HAWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HAWC1","description":"ICD-HAWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0017","description":"Alcohol and/or drug services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPE1","description":"ICD-FCPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC8H","description":"Ultra High Rehab _ ADL Index 11-16/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBCF0","description":"ICD-CBCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDVC1","description":"ICD-NDVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CABC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CABC1","description":"ICD-CABC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj paravert f jnt l/s 3 lev","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64495","description":"Inj paravert f jnt l/s 3 lev","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of colon/ileostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44155","description":"Removal of colon/ileostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B1805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B1805","description":"HCPCS-B1805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGJA1","description":"ICD-KGJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputation of upper arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24900","description":"Amputation of upper arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81539","description":"Oncology (high-grade prostate cancer)_ biochemical assay of four proteins (Total PSA_ Free PSA_ Intact PSA_ and human kallikrein-2 [hK2])_ utilizing plasma or serum_ prognosti","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of metatarsal heads","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28114","description":"Removal of metatarsal heads","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIRB1","description":"ICD-OIRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Post 1 srfc resinbased cmpst","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2391","description":"Post 1 srfc resinbased cmpst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC116","description":"Special Care High _ ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Me","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGKC1","description":"ICD-KGKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKRA1","description":"ICD-OKRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFJA0","description":"ICD-CFJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pathology lab procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"89240","description":"Pathology lab procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9890","description":"Bridge payment: A one-time payment for the first Medicare Diabetes Prevention Program (MDPP) core session_ core maintenance session_ or ongoing maintenance session furnished b","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE13C","description":"Reduced Physical Function _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsche","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE20C","description":"Clinically Complex _ ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDGC1","description":"ICD-KDGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96131","description":"Psychological testing evaluation services by physician or other qualified health care professional_ including integration of patient data_ interpretation of standardized test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC23C","description":"Reduced Physical Function _ ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unsched","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGCA1","description":"ICD-AGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYC1","description":"ICD-OBYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGAA0","description":"ICD-MGAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Planar back for ped size wc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2291","description":"Planar back for ped size wc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Conform band s w <3in/yd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6445","description":"Conform band s w <3in/yd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA18E","description":"Reduced Physical Function _ ADL Index 0-1/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXB0","description":"ICD-FHXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00702","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","description":"CPT-00702","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microsatellite instability","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81301","description":"Microsatellite instability","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligate leg veins open","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37761","description":"Ligate leg veins open","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGLU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLA1","description":"ICD-MCLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASA0","description":"ICD-HASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAJD0","description":"ICD-BAJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBD1","description":"ICD-GDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHJD1","description":"ICD-GHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDEF1","description":"ICD-FDEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAUA1","description":"ICD-JAUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise finger joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26535","description":"Revise finger joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Salicylate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80179","description":"Salicylate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0626T","description":"Automated Quantification And Characterization Of Coronary Atherosclerotic Plaque To Assess Severity Of Coronary Disease_ Using Data From Coronary Computed Tomographic Angiogra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDKA0","description":"ICD-NDKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove/graft foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28106","description":"Remove/graft foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fecal microbiota prep instil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0455","description":"Fecal microbiota prep instil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAF0","description":"ICD-KFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA8F","description":"Low Rehab_ ADL Index 0-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric mucosa imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78261","description":"Gastric mucosa imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65091","description":"Revise eye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHWF1","description":"ICD-HHWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFDF0","description":"ICD-GFDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAAF1","description":"ICD-KAAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AFK4","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFVD0","description":"ICD-FFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Guidance for radiaj tx dlvr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77387","description":"Guidance for radiaj tx dlvr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCJC1","description":"ICD-CCJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Smokeless tobacco user","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"1035F","description":"Smokeless tobacco user","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKF0","description":"ICD-JCKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gauze <= 16 sq in water/sal","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6228","description":"Gauze <= 16 sq in water/sal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAJE1","description":"ICD-CAJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90679","description":"Respiratory syncytial virus vaccine_ preF_ recombinant subunit_ adjuvanted_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCKA1","description":"ICD-FCKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDC0","description":"ICD-IGDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACED0","description":"ICD-ACED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTC1","description":"ICD-IFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDB0","description":"ICD-IEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lung ventilat&perfus imaging","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78582","description":"Lung ventilat&perfus imaging","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAHA1","description":"ICD-NAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAQB1","description":"ICD-GAQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01522","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","description":"CPT-01522","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEF1","description":"ICD-NKEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLD0","description":"ICD-CDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEPA0","description":"ICD-NEPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4364","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","description":"HCPCS-Q4364","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBE1","description":"ICD-NGBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGMC1","description":"ICD-NGMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFCE1","description":"ICD-AFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCVB0","description":"ICD-NCVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0827T","description":"Digitization of glass microscope slides for cytopathology_ fluids_ washings_ or brushings_ except cervical or vaginal; smears with interpretation (List separately in addition","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDF0","description":"ICD-JDDF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDKD0","description":"ICD-KDKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHKW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB1","description":"ICD-KDIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62320","description":"Injection(s)_ of diagnostic or therapeutic substance(s) (eg_ anesthetic_ antispasmodic_ opioid_ steroid_ other solution)_ not including neurolytic substances_ including needle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mumps antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86735","description":"Mumps antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67935","description":"Repair eyelid wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAEB1","description":"ICD-GAEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIJC1","description":"ICD-CIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AAAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AAAD1","description":"ICD-AAAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFXC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFXC0","description":"ICD-GFXC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFBF0","description":"ICD-FFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL24","description":"Very High Rehab plus Extensive _ ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA2A","description":"Medium Rehab _ ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thoracoscopy w/ th nrv exc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32664","description":"Thoracoscopy w/ th nrv exc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFC0","description":"ICD-CCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFAE0","description":"ICD-OFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUC0","description":"ICD-FEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc skin abd add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"15847","description":"Exc skin abd add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHYC0","description":"ICD-DHYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Toe loop/holder_ each","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0952","description":"Toe loop/holder_ each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIUB0","description":"ICD-EIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAFB0","description":"ICD-NAFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Salivary surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42699","description":"Salivary surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBUF0","description":"ICD-GBUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metacarpal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26607","description":"Treat metacarpal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC28I","description":"Special Care Low _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiokymography","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0035","description":"Cardiokymography","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLF1","description":"ICD-JDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGOF1","description":"ICD-GGOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHEC0","description":"ICD-OHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCND1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCND1","description":"ICD-NCND1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGKD1","description":"ICD-OGKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/14-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA120","description":"Reduced Physical Function _ ADL Index 0-1/14-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAIB0","description":"ICD-CAIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDHA1","description":"ICD-GDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJKA1","description":"ICD-NJKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMC1","description":"ICD-ABMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHCE1","description":"ICD-BHCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGMC0","description":"ICD-JGMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01500","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","description":"CPT-01500","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKC1","description":"ICD-BEKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug test presump not opt","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0479","description":"Drug test presump not opt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX3B","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heavy duty wheelchair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0006","description":"Heavy duty wheelchair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens bifocal speciality","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2299","description":"Lens bifocal speciality","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFBC1","description":"ICD-IFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3IB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3IB11","description":"ICD-3IB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQE0","description":"ICD-LBQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1238","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE1","description":"ICD-FEJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQE0","description":"ICD-OKQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant neuroelectrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64561","description":"Implant neuroelectrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OALF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OALF1","description":"ICD-OALF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0498","description":"Chemotx Adm Iv Inf Tech; Ini Inf Office/Clin Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDXC1","description":"ICD-FDXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tlso rigid frame hyperex pre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0472","description":"Tlso rigid frame hyperex pre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AGL4","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEYF1","description":"ICD-OEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL0A","description":"High Rehab plus Extensive _ ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFMS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEC0","description":"ICD-OJEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair stomach-bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43880","description":"Repair stomach-bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFWE1","description":"ICD-OFWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD11C","description":"Clinically Complex _ ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the fol","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ADM SARSCOV2 30MCG/0.3 ML BST","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0004A","description":"ADM SARSCOV2 30MCG/0.3 ML BST","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct colonography dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74261","description":"Ct colonography dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bortezomib injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9041","description":"Bortezomib injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODAD0","description":"ICD-ODAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Noner transport meals escort","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0210","description":"Noner transport meals escort","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC16","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Platelets Pathogen Reduced Ea Unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9988","description":"Platelets Pathogen Reduced Ea Unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFJA1","description":"ICD-NFJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amputate metacarpal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26910","description":"Amputate metacarpal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACBF1","description":"ICD-ACBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGKE0","description":"ICD-CGKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins cath ren art 1st unilat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36251","description":"Ins cath ren art 1st unilat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcyl bifocal 4.00d/.1","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2203","description":"Lens sphcyl bifocal 4.00d/.1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPC0","description":"ICD-JEPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-55868","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","description":"CPT-55868","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"FlowerAmnioFlo_ 0.1 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4177","description":"FlowerAmnioFlo_ 0.1 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFA1","description":"ICD-BDFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infusion supplies w/o pump","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4223","description":"Infusion supplies w/o pump","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC4D","description":"Ultra High Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elec stim unattend for press","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0281","description":"Elec stim unattend for press","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art pancreas system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1034","description":"Art pancreas system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLID0","description":"ICD-OLID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCHD0","description":"ICD-BCHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral prescription drug chemo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8999","description":"Oral prescription drug chemo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter biopsy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37200","description":"Transcatheter biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Femoral endovas graft add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34813","description":"Femoral endovas graft add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KARF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KARF1","description":"ICD-KARF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94618","description":"Pulmonary stress testing (eg_ 6-minute walk test)_ including measurement of heart rate_ oximetry_ and oxygen titration_ when performed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Release hand/finger tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26445","description":"Release hand/finger tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90721","description":"Diphtheria_ tetanus toxoids_ and acellular pertussis vaccine andhemophilus influenza b vaccine (dtap-hib)_ for intramsucular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vincristine sulfate 1 mg inj","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9370","description":"Vincristine sulfate 1 mg inj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9128","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9128","description":"CDT-D9128","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCNB1","description":"ICD-JCNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gluc monitor rental","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S1031","description":"Gluc monitor rental","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9044","description":"Injection_ bortezomib_ not otherwise specified_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Serum lvls ca/ipth/lpd ord","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3278F","description":"Serum lvls ca/ipth/lpd ord","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAKB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAKB1","description":"ICD-FAKB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFA1","description":"ICD-OCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt inelig for ref oto eval","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8561","description":"Pt inelig for ref oto eval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBKA1","description":"ICD-OBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Benzodiazepines","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6031","description":"Benzodiazepines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Construction of absent anus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46730","description":"Construction of absent anus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compression stocking bk30-40","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6531","description":"Compression stocking bk30-40","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLA0","description":"ICD-FGLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIDD0","description":"ICD-BIDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laminotomy single cervical","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63040","description":"Laminotomy single cervical","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKA0","description":"ICD-FGKA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGXF0","description":"ICD-CGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBDF1","description":"ICD-CBDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCUC0","description":"ICD-GCUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJTB1","description":"ICD-MJTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Th/wght bear nar m-l brim mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2525","description":"Th/wght bear nar m-l brim mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWD1","description":"ICD-KDWD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antistreptolysin o titer","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86060","description":"Antistreptolysin o titer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstr lwr jaw segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21198","description":"Reconstr lwr jaw segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vertebral axial decompressio","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9090","description":"Vertebral axial decompressio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D5909","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D5909","description":"CDT-D5909","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pi volunteer ambulance co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A0432","description":"Pi volunteer ambulance co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFAA1","description":"ICD-GFAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Compact travel hemodialyzer","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1635","description":"Compact travel hemodialyzer","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLCF0","description":"ICD-MLCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLHB0","description":"ICD-NLHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth one lung ventilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54151","description":"Anesth one lung ventilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M0010","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit corticosteroid/diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9490","description":"Hit corticosteroid/diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ex h rate for sz ovr 30 day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0385T","description":"Ex h rate for sz ovr 30 day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97551","description":"Caregiver training in strategies and techniques to facilitate the patient_s functional performance in the home or community (eg_ activities of daily living [ADLs]_ instrumenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GABD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GABD0","description":"ICD-GABD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36902","description":"Introduction of needle(s) and/or catheter(s)_ dialysis circuit_ with diagnostic angiography of the dialysis circuit_ including all direct puncture(s) and catheter placement(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC13","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFDB1","description":"ICD-KFDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVC1","description":"ICD-JCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE0","description":"ICD-AIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRF1","description":"ICD-PJRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy dilate w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31631","description":"Bronchoscopy dilate w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Blood glucose level test","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0412","description":"Blood glucose level test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-S4024","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","description":"HCPCS-S4024","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rev_ comm_ track_ doc biopsy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8883","description":"Rev_ comm_ track_ doc biopsy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD0","description":"ICD-CCQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBIA1","description":"ICD-BBIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nose","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30200","description":"Injection treatment of nose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0535T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; data upload_ analysis and initial report configura","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Above knee surgical stocking","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4490","description":"Above knee surgical stocking","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAUE0","description":"ICD-BAUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nephrology Mips Specialty Set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G4014","description":"Nephrology Mips Specialty Set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAUD0","description":"ICD-CAUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC151","description":"Reduced Physical Function _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9316","description":"Injection_ pertuzumab_ trastuzumab_ and hyaluronidase-zzxf_ per 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0094A","description":"Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4KB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4KB11","description":"ICD-4KB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBDC0","description":"ICD-OBDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AFL6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMD1","description":"ICD-MIMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9225","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9225","description":"CDT-D9225","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GETF0","description":"ICD-GETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33390","description":"Valvuloplasty_ aortic valve_ open_ with cardiopulmonary bypass; simple (ie_ valvotomy_ debridement_ debulking_ and/or simple commissural resuspension)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBPB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBPB0","description":"ICD-KBPB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGIC0","description":"ICD-BGIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVB8C","description":"Very High Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDHF1","description":"ICD-NDHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of skull & brain","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62145","description":"Repair of skull & brain","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGDE0","description":"ICD-CGDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gngvl flap w rootplan 1-3 th","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4241","description":"Gngvl flap w rootplan 1-3 th","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOA1","description":"ICD-HFOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAIB1","description":"ICD-KAIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calculus spectroscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82365","description":"Calculus spectroscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFMB0","description":"ICD-KFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscope proc rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45499","description":"Laparoscope proc rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHAA1","description":"ICD-IHAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for cholangiogram","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47531","description":"Injection for cholangiogram","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB0","description":"ICD-JAMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0534T","description":"Continuous recording of movement disorder symptoms_ including bradykinesia_ dyskinesia_ and tremor for 6 days up to 10 days; set-up_ patient training_ configuration of monitor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3B","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ajcc brstcncr stage 4 docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3380F","description":"Ajcc brstcncr stage 4 docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of pregnenolone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84140","description":"Assay of pregnenolone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-93146","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","description":"CPT-93146","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHGB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHGB0","description":"ICD-KHGB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCKE0","description":"ICD-JCKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB1","description":"ICD-MEMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oxford w supinat/pronat inf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3201","description":"Oxford w supinat/pronat inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-76018","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","description":"CPT-76018","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJA0","description":"ICD-GDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHKS","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Emergency dept visit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99281","description":"Emergency dept visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manipulation of spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22505","description":"Manipulation of spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IALA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IALA1","description":"ICD-IALA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of lung lesion(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"32150","description":"Removal of lung lesion(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEMC0","description":"ICD-NEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDHC0","description":"ICD-IDHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCMD1","description":"ICD-CCMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antithrombin iii activity","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85300","description":"Antithrombin iii activity","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct abd & pelv w/contrast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74177","description":"Ct abd & pelv w/contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sach foot_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5971","description":"Sach foot_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEKD1","description":"ICD-JEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEFA0","description":"ICD-BEFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHEC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHEC1","description":"ICD-GHEC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dilated macular exam was not performed_ reason not otherwise specified","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9893","description":"Dilated macular exam was not performed_ reason not otherwise specified","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEFF0","description":"ICD-CEFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBFC0","description":"ICD-BBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insj/rplc nstim apnea pls gn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0427T","description":"Insj/rplc nstim apnea pls gn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHMX","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFF1","description":"ICD-CGFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18X","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDJA0","description":"ICD-NDJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOF1","description":"ICD-KHOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEE1","description":"ICD-KDEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGYF1","description":"ICD-PGYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA0","description":"ICD-KDPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX53","description":"High Rehab plus Extensive _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD0","description":"ICD-OCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBF1","description":"ICD-OIBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDTE0","description":"ICD-IDTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSB0","description":"ICD-HGSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICIE0","description":"ICD-ICIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore epididymis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54865","description":"Explore epididymis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal vaccine inhalation","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3530","description":"Nasal vaccine inhalation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nonfamily hc train/session","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S5116","description":"Nonfamily hc train/session","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHC0","description":"ICD-AFHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hiv-2 probe&revrse trnscripj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87538","description":"Hiv-2 probe&revrse trnscripj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD121","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIPC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIPC1","description":"ICD-FIPC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFXD0","description":"ICD-CFXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLE0","description":"ICD-ECLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduct compnd facial bone fx","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7780","description":"Reduct compnd facial bone fx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGQB1","description":"ICD-OGQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHUA0","description":"ICD-EHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHTA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHTA0","description":"ICD-GHTA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron 4 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0119","description":"Ondansetron 4 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NABC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NABC0","description":"ICD-NABC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth perineal surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90477","description":"Anesth perineal surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGP5","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAMC0","description":"ICD-BAMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVF1","description":"ICD-KHVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFFE1","description":"ICD-CFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEUD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEUD1","description":"ICD-OEUD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of circumcision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54163","description":"Repair of circumcision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBA0","description":"ICD-MEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBJF1","description":"ICD-KBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe sole wedge between sole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3370","description":"Shoe sole wedge between sole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF0","description":"ICD-NGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ct neck spine w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72125","description":"Ct neck spine w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFPC0","description":"ICD-KFPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1019T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","description":"CPT-1019T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CARA0","description":"ICD-CARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploratory heart surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33310","description":"Exploratory heart surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGHB1","description":"ICD-MGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Consult slides prep elsewher","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0484","description":"Consult slides prep elsewher","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFTC1","description":"ICD-KFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABF1","description":"ICD-MABF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endocervical curettage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57505","description":"Endocervical curettage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gc stocking thighlngth 18-30","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6533","description":"Gc stocking thighlngth 18-30","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCJD0","description":"ICD-OCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DARB1","description":"ICD-DARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Small bowel endoscopy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44360","description":"Small bowel endoscopy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCHC0","description":"ICD-KCHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CD18H","description":"Clinically Complex _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA54","description":"Low Rehab_ ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUF0","description":"ICD-MFUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRB1","description":"ICD-HGRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD28H","description":"Special Care Low _ ADL Index 11-14/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHGC0","description":"ICD-OHGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHHF0","description":"ICD-MHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODJC0","description":"ICD-ODJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDLA1","description":"ICD-BDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0802T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0807T","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove drug implant device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11982","description":"Remove drug implant device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLPF1","description":"ICD-OLPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"1 bodytemp >=35.5cw/in 30min","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4559F","description":"1 bodytemp >=35.5cw/in 30min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBQB0","description":"ICD-KBQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC15","description":"Medium Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HC11","description":"ICD-2HC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of iris prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0616T","description":"Insertion of iris prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prep donor liver 3-segment","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47144","description":"Prep donor liver 3-segment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGAC1","description":"ICD-OGAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHB1","description":"ICD-KGHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-pneumatic sequential compression garment_ half leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0679","description":"Non-pneumatic sequential compression garment_ half leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGBF0","description":"ICD-CGBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGVB1","description":"ICD-BGVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2028","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","description":"HCPCS-A2028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JENA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JENA1","description":"ICD-JENA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIQE1","description":"ICD-HIQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KESF0","description":"ICD-KESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AABD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AABD1","description":"ICD-AABD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC1C","description":"Ultra High Rehab _ ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHF0","description":"ICD-GGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX8A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD25C","description":"Special Care Low _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEJE0","description":"ICD-FEJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHUB0","description":"ICD-KHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0661T","description":"Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEGE0","description":"ICD-KEGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64792","description":"Removal of nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CESF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CESF1","description":"ICD-CESF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCEA0","description":"ICD-GCEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision graft abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35907","description":"Excision graft abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hzv vaccine live subq","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90736","description":"Hzv vaccine live subq","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLD0","description":"ICD-IHLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRC0","description":"ICD-PFRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAOF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAOF1","description":"ICD-DAOF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGPA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGPA0","description":"ICD-FGPA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise spermatic cord veins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55530","description":"Revise spermatic cord veins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEDC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEDC1","description":"ICD-NEDC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVE0","description":"ICD-FGVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC18F","description":"Reduced Physical Function _ ADL Index 6-10/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDED1","description":"ICD-FDED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIMB0","description":"ICD-EIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0552","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","description":"HCPCS-G0552","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost skn barr w/o conv >4 sqi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4415","description":"Ost skn barr w/o conv >4 sqi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFQB1","description":"ICD-OFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCSB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCSB1","description":"ICD-LCSB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGQF0","description":"ICD-LGQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGUC1","description":"ICD-KGUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHA1","description":"ICD-EBHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYA1","description":"ICD-OLYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIUB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIUB1","description":"ICD-JIUB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD114","description":"Reduced Physical Function _ ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA25A","description":"Clinically Complex _ ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEWB1","description":"ICD-LEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAUF1","description":"ICD-GAUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert 2 electrode pm-defib","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33217","description":"Insert 2 electrode pm-defib","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX46","description":"High Rehab plus Extensive _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA A","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gonadorelin hydroch/ 100 mcg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1620","description":"Gonadorelin hydroch/ 100 mcg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0102","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0102","description":"HCPCS-B0102","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0351U","description":"Infectious disease (bacterial or viral)_ biochemical assays_ tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)_ interferon gamma-induced protein-10 (IP-10)_ and","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDSD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDSD1","description":"ICD-CDSD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doripenem injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1267","description":"Doripenem injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4JA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4JA21","description":"ICD-4JA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBME1","description":"ICD-EBME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBTC0","description":"ICD-MBTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGBC1","description":"ICD-KGBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGBA1","description":"ICD-EGBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHRC0","description":"ICD-LHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE13C","description":"Special Care High _ ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for breast x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19030","description":"Injection for breast x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part removal of metatarsal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28110","description":"Part removal of metatarsal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAA0","description":"ICD-JBAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHC0","description":"ICD-ABHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEB1","description":"ICD-GEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHSC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHSC0","description":"ICD-KHSC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGKC0","description":"ICD-FGKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGXE1","description":"ICD-KGXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dose optimization auc - 5fu","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S3722","description":"Dose optimization auc - 5fu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBGB1","description":"ICD-FBGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDNE0","description":"ICD-BDNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral/facial photo images","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0350","description":"Oral/facial photo images","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD0","description":"ICD-BDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBGE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBGE1","description":"ICD-CBGE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3JC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3JC11","description":"ICD-3JC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACUE0","description":"ICD-ACUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCXF0","description":"ICD-BCXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject sacroiliac joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27096","description":"Inject sacroiliac joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EADE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EADE1","description":"ICD-EADE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of eye wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65286","description":"Repair of eye wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEGC0","description":"ICD-BEGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9874","description":"Four total Medicare Diabetes Prevention Program (MDPP) core sessions were attended by an MDPP beneficiary under the MDPP Expanded Model (EM). A core session is an MDPP servi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFBC1","description":"ICD-KFBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHDD1","description":"ICD-EHDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBB1","description":"ICD-MBBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIRE0","description":"ICD-CIRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBDD0","description":"ICD-KBDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGK1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC245","description":"Special Care Low _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inc for vagus n elect impl","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64568","description":"Inc for vagus n elect impl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vital capacity test","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94150","description":"Vital capacity test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIDE0","description":"ICD-EIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEDB0","description":"ICD-KEDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGNE1","description":"ICD-JGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUF1","description":"ICD-FEUF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGL6","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX26","description":"Medium Rehab plus Extensive_ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Suspension of vagina","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57280","description":"Suspension of vagina","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDWC0","description":"ICD-DDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9739","description":"Patient unable to complete the FOTO general orthopedic intake PROM at admission and discharge due to blindness_ illiteracy_ severe mental incapacity or language incompatibilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90689","description":"Influenza virus vaccine quadrivalent (IIV4)_ inactivated_ adjuvanted_ preservative free_ 0.25 mL dosage_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFWC0","description":"ICD-KFWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LGRC0","description":"ICD-LGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment delivery","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6009","description":"Radiation treatment delivery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical foods for inborn err","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9435","description":"Medical foods for inborn err","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLYC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLYC0","description":"ICD-OLYC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive surgery of throat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42845","description":"Extensive surgery of throat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic appliance full leg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0660","description":"Pneumatic appliance full leg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Erwinaze injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9019","description":"Erwinaze injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9378","description":"Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytogenetics dna probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88271","description":"Cytogenetics dna probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Splicing of ureters","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50770","description":"Splicing of ureters","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD255","description":"Special Care Low _ ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDJE0","description":"ICD-FDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Part hand no fingers","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6020","description":"Part hand no fingers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEAB1","description":"ICD-JEAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGE0","description":"ICD-FIGE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDCE1","description":"ICD-EDCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJJB1","description":"ICD-OJJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of pilonidal cyst","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10081","description":"Drainage of pilonidal cyst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NICE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NICE1","description":"ICD-NICE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj prohance multipack","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9576","description":"Inj prohance multipack","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHD1","description":"ICD-GGHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Robotic surgical system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2900","description":"Robotic surgical system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":0.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYA0","description":"ICD-OJYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSF0","description":"ICD-HGSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGQB0","description":"ICD-DGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of prostate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55705","description":"Biopsy of prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDIB0","description":"ICD-KDIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1270","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGID0","description":"ICD-GGID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra_ w/o dye_ upper extr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8935","description":"Mra_ w/o dye_ upper extr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd 2 rx anti-emet agt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4558F","description":"Pt recvd 2 rx anti-emet agt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFVD0","description":"ICD-JFVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj testostero enanthate 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3121","description":"Inj testostero enanthate 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBOD0","description":"ICD-PBOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHE1","description":"ICD-OBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC4A","description":"High Rehab _ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cmplx rpr s/a/l 2.6-7.5 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"13121","description":"Cmplx rpr s/a/l 2.6-7.5 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revitalon 1 square cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4157","description":"Revitalon 1 square cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9701","description":"Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE115","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Implant mid ear hearing pros","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V5095","description":"Implant mid ear hearing pros","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHBD1","description":"ICD-JHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGLT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 2_ Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDKF0","description":"ICD-CDKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGBC0","description":"ICD-NGBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4432","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","description":"HCPCS-Q4432","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIBB0","description":"ICD-AIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCSE1","description":"ICD-OCSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lithium ion battery charger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L7368","description":"Lithium ion battery charger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML17","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay asse","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBRD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBRD1","description":"ICD-KBRD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBQD0","description":"ICD-HBQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KICE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KICE0","description":"ICD-KICE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo ablate liver tumor rf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"47370","description":"Laparo ablate liver tumor rf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGBA0","description":"ICD-OGBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGCB0","description":"ICD-JGCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BGLS","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompression of thigh/knee","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27496","description":"Decompression of thigh/knee","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBB0","description":"ICD-OKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCID1","description":"ICD-MCID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOB1","description":"ICD-LFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA22C","description":"Clinically Complex _ ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLBF1","description":"ICD-OLBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFBD0","description":"ICD-AFBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alpha-1-antitrypsin total","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82103","description":"Alpha-1-antitrypsin total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair rectum/remove sigmoid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45550","description":"Repair rectum/remove sigmoid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC14","description":"Very High Rehab _ ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIIE1","description":"ICD-EIIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEEC0","description":"ICD-GEEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDLD0","description":"ICD-MDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEF1","description":"ICD-ADEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML8C","description":"Medium Rehab plus Extensive_ ADL Index 2-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lumbar spine proces distract","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0171T","description":"Lumbar spine proces distract","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAAE1","description":"ICD-GAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEDD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEDD0","description":"ICD-IEDD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADLF1","description":"ICD-ADLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exploration/repair of rectum","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45563","description":"Exploration/repair of rectum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB12B","description":"Reduced Physical Function _ ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB28A","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFC0","description":"ICD-NCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antiviral not ordered","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9244","description":"Antiviral not ordered","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD10C","description":"Special Care Low _ ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of temporal bone","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69535","description":"Remove part of temporal bone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX34","description":"Very High Rehab plus Extensive _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0366U","description":"Oncology (bladder)_ analysis of 10 protein biomarkers (A1AT_ ANG_ APOE_ CA9_ IL8_ MMP9_ MMP10_ PAI1_ SDC1 and VEGFA) by immunoassays_ urine_ algorithm reported as a probabilit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat toe dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28635","description":"Treat toe dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD24D","description":"Reduced Physical Function _ ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home sleep test/type 2 porta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0398","description":"Home sleep test/type 2 porta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IFTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IFTD0","description":"ICD-IFTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX1A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenothiazine","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6057","description":"Phenothiazine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHEA1","description":"ICD-AHEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFPF1","description":"ICD-OFPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGJD1","description":"ICD-CGJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDLA0","description":"ICD-JDLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHLB0","description":"ICD-GHLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAGC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAGC1","description":"ICD-NAGC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGTD1","description":"ICD-OGTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA151","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove limb nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64782","description":"Remove limb nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"(Rapivab) Injection_ Peramivir_ 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9451","description":"(Rapivab) Injection_ Peramivir_ 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00732","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","description":"CPT-00732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGAF0","description":"ICD-JGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ocular blood flow measure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0198T","description":"Ocular blood flow measure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chemodenerv trunk musc 6/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64647","description":"Chemodenerv trunk musc 6/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHJD1","description":"ICD-FHJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE255","description":"Special Care High _ ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKKD0","description":"ICD-NKKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Seat upholstery_ replacement","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0981","description":"Seat upholstery_ replacement","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cytopath eval fna report","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88173","description":"Cytopath eval fna report","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKF1","description":"ICD-BDKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEBD1","description":"ICD-GEBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE1","description":"ICD-AEEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HE28I","description":"Special Care High _ ADL Index 15-16/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pne scrn done doc vac done","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9279","description":"Pne scrn done doc vac done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEKD1","description":"ICD-BEKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEYA0","description":"ICD-CEYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL6","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage lymph node lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38300","description":"Drainage lymph node lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not receive cervical cytology or an HPV test","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9807","description":"Patients who did not receive cervical cytology or an HPV test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBEE1","description":"ICD-FBEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit spectacles single system","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92354","description":"Fit spectacles single system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGHC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGHC1","description":"ICD-OGHC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Enzyme cell activity ra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82658","description":"Enzyme cell activity ra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCNE0","description":"ICD-KCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHHA1","description":"ICD-IHHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81258","description":"HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg_ alpha thalassemia_ Hb Bart hydrops fetalis syndrome_ HbH disease)_ gene analysis; known familial variant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection for ureter x-ray","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"50684","description":"Injection for ureter x-ray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0074U","description":"CYP2D6 (cytochrome P450_ family 2_ subfamily D_ polypeptide 6) (eg_ drug metabolism) gene analysis_ targeted sequence analysis (ie_ non-duplicated gene when duplication/multip","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAVA1","description":"ICD-KAVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nabilone oral","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J8650","description":"Nabilone oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB24C","description":"Special Care Low _ ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00936","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","description":"CPT-00936","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LCOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LCOC1","description":"ICD-LCOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CANC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CANC1","description":"ICD-CANC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CHK1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBE1","description":"ICD-GDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt recvd no inhal anesthic","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4555F","description":"Pt recvd no inhal anesthic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brca1&2 185&5385&6174 var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81212","description":"Brca1&2 185&5385&6174 var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGP3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lengthen radius or ulna","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25391","description":"Lengthen radius or ulna","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11624","description":"Exc s/n/h/f/g mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise reconst elbow joint","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24371","description":"Revise reconst elbow joint","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOC0","description":"ICD-PIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EAUF0","description":"ICD-EAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt instr nrml activities","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4245F","description":"Pt instr nrml activities","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKE0","description":"ICD-BDKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB18H","description":"Special Care Low _ ADL Index 2-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF1","description":"ICD-GFGF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEJB0","description":"ICD-KEJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAFD1","description":"ICD-CAFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CGL5","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEVC0","description":"ICD-OEVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIEA1","description":"ICD-EIEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBMC0","description":"ICD-GBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBBA1","description":"ICD-GBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove skin nerve lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64788","description":"Remove skin nerve lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAD0","description":"ICD-ACAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below knee wood socket","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L5639","description":"Below knee wood socket","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Technetium tc-99m teboroxime","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9501","description":"Technetium tc-99m teboroxime","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQE1","description":"ICD-PFQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81361","description":"HBB (hemoglobin_ subunit beta) (eg_ sickle cell anemia_ beta thalassemia_ hemoglobinopathy); common variant(s) (eg_ HbS_ HbC_ HbE)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHID1","description":"ICD-NHID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L6033","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","description":"HCPCS-L6033","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEIF0","description":"ICD-IEIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Create eardrum opening","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69433","description":"Create eardrum opening","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGAD1","description":"ICD-EGAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of iris","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66761","description":"Revision of iris","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA5B","description":"Low Rehab_ ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5CGK1","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Non-corrosive finish","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2780","description":"Non-corrosive finish","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADIC1","description":"ICD-ADIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHFF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHFF0","description":"ICD-BHFF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Phenylephrine hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2370","description":"Phenylephrine hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0343U","description":"Oncology (prostate)_ exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (RT-qPCR)_ urine_ reported as","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML11","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIWB1","description":"ICD-DIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAC1","description":"ICD-GHAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CFMV","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGXB0","description":"ICD-GGXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BGKU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLA1","description":"ICD-FDLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHYF0","description":"ICD-HHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBID1","description":"ICD-FBID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBBA1","description":"ICD-IBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1049T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1049T","description":"CPT-1049T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MIMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MIMA0","description":"ICD-MIMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHTE0","description":"ICD-BHTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHOC1","description":"ICD-KHOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LISD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LISD1","description":"ICD-LISD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Res_ nos waiver per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T2033","description":"Res_ nos waiver per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFFD1","description":"ICD-NFFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFL1","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB43","description":"High Rehab _ ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFCB1","description":"ICD-OFCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYC1","description":"ICD-KEYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFEC0","description":"ICD-GFEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGA1","description":"ICD-GBGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prefab stnlss steel crown pe","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2931","description":"Prefab stnlss steel crown pe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTA1","description":"ICD-IGTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KERB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KERB0","description":"ICD-KERB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKV","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Closed tx vert fx w/o manj","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22310","description":"Closed tx vert fx w/o manj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFLD0","description":"ICD-MFLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGXD1","description":"ICD-NGXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2206","description":"Patient received adjuvant treatment course including both chemotherapy and her2-targeted therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA14A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DAYB0","description":"ICD-DAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Truss double w/ standard pad","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8310","description":"Truss double w/ standard pad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunohisto antibody slide","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88344","description":"Immunohisto antibody slide","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKHF0","description":"ICD-NKHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEOD0","description":"ICD-OEOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repl batt silver oxide 3 v","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0602","description":"Repl batt silver oxide 3 v","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Followup eval of foot pt lop","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0246","description":"Followup eval of foot pt lop","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBXB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBXB0","description":"ICD-CBXB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Program intake assessment","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1023","description":"Program intake assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCYD0","description":"ICD-DCYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBWF0","description":"ICD-CBWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0077U","description":"Immunoglobulin paraprotein (M-protein)_ qualitative_ immunoprecipitation and mass spectrometry_ blood or urine_ including isotype","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"10006","description":"Fine needle aspiration biopsy_ including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4401","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","description":"HCPCS-Q4401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVA0","description":"ICD-BDVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwr adpt pneum vad_ rep veh","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q0504","description":"Pwr adpt pneum vad_ rep veh","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC53","description":"High Rehab _ ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX46","description":"Medium Rehab plus Extensive_ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHMT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLFA0","description":"ICD-NLFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sys bp > or = 140","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8753","description":"Sys bp > or = 140","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECIA1","description":"ICD-ECIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal septal prosthesis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8047","description":"Nasal septal prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM1","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYB0","description":"ICD-KEYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resin three surfaces-anterio","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D2332","description":"Resin three surfaces-anterio","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHF1","description":"ICD-NGHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBRF1","description":"ICD-GBRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cryoprecipitate each unit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9012","description":"Cryoprecipitate each unit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iv pole","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0776","description":"Iv pole","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB12C","description":"Clinically Complex _ ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OBR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDFD1","description":"ICD-BDFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9038","description":"Co-management services with the following elements: new diagnosis or acute exacerbation and stabilization of existing condition; condition which may benefit from joint care pl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLWE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLWE1","description":"ICD-OLWE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJVD1","description":"ICD-OJVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PD224","description":"Reduced Physical Function _ ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJE1","description":"ICD-CHJE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHL1","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNE0","description":"ICD-OJNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mirror coating","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2761","description":"Mirror coating","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BINC0","description":"ICD-BINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEBE1","description":"ICD-AEBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGHE1","description":"ICD-NGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDUA1","description":"ICD-JDUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lyme dis dna dir probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87475","description":"Lyme dis dna dir probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Supported housing_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0044","description":"Supported housing_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAPF1","description":"ICD-OAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDF1","description":"ICD-NKDF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat foot dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28606","description":"Treat foot dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Debride abdom wall","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11005","description":"Debride abdom wall","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCKC1","description":"ICD-CCKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJFC0","description":"ICD-NJFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB126","description":"Special Care High _ ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Giardia lamblia antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86674","description":"Giardia lamblia antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Vein x-ray kidney","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75831","description":"Vein x-ray kidney","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A2001","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2001","description":"HCPCS-A2001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1601","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1601","description":"CDT-D1601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pvb thoracic single inj site","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64461","description":"Pvb thoracic single inj site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACID1","description":"ICD-ACID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETB0","description":"ICD-NETB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEAF0","description":"ICD-EEAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q9992","description":"Injection_ buprenorphine extended-release (Sublocade)_ greater than 100 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D9247","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D9247","description":"CDT-D9247","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCLD0","description":"ICD-FCLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAHD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAHD1","description":"ICD-IAHD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert needle cath bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44015","description":"Insert needle cath bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJMC0","description":"ICD-OJMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA0","description":"ICD-LHQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle test nonparaspinal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95870","description":"Muscle test nonparaspinal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ablate heart dysrhythm focus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93650","description":"Ablate heart dysrhythm focus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES15A","description":"Extensive Services _ ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX60","description":"Very High Rehab plus Extensive _ ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin tissue procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17999","description":"Skin tissue procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Botulinum antitoxin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90287","description":"Botulinum antitoxin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXA0","description":"ICD-KDXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNF0","description":"ICD-NLNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHPA1","description":"ICD-NHPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAQC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAQC0","description":"ICD-LAQC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHBD1","description":"ICD-IHBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGDD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGDD1","description":"ICD-NGDD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHTD0","description":"ICD-MHTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Wheelchair heavy duty fixed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1285","description":"Wheelchair heavy duty fixed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFHA0","description":"ICD-AFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0855T","description":"Digitization of glass microscope slides for bone marrow_ smear interpretation (List separately in addition to code for primary procedure)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Flotufolastat F-18_ diagnostic_ 1 mCi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9156","description":"Flotufolastat F-18_ diagnostic_ 1 mCi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Histochemical stains add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88314","description":"Histochemical stains add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB250","description":"Reduced Physical Function _ ADL Index 2-5/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mannitol for inhaler","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7665","description":"Mannitol for inhaler","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODTC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODTC0","description":"ICD-ODTC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYB0","description":"ICD-LAYB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB13D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHCB0","description":"ICD-OHCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA201","description":"Clinically Complex _ ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/graft of foot tendon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28210","description":"Repair/graft of foot tendon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBHC0","description":"ICD-MBHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBGC0","description":"ICD-KBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKYE0","description":"ICD-OKYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE1","description":"ICD-ADEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JATA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JATA1","description":"ICD-JATA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Trb@ gene rearrange amplify","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81340","description":"Trb@ gene rearrange amplify","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYE1","description":"ICD-CDYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of penis lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54110","description":"Treatment of penis lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1011T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","description":"CPT-1011T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"64 lead ecg w/i&r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0178T","description":"64 lead ecg w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo exam of abdomen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76705","description":"Echo exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electrical bone stimulation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20974","description":"Electrical bone stimulation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MITF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MITF0","description":"ICD-MITF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Scan proc cranial extra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61782","description":"Scan proc cranial extra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair sternum/nuss w/scope","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21743","description":"Repair sternum/nuss w/scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHSC1","description":"ICD-HHSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82653","description":"Elastase_ Pancreatic (El-1)_ Fecal; Quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat midfoot fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28456","description":"Treat midfoot fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBDA0","description":"ICD-FBDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFJC1","description":"ICD-OFJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDIA0","description":"ICD-JDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBVD0","description":"ICD-OBVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01842","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","description":"CPT-01842","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEND0","description":"ICD-FEND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ cemiplimab-rwlc_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9119","description":"Injection_ cemiplimab-rwlc_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCVC1","description":"ICD-GCVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBDA1","description":"ICD-IBDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFED0","description":"ICD-OFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBME0","description":"ICD-BBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX5D","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the follo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruction tongue fold","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"41520","description":"Reconstruction tongue fold","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove brain electrodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61535","description":"Remove brain electrodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Immntx 4 sting insects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95133","description":"Immntx 4 sting insects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGFE1","description":"ICD-CGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFRF0","description":"ICD-GFRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEDE1","description":"ICD-FEDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EICA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EICA0","description":"ICD-EICA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gastric bypass incl small i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43847","description":"Gastric bypass incl small i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reset dislocated jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21485","description":"Reset dislocated jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abutment supported mtl crown","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D6064","description":"Abutment supported mtl crown","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFCF0","description":"ICD-EFCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHF0","description":"ICD-KGHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHB1","description":"ICD-MDHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGHE1","description":"ICD-KGHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97166","description":"Occupational therapy evaluation_ moderate complexity_ requiring these components: An occupational profile and medical and therapy history_ which includes an expanded review of","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBMC0","description":"ICD-NBMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unipuncture control system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E1580","description":"Unipuncture control system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC3A","description":"Medium Rehab _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIA1","description":"ICD-OKIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76979","description":"Ultrasound_ targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biopsy of thyroid","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"60100","description":"Biopsy of thyroid","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shoe molded plastazote cust","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3253","description":"Shoe molded plastazote cust","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC151","description":"Clinically Complex _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDKC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDKC1","description":"ICD-FDKC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB8C","description":"Low Rehab_ ADL Index 11-16/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of shunt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49428","description":"Ligation of shunt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HFOB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HFOB1","description":"ICD-HFOB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFIF0","description":"ICD-KFIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DIQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DIQD1","description":"ICD-DIQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infratemporal approach/skull","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61590","description":"Infratemporal approach/skull","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1039T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1039T","description":"CPT-1039T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5BGK2","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCMA1","description":"ICD-JCMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No tdap or td or 1tet/dipth","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9417","description":"No tdap or td or 1tet/dipth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0954T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","description":"CPT-0954T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLDC0","description":"ICD-MLDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHL6","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 2_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLF1","description":"ICD-FBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fistula repair & colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57307","description":"Fistula repair & colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D1003","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D1003","description":"CDT-D1003","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","description":"HCPCS-Q4402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMC1","description":"ICD-EHMC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9063","description":"Injection_ mirvetuximab soravtansine-gynx_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AHK5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of hydrocele","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55000","description":"Drainage of hydrocele","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAAE1","description":"ICD-JAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHAE1","description":"ICD-JHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BHM6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJID1","description":"ICD-MJID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKEA1","description":"ICD-NKEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Parotid duct diversion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42510","description":"Parotid duct diversion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1346","description":"Patients who did not have a net increase in pam score of at least 6 points within a 6 to 12 month period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHOD0","description":"ICD-DHOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYF0","description":"ICD-OJYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUC0","description":"ICD-CEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5122","description":"Injection_ pegfilgrastim-apgf_ biosimilar_ (nyvepria)_ 0.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUX3A","description":"Ultra High Rehab plus Extensive _ ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lymphocytotoxicity assay","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86806","description":"Lymphocytotoxicity assay","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLGA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLGA0","description":"ICD-NLGA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFLW","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autopsy (necropsy) gross","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88014","description":"Autopsy (necropsy) gross","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIHA1","description":"ICD-JIHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLNC1","description":"ICD-NLNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCDA0","description":"ICD-GCDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGMD0","description":"ICD-IGMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA214","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1182","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g._ ulcerative colitis_ crohn_s disease)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC34","description":"Very High Rehab _ ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DDQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DDQF0","description":"ICD-DDQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ganciclovir sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1570","description":"Ganciclovir sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIXE1","description":"ICD-KIXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIJC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIJC1","description":"ICD-OIJC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36909","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins)_ endovascular_ including all imaging and radiological supervision","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat elbow dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24605","description":"Treat elbow dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEIB0","description":"ICD-BEIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJNF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJNF1","description":"ICD-OJNF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intratubal occlusion device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4264","description":"Intratubal occlusion device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBQD1","description":"ICD-LBQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGUF0","description":"ICD-FGUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBYD1","description":"ICD-OBYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2068","description":"Medication Assisted Treatment_ Buprenorphine (Oral); Weekly Bundle Including Dispensing And/Or Administration_ Substance Use Counseling_ Individual And Group Therapy_ And Toxi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraventricular pacing","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93612","description":"Intraventricular pacing","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBIF1","description":"ICD-KBIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAMD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAMD1","description":"ICD-OAMD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFNC1","description":"ICD-OFNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stnd wt frame power whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0010","description":"Stnd wt frame power whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4IA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4IA11","description":"ICD-4IA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc s/n/h/f/g mal+mrg 1.1-2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11622","description":"Exc s/n/h/f/g mal+mrg 1.1-2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGTB1","description":"ICD-AGTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of carotene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82380","description":"Assay of carotene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEIC1","description":"ICD-FEIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAMB1","description":"ICD-JAMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transfer of spinal muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27105","description":"Transfer of spinal muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clin tx mdd comm to tx clin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8959","description":"Clin tx mdd comm to tx clin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFNU","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFUE1","description":"ICD-EFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt scrn dysphag/wt loss/nutr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3759F","description":"Pt scrn dysphag/wt loss/nutr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of calcium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82310","description":"Assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DFWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DFWB0","description":"ICD-DFWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIGF0","description":"ICD-CIGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of foot lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28104","description":"Removal of foot lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5107","description":"Injection_ bevacizumab-awwb_ biosimilar_ (Mvasi)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSF1","description":"ICD-LBSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCIF1","description":"ICD-MCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Molecular pathology interpr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0452","description":"Molecular pathology interpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCRF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCRF0","description":"ICD-CCRF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANA0","description":"ICD-FANA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JANE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JANE0","description":"ICD-JANE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECLF1","description":"ICD-ECLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lso sag r an/pos pnl pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0648","description":"Lso sag r an/pos pnl pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCFE1","description":"ICD-CCFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC28A","description":"Special Care High _ ADL Index 6-10/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ect provided","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4066F","description":"Ect provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL54","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJCA1","description":"ICD-MJCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"MRI jnt of lwr extre w/o dye","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73721","description":"MRI jnt of lwr extre w/o dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0717T","description":"Autologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting_ isolation and preparation of harvested cells_ i","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90912","description":"Biofeedback Training_ Perineal Muscles_ Anorectal Or Urethral Sphincter_ Including Emg And/Or Manometry_ When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIHB1","description":"ICD-GIHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBEB0","description":"ICD-KBEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1022","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1022","description":"HCPCS-E1022","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTB1","description":"ICD-IBTB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81334","description":"RUNX1 (runt related transcription factor 1) (eg_ acute myeloid leukemia_ familial platelet disorder with associated myeloid malignancy)_ gene analysis_ targeted sequence analy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-1041T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1041T","description":"CPT-1041T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ftl cgen abnor five anal","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81512","description":"Ftl cgen abnor five anal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Beta-blocker therapy rxd/tkn","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4008F","description":"Beta-blocker therapy rxd/tkn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay synovial fluid mucin","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83872","description":"Assay synovial fluid mucin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCXA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCXA0","description":"ICD-OCXA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBEF1","description":"ICD-IBEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKBA0","description":"ICD-OKBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00730","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","description":"CPT-00730","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy islet cell trans","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0342","description":"Laparoscopy islet cell trans","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFED0","description":"ICD-FFED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Stnd hemi (low seat) whlchr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0002","description":"Stnd hemi (low seat) whlchr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C9818","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C9818","description":"HCPCS-C9818","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ICLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ICLE0","description":"ICD-ICLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Microsomal antibody each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86376","description":"Microsomal antibody each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interdiscal perq aspir dx","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62267","description":"Interdiscal perq aspir dx","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJEB1","description":"ICD-OJEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHDB0","description":"ICD-IHDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAIA1","description":"ICD-OAIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUC1","description":"ICD-EDUC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-C0802","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C0802","description":"HCPCS-C0802","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHOE1","description":"ICD-OHOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BFK5","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BFPT","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt instr no bd rest 4 days/>","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4248F","description":"Pt instr no bd rest 4 days/>","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Spirmtry w/brnchdil inf-2 yr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94012","description":"Spirmtry w/brnchdil inf-2 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cone beam ct interprete man","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D0365","description":"Cone beam ct interprete man","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABIA1","description":"ICD-ABIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLC0","description":"ICD-IHLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFRF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFRF1","description":"ICD-LFRF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC22B","description":"Clinically Complex _ ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4EC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4EC11","description":"ICD-4EC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IACD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IACD1","description":"ICD-IACD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEBD0","description":"ICD-MEBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Decompress small bowel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44021","description":"Decompress small bowel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Female condom","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4268","description":"Female condom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair nasal defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"30540","description":"Repair nasal defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00604","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","description":"CPT-00604","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PBWA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PBWA0","description":"ICD-PBWA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0161U","description":"PMS2 (PMS1 homolog 2_ mismatch repair system component) (eg_ hereditary non-polyposis colorectal cancer_ Lynch syndrome) mRNA sequence analysis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBCD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBCD1","description":"ICD-MBCD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC12","description":"High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0013A","description":"IMM ADMN SARSCOV2 100 MCG/0.5 ML 3RD DOSE MODERNA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place device impacted tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7283","description":"Place device impacted tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FABB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FABB0","description":"ICD-FABB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDIE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDIE1","description":"ICD-BDIE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GINC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GINC0","description":"ICD-GINC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCDB0","description":"ICD-OCDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAE0","description":"ICD-JFAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD211","description":"Special Care High _ ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PB25B","description":"Reduced Physical Function _ ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGOC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGOC1","description":"ICD-DGOC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3LB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3LB31","description":"ICD-3LB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDUE0","description":"ICD-FDUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DGSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DGSF1","description":"ICD-DGSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Measure blood oxygen level","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94761","description":"Measure blood oxygen level","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAYE1","description":"ICD-GAYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7321","description":"Hyaluronan or derivative_ Hyalgan_ Supartz or Visco-3_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA18F","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BAAB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BAAB1","description":"ICD-BAAB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinical social work mips specialty set","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0066","description":"Clinical social work mips specialty set","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODED0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODED0","description":"ICD-ODED0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21077","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIB0","description":"ICD-BIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGPE1","description":"ICD-JGPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of urinary leakage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53085","description":"Drainage of urinary leakage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGYA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGYA1","description":"ICD-GGYA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGDB1","description":"ICD-IGDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL2D","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ u","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adult size pull-on xl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T4528","description":"Adult size pull-on xl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36836","description":"Percutaneous arteriovenous fistula creation_ upper extremity_ single access of both the peripheral artery and peripheral vein_ including fistula maturation procedures (eg_ tra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIOC0","description":"ICD-OIOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFNE1","description":"ICD-KFNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHYC1","description":"ICD-CHYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9986","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advan","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove part of neck vertebra","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22100","description":"Remove part of neck vertebra","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGEA1","description":"ICD-AGEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB8C","description":"Medium Rehab _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Adults currently taking pharmacotherapy for OUD","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1032","description":"Adults currently taking pharmacotherapy for OUD","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0196","description":"Injectable poly-l-lactic acid_ restorative implant_ 1 ml_ face (deep dermis_ subcutaneous layers)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of urethra lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"53220","description":"Treatment of urethra lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDBC1","description":"ICD-IDBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHLE1","description":"ICD-IHLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGFC1","description":"ICD-JGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rec cortico>60d or 1rx 600mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9469","description":"Rec cortico>60d or 1rx 600mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBLC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBLC0","description":"ICD-FBLC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODSF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODSF1","description":"ICD-ODSF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0491U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","description":"CPT-0491U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"98980","description":"Remote Therapeutic Monitoring Treatment Management Services_ Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FETA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FETA0","description":"ICD-FETA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9698","description":"Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDBA1","description":"ICD-GDBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q5117","description":"Injection_ trastuzumab-anns_ biosimilar_ (kanjinti)_ 10 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fit aphakia spectcl multifoc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92353","description":"Fit aphakia spectcl multifoc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76881","description":"Ultrasound_ complete joint (ie_ joint space and peri-articular soft tissue structures) real-time with image documentation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB1","description":"ICD-ODDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFMB0","description":"ICD-OFMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAGF0","description":"ICD-GAGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQE1","description":"ICD-CHQE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1943","description":"Injection_ aripiprazole lauroxil_ (aristada initio)_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K1004","description":"Low Frequency Ultrasonic Diathermy Treatment Device For Home Use_ Includes All Components And Accessories","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAID1","description":"ICD-JAID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Echo guide ova aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"76948","description":"Echo guide ova aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9794","description":"Therapeutic radiology simulation-aided field setting; complex_ including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy tre","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABMF0","description":"ICD-ABMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAOA1","description":"ICD-CAOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radiation treatment aid(s)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77333","description":"Radiation treatment aid(s)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE201","description":"Reduced Physical Function _ ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODIB1","description":"ICD-ODIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGTD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGTD0","description":"ICD-IGTD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFLA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFLA1","description":"ICD-JFLA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIUE0","description":"ICD-GIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove sympathetic nerves","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64822","description":"Remove sympathetic nerves","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHNE1","description":"ICD-BHNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interscap-thor myoelectronic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6975","description":"Interscap-thor myoelectronic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEGF0","description":"ICD-CEGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PIOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PIOD0","description":"ICD-PIOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BFK2","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28A","description":"Clinically Complex _ ADL Index 2-5/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol and/or drug assess","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0001","description":"Alcohol and/or drug assess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCLB0","description":"ICD-MCLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEPF1","description":"ICD-FEPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7294","description":"Segesterone acetate and ethinyl estradiol 0.15 mg_ 0.013 mgper 24 hours; yearly vaginal system_ ea","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGC0","description":"ICD-GBGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HIOA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HIOA1","description":"ICD-HIOA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl icar ischm mntrng dvce","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0307T","description":"Rmvl icar ischm mntrng dvce","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ant fusion 8/> vert seg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22812","description":"Ant fusion 8/> vert seg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MLMF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MLMF1","description":"ICD-MLMF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat lower jaw fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21450","description":"Treat lower jaw fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEWB1","description":"ICD-HEWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Isavuconazonium Sulfate_ 1 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9456","description":"Injection_ Isavuconazonium Sulfate_ 1 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EIBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EIBE1","description":"ICD-EIBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES23C","description":"Extensive Services _ ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_ unscheduled OB","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCIC1","description":"ICD-NCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCVE0","description":"ICD-BCVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HISD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HISD0","description":"ICD-HISD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC114","description":"Special Care Low _ ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PJRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PJRC0","description":"ICD-PJRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dialys sol fld vol > 3999cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4724","description":"Dialys sol fld vol > 3999cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAUC0","description":"ICD-OAUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sanopellis_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4308","description":"Sanopellis_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Strep b dna amp probe","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87653","description":"Strep b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC4D","description":"Medium Rehab _ ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCOB0","description":"ICD-KCOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iliac aneurysm endovas rpr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75954","description":"Iliac aneurysm endovas rpr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pneumatic compression device","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0675","description":"Pneumatic compression device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHEF1","description":"ICD-KHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFXE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFXE1","description":"ICD-KFXE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FANB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FANB1","description":"ICD-FANB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0537T","description":"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells_ per day","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFM3","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYB1","description":"ICD-GDYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OEWF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OEWF1","description":"ICD-OEWF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc forearm les sc < 3 cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25075","description":"Exc forearm les sc < 3 cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert spine fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22844","description":"Insert spine fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIPE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIPE1","description":"ICD-GIPE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cranial prosthesis","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5924","description":"Cranial prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELC1","description":"ICD-IELC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEB1","description":"ICD-MHEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDJE0","description":"ICD-GDJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy remove lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"46610","description":"Anoscopy remove lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJFA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJFA0","description":"ICD-OJFA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIHE0","description":"ICD-KIHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEBB1","description":"ICD-KEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFAF0","description":"ICD-MFAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AITC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AITC1","description":"ICD-AITC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0034U","description":"TPMT (thiopurine S-methyltransferase)_ NUDT15 (nudix hydroxylase 15)(eg_ thiopurine metabolism)_ gene analysis_ common variants (ie_ TPMT *2_ *3A_ *3B_ *3C_ *4_ *5_ *6_ *8_ *1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKQB1","description":"ICD-OKQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair defect of artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35011","description":"Repair defect of artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radial keratotomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65771","description":"Radial keratotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90620","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine_ serogroup B (MenB-4C)_ 2 dose schedule_ for intramuscular use","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACLE0","description":"ICD-ACLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of thyroid (t3 or t4)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84479","description":"Assay of thyroid (t3 or t4)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGXF0","description":"ICD-JGXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFEE1","description":"ICD-MFEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFPW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Long qt synd known fam var","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81281","description":"Long qt synd known fam var","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA10A","description":"Reduced Physical Function _ ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IILC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IILC0","description":"ICD-IILC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lift assist for elbow","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6635","description":"Lift assist for elbow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Chromosome analysis 45","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88263","description":"Chromosome analysis 45","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE18A","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB11","description":"ICD-3GB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC131","description":"Special Care Low _ ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BA221","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGVC0","description":"ICD-FGVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nrv cndj test 9-10 studies","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"95911","description":"Nrv cndj test 9-10 studies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMB0","description":"ICD-BIMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot/toes surgery procedure","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28899","description":"Foot/toes surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OASA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OASA1","description":"ICD-OASA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQE0","description":"ICD-GHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3FC31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3FC31","description":"ICD-3FC31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCEB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCEB0","description":"ICD-FCEB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0976T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","description":"CPT-0976T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87808","description":"Infectious agent antigen detection by immunoassay with direct optical (ie_ visual) observation; Trichomonas vaginalis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFUA0","description":"ICD-MFUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IICC1","description":"ICD-IICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBQB1","description":"ICD-OBQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Observ/hosp same date","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99235","description":"Observ/hosp same date","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JIVA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JIVA1","description":"ICD-JIVA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKHC0","description":"ICD-MKHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWF0","description":"ICD-KHWF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye glass case","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2756","description":"Eye glass case","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9769","description":"Cystourethroscopy_ with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB23D","description":"Special Care Low _ ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unscheduled","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBCB0","description":"ICD-OBCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"OPH AMD ALYS 3 GENE VARIANTS","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0205U","description":"OPH AMD ALYS 3 GENE VARIANTS","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ligation of inf vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37619","description":"Ligation of inf vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Open skull for drainage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"61321","description":"Open skull for drainage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFFE1","description":"ICD-KFFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJBF0","description":"ICD-MJBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIJF1","description":"ICD-FIJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"87301","description":"IAAD IA ADENOVIRUS ENTERIC TYP 40/41","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAVA0","description":"ICD-JAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMA01","description":"Medium Rehab _ ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"No doc of dsm-iv","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9213","description":"No doc of dsm-iv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1DC11","description":"ICD-1DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2KA21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2KA21","description":"ICD-2KA21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGSE0","description":"ICD-GGSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFRA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFRA1","description":"ICD-PFRA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC0","description":"ICD-KDWC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHTD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHTD1","description":"ICD-IHTD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLJA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLJA0","description":"ICD-NLJA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Evacuate mole of uterus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59870","description":"Evacuate mole of uterus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGUB0","description":"ICD-CGUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9785","description":"Endoscopic outlet reduction_ gastric pouch application_ with endoscopy and intraluminal tube insertion_ if performed_ including all system and tissue anchoring components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDAD0","description":"ICD-JDAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE146","description":"Clinically Complex _ ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBRB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBRB1","description":"ICD-OBRB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BALB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BALB0","description":"ICD-BALB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCAA1","description":"ICD-BCAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC31","description":"High Rehab _ ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDTB0","description":"ICD-MDTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prepare face/oral prosthesis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21086","description":"Prepare face/oral prosthesis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIHE1","description":"ICD-AIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKEE1","description":"ICD-OKEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reconstruct vena cava","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"34502","description":"Reconstruct vena cava","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC22D","description":"Special Care Low _ ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2125","description":"Patients 81 Years Of Age And Older With Evidence Of Frailty During The Measurement Period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of creatine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82540","description":"Assay of creatine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADHB1","description":"ICD-ADHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNA0","description":"ICD-BFNA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUC12","description":"Ultra High Rehab _ ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscopy and dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31529","description":"Laryngoscopy and dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDUB0","description":"ICD-EDUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAFE0","description":"ICD-OAFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laryngoscop w/arytenoidectom","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31560","description":"Laryngoscop w/arytenoidectom","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient is currently on a statin therapy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9796","description":"Patient is currently on a statin therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Christian sci nurse visit","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9901","description":"Christian sci nurse visit","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCIC1","description":"ICD-GCIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9945","description":"Patient had cancer_ fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair fistula w/colostomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45825","description":"Repair fistula w/colostomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFBF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFBF0","description":"ICD-MFBF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Orthopedic shoe modifica nos","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3649","description":"Orthopedic shoe modifica nos","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NELD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NELD1","description":"ICD-NELD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heat & moisture exchange sys","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7509","description":"Heat & moisture exchange sys","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tx/proph/dg addl seq iv inf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96367","description":"Tx/proph/dg addl seq iv inf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2DC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2DC11","description":"ICD-2DC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHEA0","description":"ICD-NHEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODDB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODDB0","description":"ICD-ODDB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE214","description":"Reduced Physical Function _ ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EO","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGMU","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2170","description":"Percutaneous arteriovenous fistula creation (AVF)_ direct_ any site_ by tissue approximation using thermal resistance e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone/skin graft iliac crest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20970","description":"Bone/skin graft iliac crest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CASA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CASA0","description":"ICD-CASA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Muscle transfer shoulder/arm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23395","description":"Muscle transfer shoulder/arm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHXD1","description":"ICD-JHXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBHB0","description":"ICD-EBHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-L1557","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1557","description":"HCPCS-L1557","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDME1","description":"ICD-BDME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMF0","description":"ICD-ADMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHWB1","description":"ICD-KHWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDLE0","description":"ICD-CDLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKA1","description":"ICD-CBKA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIWB0","description":"ICD-GIWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFOE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFOE1","description":"ICD-PFOE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Antipsychotics nos 1-3","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80342","description":"Antipsychotics nos 1-3","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0759T","description":"Digitization of glass microscope slides for special stain_ including interpretation and report_ group III_ for enzyme constituents (List separately in addition to code for pri","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIDE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIDE0","description":"ICD-KIDE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7957","description":"guided tissue regeneration_ edentulous area - non-resorbable barrier_ per site","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIIE0","description":"ICD-IIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGIB0","description":"ICD-MGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3CHKW","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NETF0","description":"ICD-NETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBUC0","description":"ICD-JBUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4AGM5","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD251","description":"Special Care High _ ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBJF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBJF1","description":"ICD-JBJF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUC0","description":"ICD-KEUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBNC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBNC1","description":"ICD-FBNC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFN2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 4_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient alive as of the last day of the measurement year","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9787","description":"Patient alive as of the last day of the measurement year","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0508U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0508U","description":"CPT-0508U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LIQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LIQF0","description":"ICD-LIQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ondansetron hcl injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2405","description":"Ondansetron hcl injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNF0","description":"ICD-CFNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFHE0","description":"ICD-NFHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIIB0","description":"ICD-CIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA0","description":"ICD-FHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aqueous shunt eye w/graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66180","description":"Aqueous shunt eye w/graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Art byp grft fem-femoral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35558","description":"Art byp grft fem-femoral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BECB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BECB1","description":"ICD-BECB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Incis 1 vertebral seg cerv","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"22210","description":"Incis 1 vertebral seg cerv","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADEE0","description":"ICD-ADEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D9954","description":"Fabrication and delivery of oral appliance therapy (OAT) morning repositioning device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEJD0","description":"ICD-GEJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCCB0","description":"ICD-KCCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIHE1","description":"ICD-NIHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lactation class","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9443","description":"Lactation class","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHDA0","description":"ICD-NHDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAVD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAVD0","description":"ICD-FAVD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GECC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GECC1","description":"ICD-GECC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFTC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFTC1","description":"ICD-BFTC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-E1827","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","description":"HCPCS-E1827","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBBA0","description":"ICD-OBBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHCF0","description":"ICD-AHCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHEF1","description":"ICD-FHEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PC25B","description":"Reduced Physical Function _ ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC11A","description":"Special Care Low _ ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA o","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1FC11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1FC11","description":"ICD-1FC11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIVF1","description":"ICD-FIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Icar ischm mntrng sys device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0304T","description":"Icar ischm mntrng sys device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHQC1","description":"ICD-CHQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAUF0","description":"ICD-IAUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat metatarsal fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28485","description":"Treat metatarsal fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"History aids-defining cond","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3490F","description":"History aids-defining cond","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal/revision of cast","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"29705","description":"Removal/revision of cast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGLF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGLF0","description":"ICD-FGLF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HEOE0","description":"ICD-HEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection treatment of nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64680","description":"Injection treatment of nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81238","description":"F9 (coagulation factor IX) (eg_ hemophilia B)_ full gene sequence","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sigmoidoscopy for bleeding","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"45334","description":"Sigmoidoscopy for bleeding","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDYD0","description":"ICD-GDYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEED1","description":"ICD-BEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL36","description":"Very High Rehab plus Extensive _ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBAE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBAE0","description":"ICD-EBAE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OISE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OISE1","description":"ICD-OISE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHXA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHXA1","description":"ICD-BHXA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Partial removal of colon","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44146","description":"Partial removal of colon","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IDCF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IDCF0","description":"ICD-IDCF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8E","description":"High Rehab _ ADL Index 0-5/TRICARE 240-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc f/e/e/n/l mal+mrg 3.1-4","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11644","description":"Exc f/e/e/n/l mal+mrg 3.1-4","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIMC0","description":"ICD-BIMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rebuild eardrum structures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"69636","description":"Rebuild eardrum structures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Radxps in end rprt4fluro pxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"6045F","description":"Radxps in end rprt4fluro pxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lesion destruction","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7465","description":"Lesion destruction","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKIF1","description":"ICD-OKIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGHC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGHC0","description":"ICD-GGHC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCUF0","description":"ICD-KCUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFMB1","description":"ICD-EFMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0543","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","description":"HCPCS-G0543","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHVB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHVB1","description":"ICD-NHVB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hemin_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1640","description":"Hemin_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHKD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHKD0","description":"ICD-CHKD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Syphilis test non-trep qual","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86592","description":"Syphilis test non-trep qual","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFGF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFGF0","description":"ICD-GFGF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IAIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IAIF0","description":"ICD-IAIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rpr ing hernia baby blocked","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49496","description":"Rpr ing hernia baby blocked","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHMA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHMA1","description":"ICD-JHMA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIPD0","description":"ICD-NIPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GENE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GENE1","description":"ICD-GENE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGSA0","description":"ICD-HGSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FICC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FICC1","description":"ICD-FICC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pt rcv hedia outpt dyls fac","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8956","description":"Pt rcv hedia outpt dyls fac","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0805","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0805","description":"HCPCS-B0805","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIJB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIJB0","description":"ICD-NIJB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GARB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GARB1","description":"ICD-GARB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCB1","description":"ICD-BDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1272","description":"Patients on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGNA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGNA1","description":"ICD-FGNA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGCA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGCA1","description":"ICD-OGCA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-G0535","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","description":"HCPCS-G0535","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reoperation bypass graft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35700","description":"Reoperation bypass graft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFTF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFTF0","description":"ICD-MFTF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hepa vacc ped/adol 2 dose im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90633","description":"Hepa vacc ped/adol 2 dose im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIBC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIBC1","description":"ICD-FIBC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFAC0","description":"ICD-JFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Corneal tissue transplant","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"65767","description":"Corneal tissue transplant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-J3290","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3290","description":"HCPCS-J3290","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Annual nursing fac assessmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99318","description":"Annual nursing fac assessmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC0D","description":"Medium Rehab _ ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repr elbow lat ligmnt w/tiss","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24343","description":"Repr elbow lat ligmnt w/tiss","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect forearm/wrist tum<3cm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"25077","description":"Resect forearm/wrist tum<3cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDCB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDCB1","description":"ICD-MDCB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IIUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IIUE1","description":"ICD-IIUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Destruction of skin lesions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"17263","description":"Destruction of skin lesions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NLAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NLAD1","description":"ICD-NLAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEPA1","description":"ICD-JEPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 52mg 3 yr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7297","description":"Levonorgestrel iu 52mg 3 yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CDT-D2956","billing_code_type":"CDT","billing_code_type_version":"2026","billing_code":"D2956","description":"CDT-D2956","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Infrared heating pad system","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0221","description":"Infrared heating pad system","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHUC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHUC0","description":"ICD-OHUC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual wc hand rim w project","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0967","description":"Manual wc hand rim w project","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Realignment of tendons","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"26437","description":"Realignment of tendons","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CGM3","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGEA0","description":"ICD-MGEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHHE0","description":"ICD-FHHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHQD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHQD0","description":"ICD-HHQD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"F18 fdg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A9552","description":"F18 fdg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Artery x-rays spine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75705","description":"Artery x-rays spine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDLD0","description":"ICD-FDLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Axolotl ambient or axolotl cryo_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4215","description":"Axolotl ambient or axolotl cryo_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBNB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBNB0","description":"ICD-JBNB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJYE1","description":"ICD-OJYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIUB0","description":"ICD-OIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 11-14/60-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LD240","description":"Special Care Low _ ADL Index 11-14/60-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE25B","description":"Clinically Complex _ ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Term dev mech hook vol close","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6707","description":"Term dev mech hook vol close","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of humerus lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"23156","description":"Removal of humerus lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Heroin metabolite","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80356","description":"Heroin metabolite","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pegaspargase injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9266","description":"Pegaspargase injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove spine lamina 1/2 lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63005","description":"Remove spine lamina 1/2 lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CICD0","description":"ICD-CICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCUE0","description":"ICD-MCUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Brachytx isodose complex","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"77318","description":"Brachytx isodose complex","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Explore deep node(s) neck","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"38542","description":"Explore deep node(s) neck","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAAE1","description":"ICD-OAAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KFAD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KFAD0","description":"ICD-KFAD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IELD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IELD0","description":"ICD-IELD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gonadotropin hormone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80426","description":"Gonadotropin hormone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dstry eye lesn_fdr vssl tech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0186","description":"Dstry eye lesn_fdr vssl tech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBBB0","description":"ICD-FBBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBME0","description":"ICD-NBME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDKB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDKB0","description":"ICD-GDKB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCVE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCVE1","description":"ICD-JCVE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4433","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","description":"HCPCS-Q4433","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGXB1","description":"ICD-BGXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tissue culture placenta","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88235","description":"Tissue culture placenta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBFC0","description":"ICD-CBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFDC0","description":"ICD-MFDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGDE1","description":"ICD-JGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKTE0","description":"ICD-MKTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA10D","description":"Clinically Complex _ ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFIB0","description":"ICD-NFIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB115","description":"Special Care High _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treat kneecap dislocation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27562","description":"Treat kneecap dislocation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Refer to hospice","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9524","description":"Refer to hospice","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0679T","description":"Laparoscopic Removal Of Diaphragmatic Lead(S)_ Permanent Implantable Synchronized Diaphragmatic Stimulation System For Augmentation Of Cardiac Function","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGBE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGBE0","description":"ICD-GGBE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JACC1","description":"ICD-JACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraop cyto path consult 2","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"88334","description":"Intraop cyto path consult 2","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC26","description":"Medium Rehab _ ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDGA1","description":"ICD-BDGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHHB1","description":"ICD-JHHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFCE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFCE1","description":"ICD-JFCE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparo total proctocolectomy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44210","description":"Laparo total proctocolectomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Below/above elbow lock mech","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6698","description":"Below/above elbow lock mech","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Med reas rpt no histo type","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9423","description":"Med reas rpt no histo type","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIPA1","description":"ICD-CIPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of bowel pouch","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57270","description":"Repair of bowel pouch","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFFF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFFF1","description":"ICD-OFFF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0442","description":"ANNUAL ALCOHOL MISUSE SCREENING_ 15 MINUTES","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Onc dx colon t1-4 no dx prog","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9086","description":"Onc dx colon t1-4 no dx prog","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intracranial limited study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93888","description":"Intracranial limited study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDXD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDXD0","description":"ICD-GDXD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFAF1","description":"ICD-EFAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Perq dev breast add strtctc","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"19284","description":"Perq dev breast add strtctc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PA23A","description":"Reduced Physical Function _ ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEVD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEVD1","description":"ICD-NEVD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Refract not +/- 1.0 w/in 90d","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9520","description":"Refract not +/- 1.0 w/in 90d","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHEC0","description":"ICD-MHEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C7511","description":"Bronchoscopy_ rigid or flexible_ with single or multiple bronchial or endobronchial biopsy(ies)_ single or multiple sites_ with computer-assisted image-guided navigation_ incl","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHVC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHVC1","description":"ICD-BHVC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PHQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PHQE0","description":"ICD-PHQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBFC0","description":"ICD-JBFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9772","description":"Revascularization_ endovascular_ open or percutaneous_ tibial/peroneal artery(ies)_ with intravascular lithotripsy_ includes angioplasty within the same vessel (s)_ when perfo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FFXC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FFXC1","description":"ICD-FFXC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEUF0","description":"ICD-CEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCME1","description":"ICD-FCME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCIF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCIF1","description":"ICD-CCIF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA226","description":"Clinically Complex _ ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA O","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients who use hospice services any time during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9715","description":"Patients who use hospice services any time during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"F5 gene","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81241","description":"F5 gene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medical conference by physic","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0220","description":"Medical conference by physic","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGEF0","description":"ICD-EGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anesth vaginal procedures","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"94051","description":"Anesth vaginal procedures","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAVA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAVA0","description":"ICD-OAVA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSA1","description":"ICD-PFSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHPC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHPC0","description":"ICD-CHPC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair fixed retainers","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D8694","description":"Repair fixed retainers","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBC0","description":"ICD-FDBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Com wrap-around sv_ per diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H2022","description":"Com wrap-around sv_ per diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4CFKW","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 1_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEUB0","description":"ICD-FEUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MKAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MKAD1","description":"ICD-MKAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACB0","description":"ICD-AACB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABCB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABCB0","description":"ICD-ABCB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIVF1","description":"ICD-BIVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAFD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAFD0","description":"ICD-JAFD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIIE0","description":"ICD-KIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Respite care service 15 min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1005","description":"Respite care service 15 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cardiac MRI for morph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75557","description":"Cardiac MRI for morph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext wear ost skn barr <=4sqin","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4407","description":"Ext wear ost skn barr <=4sqin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drainage of throat abscess","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42725","description":"Drainage of throat abscess","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ECEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ECEF1","description":"ICD-ECEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEHF1","description":"ICD-IEHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJJD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJJD1","description":"ICD-NJJD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0530T","description":"Removal of intracardiac ischemia monitoring system_ including all imaging supervision and interpretation; complete system (electrode and implantable monitor)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ADMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ADMA0","description":"ICD-ADMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Replacement diaphragm/fplate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7502","description":"Replacement diaphragm/fplate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES28B","description":"Extensive Services _ ADL Index 2-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ crizanlizumab-tmca_ 5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J0791","description":"Injection_ crizanlizumab-tmca_ 5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCDA1","description":"ICD-FCDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DCRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DCRA0","description":"ICD-DCRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCFA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCFA1","description":"ICD-NCFA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIWB1","description":"ICD-KIWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEJB1","description":"ICD-NEJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBTA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBTA1","description":"ICD-IBTA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDEC0","description":"ICD-GDEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBTF1","description":"ICD-JBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Methylnaltrexone injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J2212","description":"Methylnaltrexone injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4363","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","description":"HCPCS-Q4363","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay acid phosphatase","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84060","description":"Assay acid phosphatase","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"PolyCyte_ for topical use only_ per 0.5 cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4241","description":"PolyCyte_ for topical use only_ per 0.5 cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFE0","description":"ICD-GFFE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGIB0","description":"ICD-FGIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo nontorsion jnts pre ots","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3930","description":"Hfo nontorsion jnts pre ots","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lap esophagomyotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2079","description":"Lap esophagomyotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0513T","description":"Extracorporeal shock wave for integumentary wound healing_ high energy_ including topical application and dressing care; each additional wound (List separately in addition to","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIME0","description":"ICD-AIME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVL0D","description":"Very High Rehab plus Extensive _ ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Pwc gp 2 std port cap chair","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"K0821","description":"Pwc gp 2 std port cap chair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NJNF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NJNF0","description":"ICD-NJNF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHBE1","description":"ICD-KHBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEF0","description":"ICD-OAEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIIE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIIE0","description":"ICD-BIIE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"DuoAmnion_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4327","description":"DuoAmnion_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9982","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a Medicare-approved Bundled Payments for Care Improvement Advanced (BPCI Advanced) mode","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFFB0","description":"ICD-GFFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low cost skin substitute app","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C5272","description":"Low cost skin substitute app","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAPB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAPB1","description":"ICD-NAPB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0108U","description":"Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BGKX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HARA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HARA0","description":"ICD-HARA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC8A","description":"Medium Rehab _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL05","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-97008","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","description":"CPT-97008","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AILD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AILD0","description":"ICD-AILD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"96160","description":"Administration of patient-focused health risk assessment instrument (eg_ health hazard appraisal) with scoring and documentation_ per standardized instrument","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLB0","description":"ICD-MJLB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1404","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","description":"HCPCS-M1404","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEYF1","description":"ICD-PEYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHF1","description":"ICD-CAHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHRE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHRE0","description":"ICD-CHRE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-00406","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","description":"CPT-00406","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9910","description":"Patients age 65 or older in institutional special needs plans (SNP) or residing in long-term care with POS code 32_ 33_ 34_ 54_ or 56 anytime during the measurement period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Glaucoma surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"66170","description":"Glaucoma surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81456","description":"Targeted genomic sequence analysis panel_ solid organ or hematolymphoid neoplasm or disorder_ 51 or greater genes (eg_ ALK_ BRAF_ CDKN2A_ CEBPA_ DNMT3A_ EGFR_ ERBB2_ EZH2_ FLT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Positioning cushion","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0190","description":"Positioning cushion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCWD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCWD0","description":"ICD-HCWD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EETD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EETD0","description":"ICD-EETD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cast sup lng leg cylinder fb","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4034","description":"Cast sup lng leg cylinder fb","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKPF0","description":"ICD-NKPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFDA1","description":"ICD-NFDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Irrigation tray","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4320","description":"Irrigation tray","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93986","description":"Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Unilateral Study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE22B","description":"Special Care Low _ ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair/transpose nerve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64856","description":"Repair/transpose nerve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEEB1","description":"ICD-IEEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AGAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AGAF0","description":"ICD-AGAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CGYD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CGYD0","description":"ICD-CGYD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0227U","description":"Drug Assay_ Presumptive_ 30 Or More Drugs Or Metabolites_ Urine_ Liquid Chromatography With Tandem Mass Spectrometry (Lc-Ms/Ms) Using Multiple Reaction Monitoring (Mrm)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Psa/t/glsc docd b/4 txmnt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"3268F","description":"Psa/t/glsc docd b/4 txmnt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"AmnioText_ per cc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4245","description":"AmnioText_ per cc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODQB0","description":"ICD-ODQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUA22","description":"Ultra High Rehab _ ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LEYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LEYF0","description":"ICD-LEYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Oral surgery procedure","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7999","description":"Oral surgery procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPF0","description":"ICD-GCPF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JAPF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JAPF1","description":"ICD-JAPF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGBF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGBF1","description":"ICD-FGBF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHLB1","description":"ICD-NHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMC42","description":"Medium Rehab _ ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEVF0","description":"ICD-KEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Manual wc accessory_ handrim","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2205","description":"Manual wc accessory_ handrim","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE15A","description":"Special Care Low _ ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-90484","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","description":"CPT-90484","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAEA0","description":"ICD-OAEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKGC0","description":"ICD-OKGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-1BC21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"1BC21","description":"ICD-1BC21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"PE28F","description":"Reduced Physical Function _ ADL Index 15-16/TRICARE 270-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYF1","description":"ICD-GFYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient not eligible due to active diagnosis of hypertension","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1290","description":"Patient not eligible due to active diagnosis of hypertension","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PDOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PDOB0","description":"ICD-PDOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFQF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFQF0","description":"ICD-CFQF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Periph field stimul perm","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0283T","description":"Periph field stimul perm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFYE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFYE0","description":"ICD-GFYE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGNE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGNE1","description":"ICD-NGNE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHL5A","description":"High Rehab plus Extensive _ ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Thigh/wght bear lacer non-mo","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L2530","description":"Thigh/wght bear lacer non-mo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDKD1","description":"ICD-BDKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cancer treatmentplan initial","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0353","description":"Cancer treatmentplan initial","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHOC0","description":"ICD-GHOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHHF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHHF0","description":"ICD-GHHF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FGEF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FGEF0","description":"ICD-FGEF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFSE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFSE1","description":"ICD-OFSE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBSE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBSE0","description":"ICD-LBSE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Composite byp grft 3/> segmt","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35683","description":"Composite byp grft 3/> segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDVF0","description":"ICD-FDVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0660U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0660U","description":"CPT-0660U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBHB1","description":"ICD-OBHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFLA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFLA0","description":"ICD-GFLA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EGCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EGCE0","description":"ICD-EGCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIC1","description":"ICD-NDIC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHIA1","description":"ICD-NHIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lamellas_ per square centimeter","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4292","description":"Lamellas_ per square centimeter","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFC1","description":"ICD-NGFC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLA44","description":"Low Rehab_ ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iiv3 vaccine 6-35 months im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90657","description":"Iiv3 vaccine 6-35 months im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone cutting segmented","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7944","description":"Bone cutting segmented","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDPA1","description":"ICD-KDPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0381U","description":"Maple syrup urine disease monitoring by patient-collected blood card sample_ quantitative measurement of allo-isoleucine_ leucine_ isoleucine_ and valine_ liquid chromatograph","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MHLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MHLF1","description":"ICD-MHLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDJB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDJB1","description":"ICD-KDJB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Laparoscopy aspiration","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"49322","description":"Laparoscopy aspiration","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIAF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIAF0","description":"ICD-AIAF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LARB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LARB0","description":"ICD-LARB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision subvalvular tissue","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33415","description":"Revision subvalvular tissue","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IHUA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IHUA0","description":"ICD-IHUA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Osteochondral knee allograft","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27415","description":"Osteochondral knee allograft","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home health aide or certifie","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9122","description":"Home health aide or certifie","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JCBD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JCBD0","description":"ICD-JCBD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9472","description":"Injection_ talimogene laherparepvec_ 1 million plaque forming units (PFU) (Imlygic)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"ES354","description":"Extensive Services _ ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIBA1","description":"ICD-KIBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEEA0","description":"ICD-BEEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1071","description":"Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEHA1","description":"ICD-GEHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMB1C","description":"Medium Rehab _ ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ elranatamab-bcmm_ 1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1323","description":"Injection_ elranatamab-bcmm_ 1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCQA1","description":"ICD-OCQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLDB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLDB1","description":"ICD-OLDB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KGDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KGDE1","description":"ICD-KGDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tensix_ 1cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4146","description":"Tensix_ 1cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0139U","description":"Neurology (autism spectrum disorder [ASD])_ quantitative measurements of 6 central carbon metabolites (ie_ a-ketoglutarate_ alanine_ lactate_ phenylalanine_ pyruvate_ and succ","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"5AGKV","description":"Early or Late Episode_ 20+ therapies_Clinical Severity Level 1_Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBHE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBHE1","description":"ICD-CBHE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q4352","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","description":"HCPCS-Q4352","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFEB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFEB1","description":"ICD-CFEB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nuclear exam of tear flow","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78660","description":"Nuclear exam of tear flow","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIID1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIID1","description":"ICD-GIID1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Digoxin injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J1160","description":"Digoxin injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NCJD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NCJD0","description":"ICD-NCJD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GBGD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GBGD0","description":"ICD-GBGD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MADF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MADF1","description":"ICD-MADF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair of heart defects","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33697","description":"Repair of heart defects","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hfo w/o joints cf","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3913","description":"Hfo w/o joints cf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LAYF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LAYF1","description":"ICD-LAYF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CBKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CBKF0","description":"ICD-CBKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EDAA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EDAA0","description":"ICD-EDAA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CHNX","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 6_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IGBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IGBB0","description":"ICD-IGBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ost pch w bar/bltinconv/fltr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A4417","description":"Ost pch w bar/bltinconv/fltr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Sgd prerec msg >8min <=20min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2502","description":"Sgd prerec msg >8min <=20min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HC155","description":"Special Care High _ ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKIF0","description":"ICD-NKIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Xray place dist ext thor ao","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75959","description":"Xray place dist ext thor ao","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBSF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBSF0","description":"ICD-HBSF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEBB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEBB1","description":"ICD-FEBB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCPD1","description":"ICD-GCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCEF1","description":"ICD-CCEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHB8I","description":"High Rehab _ ADL Index 6-10/TRICARE 360-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair blood vessel lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"35231","description":"Repair blood vessel lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHA8H","description":"High Rehab _ ADL Index 0-5/TRICARE 330-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OIBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OIBC0","description":"ICD-OIBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3GB31","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3GB31","description":"ICD-3GB31","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam entire spi 2/3 vw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"72082","description":"X-ray exam entire spi 2/3 vw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1CFPS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 3_ Functional Severity Level 1_Service Severity Level 5_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of vitamin b-6","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84207","description":"Assay of vitamin b-6","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fetal surg pulmon sequest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2403","description":"Fetal surg pulmon sequest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE110","description":"Clinically Complex _ ADL Index 15-16/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Breast prosthesis w adhesive","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L8031","description":"Breast prosthesis w adhesive","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CB28C","description":"Clinically Complex _ ADL Index 2-5/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ACAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ACAE1","description":"ICD-ACAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACC1","description":"ICD-GACC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Iliac revasc w/stent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37221","description":"Iliac revasc w/stent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intens cardiac rehab w/exerc","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0422","description":"Intens cardiac rehab w/exerc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCTF1","description":"ICD-CCTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair artery blockage each","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"75964","description":"Repair artery blockage each","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EBTF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EBTF1","description":"ICD-EBTF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9318","description":"Injection_ romidepsin_ nonlyophilized_ 0.1 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inject skin lesions >7","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11901","description":"Inject skin lesions >7","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KHVC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KHVC0","description":"ICD-KHVC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CFNB1","description":"ICD-CFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGK1","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 1_Supply Severity Level 1_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Doc rsn no adeno/neopl detec","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9496","description":"Doc rsn no adeno/neopl detec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BHKF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BHKF1","description":"ICD-BHKF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBLE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBLE0","description":"ICD-KBLE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LFOA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LFOA0","description":"ICD-LFOA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Halo cervical into jckt vest","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L0810","description":"Halo cervical into jckt vest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext pwrd shlder lock/unlock","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6648","description":"Ext pwrd shlder lock/unlock","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"External urinary catheter; non-disposable_ for use with suction pump_ per month","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6591","description":"External urinary catheter; non-disposable_ for use with suction pump_ per month","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFQB1","description":"ICD-PFQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIKF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIKF0","description":"ICD-CIKF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JDDC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JDDC0","description":"ICD-JDDC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IEBA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IEBA0","description":"ICD-IEBA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-2HA11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"2HA11","description":"ICD-2HA11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Exc tr-ext mal+marg 0.5 cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"11600","description":"Exc tr-ext mal+marg 0.5 cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDEA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDEA1","description":"ICD-KDEA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAGB1","description":"ICD-KAGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LE106","description":"Special Care Low _ ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medica","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of pulmonary valve","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33470","description":"Revision of pulmonary valve","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Generator_ Cardiac Contractility Modulation (Implantable)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C1824","description":"Generator_ Cardiac Contractility Modulation (Implantable)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGRC0","description":"ICD-HGRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bl smear w/o diff wbc count","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"85008","description":"Bl smear w/o diff wbc count","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDAA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDAA1","description":"ICD-GDAA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9465","description":"Hyaluronan or derivative_ Durolane_ for intra-articular injection_ per dose","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHUA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHUA1","description":"ICD-FHUA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transdermal gfr monitoring","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0603T","description":"Transdermal gfr monitoring","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-3BB11","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"3BB11","description":"ICD-3BB11","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair throat wound","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"42900","description":"Repair throat wound","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHAE1","description":"ICD-GHAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LHQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LHQA1","description":"ICD-LHQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Porfimer sodium injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9600","description":"Porfimer sodium injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01442","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","description":"CPT-01442","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHXF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHXF0","description":"ICD-FHXF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of haptoglobins","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"83012","description":"Assay of haptoglobins","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHX5D","description":"High Rehab plus Extensive _ ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MJLE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MJLE1","description":"ICD-MJLE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CIMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CIMD0","description":"ICD-CIMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lens sphcy trifocal 4.25-7/.","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"V2307","description":"Lens sphcy trifocal 4.25-7/.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDBE1","description":"ICD-KDBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mra w/o fol w/cont_ pelvis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C8920","description":"Mra w/o fol w/cont_ pelvis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGMW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-P9027","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","description":"HCPCS-P9027","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0002A","description":"IMM ADMN SARSCOV2 30MCG/0.3ML DIL RECON 2ND DOSE","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9896","description":"Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GIBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GIBB0","description":"ICD-GIBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFNB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFNB1","description":"ICD-BFNB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEXD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEXD1","description":"ICD-NEXD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bone harvest_auto graft proc","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D7295","description":"Bone harvest_auto graft proc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BIEF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BIEF1","description":"ICD-BIEF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0579T","description":"Interrogation Device Evaluation(S) (Remote)_ Up To 90 Days_ Substernal Lead Implantable Cardioverter-Defibrillator System_ Remote Data Acquisition(S)_ Receipt Of Transmissions","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDVE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDVE0","description":"ICD-BDVE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Domicil/r-home visit new pat","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99325","description":"Domicil/r-home visit new pat","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLND0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLND0","description":"ICD-OLND0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0521U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","description":"CPT-0521U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCME0","description":"ICD-GCME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ins vag brachytx device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"57156","description":"Ins vag brachytx device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFME0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFME0","description":"ICD-EFME0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gluco mngmnt plan docd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0540F","description":"Gluco mngmnt plan docd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"91300","description":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine_ mRNA-LNP_ spike protein_ preservative free_ 30 mcg/0.3mL dosage_ diluent","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBRC0","description":"ICD-DBRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CAHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CAHA1","description":"ICD-CAHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AFIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AFIB1","description":"ICD-AFIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDLD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDLD1","description":"ICD-NDLD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD25D","description":"Special Care High _ ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following_ unschedu","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0093U","description":"Prescription drug monitoring_ evaluation of 65 common drugs by LC-MS/MS_ urine_ each drug reported detected or not detected","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9199","description":"Injection_ Gemcitabine Hydrochloride (Infugem)_ 200 Mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HCSC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HCSC1","description":"ICD-HCSC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGCC1","description":"ICD-GGCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQE0","description":"ICD-PEQE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Application of caries arresting medicament-per tooth","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D1354","description":"Application of caries arresting medicament-per tooth","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LDQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LDQC1","description":"ICD-LDQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Levonorgestrel iu 13.5 mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J7301","description":"Levonorgestrel iu 13.5 mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair bowel fistula","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44650","description":"Repair bowel fistula","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFHB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFHB0","description":"ICD-JFHB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31241","description":"Nasal/sinus endoscopy_ surgical; with ligation of sphenopalatine artery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-Q5166","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5166","description":"HCPCS-Q5166","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CHK6","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 6_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB112","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEJC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEJC0","description":"ICD-JEJC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OAQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OAQD1","description":"ICD-OAQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSB0","description":"ICD-PFSB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PFSD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PFSD0","description":"ICD-PFSD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Caster fork replacement only","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E2226","description":"Caster fork replacement only","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"BB10D","description":"Behavioral Symptoms and Cognitive Performance _ ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIGA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIGA1","description":"ICD-FIGA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OITB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OITB1","description":"ICD-OITB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDCC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDCC1","description":"ICD-BDCC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GAWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GAWE0","description":"ICD-GAWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray guide gi dilation","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74360","description":"X-ray guide gi dilation","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise ventricle muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33416","description":"Revise ventricle muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Skin seal protect moisturizr","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A6250","description":"Skin seal protect moisturizr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CEED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CEED1","description":"ICD-CEED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NGFE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NGFE1","description":"ICD-NGFE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Removal of donor heart/lung","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33930","description":"Removal of donor heart/lung","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BEUF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BEUF0","description":"ICD-BEUF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hit antibiotic q3h diem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S9497","description":"Hit antibiotic q3h diem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OKKC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OKKC0","description":"ICD-OKKC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDRC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDRC1","description":"ICD-CDRC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Abx reg prescribed","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9498","description":"Abx reg prescribed","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEHE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEHE0","description":"ICD-EEHE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIEA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIEA0","description":"ICD-KIEA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bp sys>=140 and/or dias >=90","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8477","description":"Bp sys>=140 and/or dias >=90","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder blade","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73010","description":"X-ray exam of shoulder blade","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0641U","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0641U","description":"CPT-0641U","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVX8A","description":"Very High Rehab plus Extensive _ ADL Index 11-16/TRICARE 120-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LB101","description":"Special Care Low _ ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PEQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PEQB0","description":"ICD-PEQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGQB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGQB0","description":"ICD-PGQB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj_ ado-trastuzumab emt 1mg","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9354","description":"Inj_ ado-trastuzumab emt 1mg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-M1439","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","description":"HCPCS-M1439","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"4BHKT","description":"Late Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Asst oocyte fert case rate","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S4022","description":"Asst oocyte fert case rate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Excision of bone lower jaw","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"21025","description":"Excision of bone lower jaw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"81339","description":"Mpl (Mpl Proto-Oncogene_ Thrombopoietin Receptor) (Eg_ Myeloproliferative Disorder) Gene Analysis; Sequence Analysis_ Exon 10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GACB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GACB1","description":"ICD-GACB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBBC0","description":"ICD-JBBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBJE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBJE0","description":"ICD-NBJE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FCPD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FCPD0","description":"ICD-FCPD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD20A","description":"Special Care High _ ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OHYF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OHYF0","description":"ICD-OHYF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GFHD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GFHD0","description":"ICD-GFHD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Calculated 10-year ascvd risk score of = 20 percent during the performance period","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1364","description":"Calculated 10-year ascvd risk score of = 20 percent during the performance period","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BBMB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BBMB1","description":"ICD-BBMB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AFL4","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 1_Service Severity Level 2_Supply Severity Level 4_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of chromium","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82495","description":"Assay of chromium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCYE1","description":"ICD-GCYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S0285","description":"Colonoscopy consultation performed prior to a screening colonoscopy procedure","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ext ecg review and interp","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0298T","description":"Ext ecg review and interp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Inj foramen epidural l/s","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64483","description":"Inj foramen epidural l/s","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HBWE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HBWE0","description":"ICD-HBWE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFPA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFPA1","description":"ICD-NFPA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCEC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCEC0","description":"ICD-OCEC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HHRA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HHRA0","description":"ICD-HHRA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove tear gland lesion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68540","description":"Remove tear gland lesion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0795T","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker_ including imaging guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ right ventricul","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBAC1","description":"ICD-JBAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCYD1","description":"ICD-OCYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RMX4A","description":"Medium Rehab plus Extensive_ ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HASB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HASB0","description":"ICD-HASB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NFAC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NFAC1","description":"ICD-NFAC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJQC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJQC1","description":"ICD-OJQC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Aerosol mask used w nebulize","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7015","description":"Aerosol mask used w nebulize","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Intraoral con def inter plt","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D5958","description":"Intraoral con def inter plt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL4A","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KCFB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KCFB0","description":"ICD-KCFB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCSA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCSA1","description":"ICD-GCSA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCFC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCFC0","description":"ICD-OCFC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OCPD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OCPD1","description":"ICD-OCPD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revision of humerus","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"24410","description":"Revision of humerus","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFBC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFBC0","description":"ICD-BFBC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair art intramural","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"33507","description":"Repair art intramural","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revise eye muscle","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67314","description":"Revise eye muscle","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01860","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","description":"CPT-01860","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CERA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CERA1","description":"ICD-CERA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rmvl devital tis addl 20cm/<","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97598","description":"Rmvl devital tis addl 20cm/<","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCTE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCTE0","description":"ICD-GCTE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CCQD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CCQD1","description":"ICD-CCQD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KELE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KELE1","description":"ICD-KELE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G6028","description":"Anoscopy_ high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEVF0","description":"ICD-GEVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-92638","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","description":"CPT-92638","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JETF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JETF0","description":"ICD-JETF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EFHB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EFHB1","description":"ICD-EFHB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dexamethasone panel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"80420","description":"Dexamethasone panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NBLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NBLF1","description":"ICD-NBLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC15A","description":"Clinically Complex _ ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insert heyman uteri capsule","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"58346","description":"Insert heyman uteri capsule","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBYA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBYA0","description":"ICD-DBYA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HD134","description":"Special Care High _ ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DBWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DBWC1","description":"ICD-DBWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remove penis & nodes","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"54130","description":"Remove penis & nodes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFBE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFBE1","description":"ICD-JFBE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEYE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEYE1","description":"ICD-KEYE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AACF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AACF1","description":"ICD-AACF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9536","description":"Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e._ patient has an abnormal neurological exa","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHM2","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCSA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCSA0","description":"ICD-PCSA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray upper gi&small intest","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"74245","description":"X-ray upper gi&small intest","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OBMD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OBMD0","description":"ICD-OBMD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FDBD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FDBD1","description":"ICD-FDBD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLIF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLIF0","description":"ICD-OLIF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC8B","description":"High Rehab _ ADL Index 11-16/TRICARE 150-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHLB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHLB1","description":"ICD-EHLB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Acetylcholine receptor (AChR); blocking antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86042","description":"Acetylcholine receptor (AChR); blocking antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BADA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BADA1","description":"ICD-BADA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BGLD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BGLD0","description":"ICD-BGLD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EHMA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EHMA0","description":"ICD-EHMA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (Health Safety)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7336","description":"Community Transition Svcs (Health Safety)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OESF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OESF0","description":"ICD-OESF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OJWA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OJWA1","description":"ICD-OJWA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FEID0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FEID0","description":"ICD-FEID0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection_Nivolumab_ 1mg (Opdivo)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"C9453","description":"Injection_Nivolumab_ 1mg (Opdivo)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Cciiv3 vac im cult prsv free","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90661","description":"Cciiv3 vac im cult prsv free","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FILF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FILF1","description":"ICD-FILF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KEUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KEUE0","description":"ICD-KEUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKVF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKVF1","description":"ICD-NKVF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Extensive prostate surgery","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"55810","description":"Extensive prostate surgery","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CILC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CILC1","description":"ICD-CILC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AHTE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AHTE1","description":"ICD-AHTE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML32","description":"Medium Rehab plus Extensive_ ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rbc irradiated","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"P9038","description":"Rbc irradiated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef < 40% or lvsd","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8923","description":"Lvef < 40% or lvsd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC251","description":"Special Care Low _ ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB236","description":"Special Care High _ ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLQA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLQA0","description":"ICD-OLQA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay blood catecholamines","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"82383","description":"Assay blood catecholamines","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0702T","description":"Remote Therapeutic Monitoring Of A Standardized Online Digital Cognitive Behavioral Therapy Program Ordered By A Physician Or Other Qualified Health Care Professional; Supply","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBAD1","description":"ICD-IBAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CA217","description":"Clinically Complex _ ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AN","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Assay of total thyroxine","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"84436","description":"Assay of total thyroxine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KIUE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KIUE0","description":"ICD-KIUE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-DHRC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"DHRC0","description":"ICD-DHRC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Complete phys skin exam done","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"2029F","description":"Complete phys skin exam done","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hep a/hep b vacc adult im","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90636","description":"Hep a/hep b vacc adult im","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AEEE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AEEE0","description":"ICD-AEEE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/30-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC30","description":"Very High Rehab _ ADL Index 11-16/30-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JBVB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JBVB0","description":"ICD-JBVB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Set-up cardiovert-defibrill","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"93745","description":"Set-up cardiovert-defibrill","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HESD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HESD0","description":"ICD-HESD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JICD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JICD0","description":"ICD-JICD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHJA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHJA1","description":"ICD-CHJA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1241","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person_ not just someone with a medical problem","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ercp stent exchange w/dilate","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43276","description":"Ercp stent exchange w/dilate","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHVF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHVF0","description":"ICD-FHVF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-IBIB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"IBIB1","description":"ICD-IBIB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Shdr fair lead cable molded","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L6588","description":"Shdr fair lead cable molded","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Eye photodynamic ther add-on","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67225","description":"Eye photodynamic ther add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLX8D","description":"Low Rehab plus Extensive _ ADL Index 2-16/TRICARE 210-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G2061","description":"Qualified Nonphysician Healthcare Professional Online Assessment_ For An Established Patient_ For Up To Seven Days_ Cumulative Time During The 7 Days; 5-10 Minutes","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheo-esophagoplasty cong","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"43314","description":"Tracheo-esophagoplasty cong","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Probe nasolacrimal duct","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"68815","description":"Probe nasolacrimal duct","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OGEE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OGEE1","description":"ICD-OGEE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHAF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHAF1","description":"ICD-NHAF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MABA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MABA1","description":"ICD-MABA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bronchoscopy treat blockage","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31641","description":"Bronchoscopy treat blockage","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FAMF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FAMF0","description":"ICD-FAMF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBWB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBWB1","description":"ICD-KBWB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKBB0","description":"ICD-NKBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3BHMU","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FBXE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FBXE0","description":"ICD-FBXE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHXB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHXB1","description":"ICD-NHXB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RLB5A","description":"Low Rehab_ ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCPA or CCA","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-EEMC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"EEMC0","description":"ICD-EEMC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NEAE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NEAE1","description":"ICD-NEAE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDXF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDXF1","description":"ICD-KDXF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FHKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FHKE0","description":"ICD-FHKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Alcohol/substance abuse skil","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"T1012","description":"Alcohol/substance abuse skil","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BFAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BFAC0","description":"ICD-BFAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHUB0","description":"ICD-JHUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1BHNS","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 2_ Functional Severity Level 3_Service Severity Level 4_Supply Severity Level 1_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-0949T","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","description":"CPT-0949T","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Nasal/sinus endoscopy surg","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"31238","description":"Nasal/sinus endoscopy surg","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1234","description":"Patient has a reactive hcv antibody test_ and has a follow up hcv viral test that does not detect hcv viremia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NKDE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NKDE1","description":"ICD-NKDE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Potent antivir thxpy rxd","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"4276F","description":"Potent antivir thxpy rxd","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rails bed side full length","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"E0310","description":"Rails bed side full length","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MEMB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MEMB0","description":"ICD-MEMB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JFIC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JFIC0","description":"ICD-JFIC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BCIA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BCIA1","description":"ICD-BCIA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Unscheduled dressing change","billing_code_type":"CDT","billing_code_type_version":"2024","billing_code":"D4920","description":"Unscheduled dressing change","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Financial Management Services","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7341","description":"Financial Management Services","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ODBB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ODBB0","description":"ICD-ODBB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99218","description":"Initial observation care_ per day_ for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or com","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GHQB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GHQB1","description":"ICD-GHQB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Lvef <40% or dep lv sys fcn","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G8934","description":"Lvef <40% or dep lv sys fcn","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Bx/exc idrl spine lesn lmbr","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"63282","description":"Bx/exc idrl spine lesn lmbr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2BGLW","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 2_ Functional Severity Level 2_Service Severity Level 2_Supply Severity Level 5_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Minimally invasive direct co","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"S2205","description":"Minimally invasive direct co","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEYB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEYB1","description":"ICD-GEYB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NIKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NIKE0","description":"ICD-NIKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"LC121","description":"Special Care Low _ ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PKOC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PKOC0","description":"ICD-PKOC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PASF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PASF1","description":"ICD-PASF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0585T","description":"Islet Cell Transplant_ Includes Portal Vein Catheterization And Infusion_ Including All Imaging_ Including Guidance_ And Radiological Supervision And Interpretation_ When Perf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MCED1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MCED1","description":"ICD-MCED1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOD0","description":"ICD-PGOD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Typhoid vaccine oral","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"90690","description":"Typhoid vaccine oral","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Rubella antibody","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86762","description":"Rubella antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDDA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDDA0","description":"ICD-MDDA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9928","description":"Warfarin or another FDA-approved anticoagulant not prescribed_ reason not given","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Electric current therapy","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"97033","description":"Electric current therapy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGLF1","description":"ICD-JGLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NDIA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NDIA0","description":"ICD-NDIA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GEOE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GEOE0","description":"ICD-GEOE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GCNE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GCNE0","description":"ICD-GCNE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Fluorescent antibody screen","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86255","description":"Fluorescent antibody screen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-BDAD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"BDAD1","description":"ICD-BDAD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"1AHKV","description":"Early Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 1_Supply Severity Level 4_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-HGQA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"HGQA1","description":"ICD-HGQA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Repair eyelid defect","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"67924","description":"Repair eyelid defect","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-LBWB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"LBWB0","description":"ICD-LBWB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDGC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDGC0","description":"ICD-CDGC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KAOF0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KAOF0","description":"ICD-KAOF0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-A1402","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A1402","description":"HCPCS-A1402","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9703","description":"Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OENF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OENF1","description":"ICD-OENF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"62292","description":"Injection procedure for chemonucleolysis_ including discography_ intervertebral disc_ single or multiple levels_ lumbar","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Drugs unclassified injection","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J3490","description":"Drugs unclassified injection","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RML10","description":"Medium Rehab plus Extensive_ ADL Index 2-10/5-day or readmission return.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Self-help/peer svc per 15min","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"H0038","description":"Self-help/peer svc per 15min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"C-reactive protein hs","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"86141","description":"C-reactive protein hs","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OFUE1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OFUE1","description":"ICD-OFUE1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CC28C","description":"Clinically Complex _ ADL Index 6-10/TRICARE 180-day assessment","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of jaw 4/> views","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"70110","description":"X-ray exam of jaw 4/> views","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Home visit mech ventilator","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"99504","description":"Home visit mech ventilator","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-ABHF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"ABHF1","description":"ICD-ABHF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Foot arch supp longitud/meta","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3060","description":"Foot arch supp longitud/meta","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-AIUB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"AIUB0","description":"ICD-AIUB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NHFD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NHFD1","description":"ICD-NHFD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CHCE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CHCE0","description":"ICD-CHCE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Survey not complete","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G0914","description":"Survey not complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Apply rem fixation device","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"20660","description":"Apply rem fixation device","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MDHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MDHA1","description":"ICD-MDHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Hinge ext/flex wrist finger","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"L3901","description":"Hinge ext/flex wrist finger","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RVC02","description":"Very High Rehab _ ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay).","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-FIIB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"FIIB0","description":"ICD-FIIB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Revascularization penis","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"37788","description":"Revascularization penis","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KDWC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KDWC1","description":"ICD-KDWC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JEDA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JEDA1","description":"ICD-JEDA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-CDYD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"CDYD1","description":"ICD-CDYD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-NAKE0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"NAKE0","description":"ICD-NAKE0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36573","description":"Insertion of peripherally inserted central venous catheter (PICC)_ without subcutaneous port or pump_ including all imaging guidance_ image documentation_ and all associated r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"3AGPT","description":"Late Episode_ 0-13 therapies_Clinical Severity Level 1_ Functional Severity Level 2_Service Severity Level 5_Supply Severity Level 2_ supplies provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"N block stellate ganglion","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"64510","description":"N block stellate ganglion","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE11A","description":"Clinically Complex _ ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT_ may be combined or not w/ 1 of following_ unscheduled OBRA SCSA or SCP","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Dissolve clot heart vessel","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"92975","description":"Dissolve clot heart vessel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"CPT-01939","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","description":"CPT-01939","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MBBA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MBBA1","description":"ICD-MBBA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MFHA0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MFHA0","description":"ICD-MFHA0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PGOB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PGOB0","description":"ICD-PGOB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Tracheostomy mask","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"A7525","description":"Tracheostomy mask","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-MGME1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"MGME1","description":"ICD-MGME1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"CE28X","description":"Clinically Complex _ ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2CGM2","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 3_ Functional Severity Level 2_Service Severity Level 3_Supply Severity Level 2_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"2AHM3","description":"Early Episode_ 14-19 therapies_Clinical Severity Level 1_ Functional Severity Level 3_Service Severity Level 3_Supply Severity Level 3_ supplies not provided","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Leuprolide acetate implant","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"J9219","description":"Leuprolide acetate implant","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Episiotomy or vaginal repair","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"59300","description":"Episiotomy or vaginal repair","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-4CB21","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"4CB21","description":"ICD-4CB21","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"X-ray exam of shoulder","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"73020","description":"X-ray exam of shoulder","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"0801T","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker_ including imaging?guidance (eg_ fluoroscopy_ venous ultrasound_ right atrial angiography_ r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-KBUD0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"KBUD0","description":"ICD-KBUD0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GGAC0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GGAC0","description":"ICD-GGAC0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-PCYC1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"PCYC1","description":"ICD-PCYC1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Place cath carotid/inom art","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"36222","description":"Place cath carotid/inom art","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"Q4239","description":"Amnio-Maxx or Amnio Maxx Lite_ per sq cm","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Colonoscopy w/decompression","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"44408","description":"Colonoscopy w/decompression","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-GDLF1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"GDLF1","description":"ICD-GDLF1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"G9487","description":"Remote in-home visit for the e&m of an estab patient for use only in the Medicare-approved Comprehensive Care for Joint Replacement model_ which requires 2 of 3 key components","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"HB251","description":"Special Care High _ ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLGB1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLGB1","description":"ICD-OLGB1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Gated heart planar single","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"78472","description":"Gated heart planar single","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-OLHA1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"OLHA1","description":"ICD-OLHA1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"HCPCS-B0304","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B0304","description":"HCPCS-B0304","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"High Rehab _ ADL Index 11-16/90-day.","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RHC50","description":"High Rehab _ ADL Index 11-16/90-day.","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JHKD1","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JHKD1","description":"ICD-JHKD1","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Resect metatarsal tumor","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"28173","description":"Resect metatarsal tumor","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Patients with a diagnosis of end stage renal disease (esrd)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"M1187","description":"Patients with a diagnosis of end stage renal disease (esrd)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","billing_code_type":"ICD","billing_code_type_version":"2024","billing_code":"RUL06","description":"Ultra High Rehab plus Extensive _ ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OM","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"ICD-JGTB0","billing_code_type":"ICD","billing_code_type_version":"2026","billing_code":"JGTB0","description":"ICD-JGTB0","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Treatment of ankle fracture","billing_code_type":"CPT","billing_code_type_version":"2024","billing_code":"27816","description":"Treatment of ankle fracture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}, {"negotiation_arrangement":"ffs","name":"Community Transition Svcs (House Hold Suppl)","billing_code_type":"HCPCS","billing_code_type_version":"2024","billing_code":"W7332","description":"Community Transition Svcs (House Hold Suppl)","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[2025504211]}]}]}